Challenges to Opioid Treatment Programs After Hurricane Sandy: Patient and Provider Perspectives on Preparation, Impact, and Recovery
Challenges to Opioid Treatment Programs After Hurricane Sandy: Patient and Provider Perspectives on Preparation, Impact, and Recovery
复制标题
DOI：
10.1080/10826084.2016.1267225
复制
发表时间：
2018-01-01
影响因子：
2
通讯作者：
Rosenblum, Andrew
中科院分区：
文献类型：
--
作者：
Matusow, Harlan;Benoit, Ellen;Rosenblum, Andrew
在美国，超过 300,000 名阿片类药物使用障碍 (OUD) 患者接受阿片类药物治疗计划 (OTP) 的美沙酮维持治疗。其中大量患者前往位于纽约和新泽西的 OTP，这些地区（主要但不限于沿海）于 2012 年 10 月 29 日受到桑迪 (桑迪) 飓风的影响。美沙酮配药和其他服务的中断可能会给患者（和寻求治疗者）带来严重后果，例如复发、中止治疗和恢复或艾滋病毒/丙型肝炎注射风险行为增加。为了促进 OTP 的准备和响应，我们为未来紧急情况的 OTP 制定了建议。通过定性和定量测量，我们从 OTP 主管、工作人员、患者和未接受治疗的人员那里获取了数据，以了解 OTP 如何为即将到来的飓风做好准备、恢复工作是否成功以及飓风产生了哪些影响。我们观察到参与项目中广泛的准备和恢复工作。主任、工作人员和患者对项目响应和风暴影响的看法往往不同。三角数据表明，计划反应对于大多数患者来说是足够的。对于相当多的患者来说，项目的反应非常成功；至少 20% 的诊所的项目规划和应对措施不足以满足患者的需求。为在未来紧急情况下维持护理连续性而提出的建议包括：重点改善沟通、采购交通、客人剂量和带回家的食物。
Over 300,000 patients with an opioid use disorder (OUD) receive methadone maintenance therapy from opioid treatment programs (OTPs) in the United States. Large numbers of these attend OTPs located in New York and New Jersey, areas (largely but not exclusively coastal) impacted by Hurricane Sandy (Sandy) on October 29th, 2012. Disruption of methadone dispensing and other services can have severe consequences to patients (and treatment seekers) such as relapse, dropping out of treatment and resumption or increase in HIV/HCV injection risk behaviors. To facilitate OTP preparedness and response, we developed recommendations for OTPs for future emergencies. Using both qualitative and quantitative measures, we obtained data from OTP directors, staff, patients and out-of-treatment persons to learn how OTPs prepared for the impending hurricane, whether recovery efforts were successful, and what impact the hurricane has had. We observed a wide range of preparation and recovery efforts among participating programs. Director, staff, and patient perspectives on programs' responses and storm impact often differed. Triangulated data suggest that program responses were adequate for a majority of patients. For a sizeable minority of patients, program responses were very successful; for at least 20% of the clinics, program planning and responses were inadequate to meet the needs of patients. Among the recommendations made for sustaining continuity of care in future emergencies are: a focus on improving communication, procuring transportation, guest dosing, and take home provisions.