Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19.
Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19.
复制标题
在Covid-19期间接受美沙酮维护治疗的人中的剂量经历。
DOI：
10.1016/j.jsat.2021.108276
复制
发表时间：
2021-04
影响因子：
3.9
通讯作者：
Dasgupta N
中科院分区：
文献类型：
--
作者：
Figgatt MC;Salazar Z;Day E;Vincent L;Dasgupta N
美沙酮维持治疗是阿片类药物使用障碍（OUD）患者的救命治疗方法。冠状病毒大流行（COVID-19）引发了许多关于获得阿片类药物治疗的担忧。2020年3月，药物滥用和精神健康服务管理局（SAMHSA）发布了指导意见，允许扩大美沙酮的带回家剂量。我们试图从在门诊治疗机构接受美沙酮治疗OUD的人的角度描述治疗经历的变化。我们于2020年6月和7月对北卡罗来纳州中部三家诊所接受美沙酮治疗的104人进行了面对面调查。调查收集了COVID-19背景下（即2020年3月之前和之后）的人口统计学特征、美沙酮治疗史以及美沙酮带回家剂量的信息。在COVID-19之前，在每个诊所接受任何天数的带回家剂量供应的临床水平的参与者百分比从56%到82%不等，而自COVID-19以来，这一比例从78%到100%不等。自COVID-19以来，接受一周或更长时间（即≥6天）带回家日供应的临床水平的参与者百分比从11%到56%不等。在自COVID-19以来接受带回家的87名参与者中，只有4人报告出售了带回家的剂量。我们的研究发现，不同诊所的带回家给药经验存在差异，带回家给药的剂量几乎没有变化。虽然SAMSHA指南应允许扩大获得带回家的剂量，但在诊所一级，这些指南的采用情况可能有所不同。应该进一步探讨这些政策的采用，特别是在寻求OUD治疗的患者获益的背景下。
Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) has introduced many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing for the expansion of take-home methadone doses. We sought to describe changes to treatment experiences from the perspective of persons receiving methadone at outpatient treatment facilities for OUD. We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina in June and July 2020. Surveys collected information on demographic characteristics, methadone treatment history, and experiences with take-home methadone doses in the context of COVID-19 (i.e., before and since March 2020). Before COVID-19, the clinic-level percent of participants receiving any amount of days' supply of take-home doses at each clinic ranged from 56% to 82%, while it ranged from 78% to 100% since COVID-19. The clinic-level percent of participants receiving a take-homes days' supply of a week or longer (i.e., ≥6 days) since COVID-19 ranged from 11% to 56%. Among 87 participants who received take-homes since COVID-19, only four reported selling their take-home doses. Our study found variation in experiences of take-home dosing by clinic and little diversion of take-home doses. While SAMSHA guidance should allow expanded access to take-home doses, adoption of these guidelines may vary at the clinic level. The adoption of these policies should be explored further, particularly in the context of benefits to patients seeking OUD treatment.
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