"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic
"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic
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DOI：
10.1186/s12916-020-01693-9
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发表时间：
2020-07-31
期刊：
影响因子：
9.3
通讯作者：
Gual, Antoni
中科院分区：
文献类型：
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作者：
Lopez-Pelayo, Hugo;Aubin, Henri-Jean;Gual, Antoni
受物质使用障碍影响的公民是SARS-CoV-2感染和COVID-19相关死亡的高危人群。在之前的通信中描述了患有物质使用障碍的人对COVID-19的相关脆弱性。COVID-19大流行为重塑和更新成瘾治疗网络提供了一个独特的机会。主体更新的治疗系统应基于以下七大支柱：（1）远程医疗和数字解决方案，（2）在家住院，（3）咨询联络精神病和成瘾服务，（4）减少伤害设施，（5）以人为本的护理，（6）促进有偿工作，以改善物质使用障碍患者的生活质量，以及（7）综合成瘾护理。世界卫生组织的三个“最佳购买”（减少可用性，提高价格和禁止广告）仍然有效。此外，必须实施新的战略，以系统地处理（a）假新闻有关法律的和非法药物和（B）有争议的科学information.ConclusionThe海洛因大流行四十年前是最后一次成瘾治疗系统更新，在许多西方国家。一个经过修订和现代化的成瘾治疗网络必须包括改善获得护理的机会，在适当的情况下通过技术提供便利;与成瘾专家支持非专家的更综合的护理;以及减少SUD患者所经历的耻辱。
BackgroundCitizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks.Main bodyRenewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three "best buys" of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information.ConclusionThe heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.