Common themes in early state policy responses to substance use disorder treatment during COVID-19.
Common themes in early state policy responses to substance use disorder treatment during COVID-19.
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DOI：
10.1080/00952990.2021.1903023
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发表时间：
2021-07-04
期刊：
影响因子：
--
通讯作者：
Stein BD
中科院分区：
文献类型：
--
作者：
Andraka-Christou B;Bouskill K;Haffajee RL;Randall-Kosich O;Golan M;Totaram R;Gordon AJ;Stein BD
有限的研究调查了各州在COVID-19大流行期间如何改变药物使用障碍（SUD）的治疗政策。我们的目的是在SUD治疗的背景下确定国家政策应对大流行的主题。确定政策答复中的主题为随后评估国家政策与保健服务利用之间的关系提供了一个框架。在2020年5月至6月期间，我们搜索了所有单一州药物滥用服务机构（SSA）网站，以获取SUD应对大流行的治疗政策声明。我们对门诊项目、阿片类药物治疗项目和其他治疗环境的政策进行了迭代分类，以确定政策响应中的主题。我们从45个州和华盛顿特区的SSA网站上收集了220份文件。我们的内容分析产生了8个具体主题：提供药理学和非药理学服务，获得远程服务的知情同意和文件，进行健康评估，设施操作程序和人员配备要求，以及允许的远程医疗技术和计费协议。政策变化经常反映联邦指导，例如，通过扩大阿片类药物治疗项目的美沙酮带回家选择。政策变化的程度和性质因司法管辖区而异，包括远程保健技术要求和人员配置灵活性。各国在2019冠状病毒病期间对SUD治疗政策进行了重大政策调整，特别是在远程医疗和促进远程护理方面。了解这些变化可以帮助决策者在大流行期间和未来的卫生危机中优先考虑指导。应考虑政策对差别待遇人群的影响，包括对技术获取有限的人群的影响。
Limited research has examined how states have changed policies for treatment of substance use disorder (SUD) during the COVID-19 pandemic. We aimed to identify themes in state policy responses to the pandemic in the context of SUD treatment. Identifying themes in policy responses provides a framework for subsequent evaluations of the relationship between state policies and health service utilization. Between May and June 2020, we searched all Single State Agencies for Substance Abuse Services (SSA) websites for statements of SUD treatment policy responses to the pandemic. We conducted Iterative Categorization of policies for outpatient programs, opioid treatment programs, and other treatment settings to identify themes in policy responses. We collected 220 documents from SSA websites from 45 states and Washington D.C. Eight specific themes emerged from our content analysis: delivery of pharmacological and non-pharmacological services, obtaining informed consent and documentation for remote services, conducting health assessments, facility operating procedures and staffing requirements, and permissible telehealth technology and billing protocols. Policy changes often mirrored federal guidance, for instance, by expanding methadone take-home options for opioid treatment programs. The extent and nature of policy changes varied across jurisdictions, including telehealth technology requirements and staffing flexibility. States have made significant policy changes to SUD treatment policies during COVID-19, particularly regarding telehealth and facilitation of remote care. Understanding these changes could help policymakers prioritize guidance during the pandemic and for future health crises. Impacts of policies on disparate treatment populations, including those with limited technological access, should be considered.
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