Journal of substance abuse treatment
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J Subst Abuse Treat · Apr 2021
Supportive alternate site provision of buprenorphine: Overcoming barriers and improving patient outcomes.
Improving access to medications for opioid use disorder (MOUD) is a national priority; however, these efforts commonly focus on the provider. Access to buprenorphine through retail pharmacies and stigma associated with filling prescriptions for MOUD pose additional barriers for patients when embarking on their road to recovery. ⋯ Provision of buprenorphine to patients at their treatment visit was associated with higher patient retention rates and better health outcomes compared with patients who filled their buprenorphine at pharmacies prior to the program's integration of medication provision at patient office visits. Understanding how alleviating barriers to medication access impacts retention in care has meaningful implications for opioid use disorder patients and treatment providers.
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J Subst Abuse Treat · Apr 2021
Leveraging COVID-19 to sustain regulatory flexibility in the treatment of opioid use disorder.
The U. S. government declared the opioid epidemic as a national public health emergency in 2017, but regulatory frameworks that govern the treatment of opioid use disorder (OUD) through pharmaceutical interventions have remained inflexible. ⋯ The regulatory flexibilities implemented to avoid unnecessary COVID-related death must be made permanent to ensure that improved access to evidence-based treatment remains available to vulnerable individuals with OUD who otherwise face formidable barriers to MOUD. We must seize this moment of COVOD-19 regulatory flexibilities to demonstrate the feasibility, acceptability, and safety of delivering treatment for OUD through a low-threshold approach.
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J Subst Abuse Treat · Apr 2021
Multicenter StudySharp decline in hospital and emergency department initiated buprenorphine for opioid use disorder during COVID-19 state of emergency in California.
The California Bridge Program supports expansion of medications for opioid use disorder (MOUD) in emergency departments (EDs) and hospital inpatient units across the state. Here, we describe the change in activity before and after the coronavirus disease 2019 (COVID-19) California statewide shutdown. ⋯ In estimating the expected number of patients who met each outcome in April 2020, we found decreases in the expected to observed number of patients across all outcomes (all p-values<0.002): 37% (from 1053 to 667) decrease in the number of patients identified with OUD, 34% (from 632 to 420) decrease in the number of patients who accepted a referral, 48% (from 521 to 272) decrease in the number of patients who were prescribed buprenorphine, 53% (from 501 to 234) decrease in the number of patients who were administered buprenorphine, and 33% (from 416 to 277) decrease in the number of patients who attended at least one follow-up visit for addiction treatment. The COVID-19 California statewide shutdown was associated with an abrupt and large decrease in the progress toward expanded access to OUD treatment.