The estimated impact of state-level support for expanded delivery of substance use disorder treatment during the COVID-19 pandemic.
The estimated impact of state-level support for expanded delivery of substance use disorder treatment during the COVID-19 pandemic.
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DOI：
10.1111/add.15778
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
Martins SS
中科院分区：
文献类型：
--
作者：
Nesoff ED;Marziali ME;Martins SS
为防止COVID-19传播，美国（US）部分有关物质使用障碍（SUD）治疗的联邦法规于二零二零年三月暂停执行。这项研究旨在量化州一级政策吸收的程度和美国各地受这些政策变化影响的SUD患者的潜在人数，以及评估政策吸收是否与已经接受治疗或需要治疗的SUD患者的比率相关。对截至2020年4月13日实施的政策进行横截面分析。美国共有50个州和哥伦比亚特区在州一级实施了：口服附表二管制物质紧急处方、阿片类药物使用障碍（MOUD）药物的延长带回家剂量、带回家药物的送货上门、附表二至IV处方的远程医疗、丁丙诺啡处方启动的远程医疗以及州外药物执行管理局（DEA）注册的豁免。每10万人口中的发生率：接受SUD治疗的成年人，在阿片类药物治疗项目机构接受MOUD治疗，基于精神疾病诊断和统计手册（DSM）-IV标准的SUD，以及需要但未接受治疗。一半的州（n = 24）没有制定任何政策，约有460955人在接受治疗，114370人在大流行前接受MOUD治疗。在单变量分析中，只有丁丙诺啡启动远程医疗与大流行前SUD治疗率（OR = 1.003，95% CI = [1.001，1.006]）和MOUD治疗率（OR = 1.006，95% CI = [1.002，1.011]）略微相关，但在控制州一级人口统计学时，这些相关性不再显著。没有政策与全州SUD患病率或未满足的治疗需求率相关（P > 0.05）。截至2020年4月，美国有24个州没有实施至少一项关于扩大物质使用障碍治疗的联邦政策，导致约50万人在大流行前接受治疗，可能无法获得治疗或冒着接触COVID-19的风险继续接受面对面治疗。
To prevent COVID-19 transmission, some United States (US) federal regulations on substance use disorder (SUD) treatment were suspended in March 2020. This study aimed to quantify the extent of state-level policy uptake and the potential number of people with SUD affected by these policy changes across the US, as well as to assess if policy uptake correlated with rates of people with SUD already in treatment or needing treatment. Cross-sectional analysis of policies implemented as of April 13, 2020. A total of 50 US states and the District of Columbia State-level implementation of: oral schedule II controlled substances emergency prescription, extended take-home doses for medication for opioid use disorders (MOUD), home-delivery of take-home medications, telemedicine for schedule II-IV prescriptions, telemedicine for buprenorphine prescribing initiation, and waiver of out-of-state Drug Enforcement Administration (DEA) registration. Rates per 100 000 population of: adults in treatment for SUD, MOUD treatment at facilities with opioid treatment programs, SUD based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria, and needing, but not receiving treatment. Half of the states (n = 24) enacted no policies, leaving ~460 955 people in treatment and 114 370 people on MOUD pre-pandemic uncovered by any policy expansion. Only telemedicine for buprenorphine initiation was marginally associated with pre-pandemic rate of SUD treatment (OR = 1.003, 95% CI = [1.001, 1.006]) and rate of MOUD therapy (OR = 1.006, 95% CI = [1.002, 1.011]) in univariable analysis, but these associations were no longer significant when controlling for state-level demographics. No policies were associated with state-wide SUD prevalence or rate of unmet treatment need (P > 0.05). Twenty-four United States states did not implement at least one federal policy for substance use disorder treatment expansion as of April 2020, leaving approximately half a million people in treatment pre-pandemic potentially without access to treatment or risking exposure to COVID-19 to continue in-person therapies.
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影响因子：
13.8
作者：
Czeisler MÉ;Lane RI;Wiley JF;Czeisler CA;Howard ME;Rajaratnam SMW
通讯作者：
Rajaratnam SMW
影响因子：
5.5
作者：
Thornton JD;Varisco TJ;Bapat SS;Downs CG;Shen C
通讯作者：
Shen C
影响因子：
25.8
作者：
Lin LA;Fernandez AC;Bonar EE
通讯作者：
Bonar EE
DOI：
10.1016/j.drugpo.2021.103140
发表时间：
2021-06
期刊：
The International journal on drug policy
影响因子：
--
作者：
Krawczyk N;Bunting AM;Frank D;Arshonsky J;Gu Y;Friedman SR;Bragg MA
通讯作者：
Bragg MA
影响因子：
4.2
作者：
Slaunwhite, Amanda Kathleen;Gan, Wen Qi;Desai, Roshni
通讯作者：
Desai, Roshni