Changes in methadone program practices and fatal methadone overdose rates in Connecticut during COVID-19.
Changes in methadone program practices and fatal methadone overdose rates in Connecticut during COVID-19.
复制标题
DOI：
10.1016/j.jsat.2021.108449
复制
发表时间：
2021-12
影响因子：
3.9
通讯作者：
Heimer, Robert
中科院分区：
文献类型：
--
作者：
Brothers, Sarah;Viera, Adam;Heimer, Robert
由于COVID-19大流行，物质滥用和精神卫生服务管理局（SAMHSA）放宽了美国对美沙酮治疗的限制。有人担心，放宽可能会增加致命的过量率。这项研究检查了COVID-19期间美沙酮治疗的阿片类药物治疗计划（OTP）变化以及康涅狄格州致命美沙酮相关过量率的变化。从2020年7月8日至8月18日，我们对康涅狄格州所有八家提供美沙酮的OTP进行了一项全面的全州调查，以检查COVID-19期间的计划变化。我们还分析了关于确认的阿片类药物意外死亡的州一级数据，以评估放宽带回家的剂量限制和亲自出席要求是否与美沙酮相关的致命过量率增加相关。OTP报告说，为应对COVID-19大流行，美沙酮治疗实施了多项改变。接受28天带回家剂量的患者百分比从0.1%增加到16.8%，14天带回家剂量从14.2%增加到26.8%，接受一次或没有带回家剂量的百分比从37.5%下降到9.6%。每月或更频繁的药物检测从15%下降到4.6%，75.2%的美沙酮患者个人咨询过渡到远程医疗。然而，美沙酮治疗的变化因项目而异。OTP提供者说，应该放松对美沙酮的限制，在非大流行情况下应该继续增加带回家的剂量和远程保健。在OTP做法发生变化后，康涅狄格州美沙酮相关死亡人数相对于其他阿片类药物相关死亡人数并没有增加。康乃狄克州的OTP在COVID-19期间放宽了美沙酮治疗要求。由于放宽美沙酮治疗的限制并未增加致命过量，我们建议应继续实施COVID-19大流行期间实施的减少个人剂量和出勤要求，并将其永久化。
Due to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) has relaxed restrictions on methadone treatment in the United States. There is concern that the relaxation may increase fatal overdose rates. This study examines opioid treatment program (OTP) changes to methadone treatment during COVID-19 and changes in fatal methadone-involved overdose rates in Connecticut. From July 8th to August 18th, 2020, we conducted a comprehensive state-wide survey of all eight OTPs that dispense methadone in Connecticut to examine programmatic changes during COVID-19. We also analyzed state-level data on confirmed accidental opioid-involved deaths to assess if relaxation of take-home dosing restrictions and in-person attendance requirements correlated with increased methadone-involved fatal overdose rates. OTPs reported implementing multiple changes to methadone treatment in response to the COVID-19 pandemic. The percent of patients receiving 28-day take-home doses increased from 0.1% to 16.8%, 14-day take-home doses increased from 14.2% to 26.8%, and the percent receiving one or no take-home doses decreased from 37.5% to 9.6%. Monthly or more frequent drug testing decreased from 15% to 4.6% and 75.2% of individual counseling for methadone patients transitioned to telehealth. However, changes to methadone treatment varied considerably by program. OTP providers said restrictions on methadone should be relaxed and increases in take-home dosing as well as telehealth should be continued in non-pandemic situations. Methadone-involved fatalities relative to other opioid-involved fatalities did not increase in Connecticut following changes in OTP practices. Connecticut OTPs relaxed methadone treatment requirements during COVID-19. Since relaxing restrictions on methadone treatment has not increased fatal overdoses, we recommend that the reductions in-person dosing and attendance requirements implemented during the COVID-19 pandemic should be continued and made permanent.
登录
查看更多内容
影响因子：
3.9
作者：
Sarasvita, Riza;Tonkin, Anne;Ali, Robert
通讯作者：
Ali, Robert
DOI：
10.1097/00000433-200012000-00012
发表时间：
2000-12-01
影响因子：
1
作者：
Green, H;James, RA;Byard, RW
通讯作者：
Byard, RW
影响因子：
6
作者：
Fountain, J;Strang, J;Griffiths, P
通讯作者：
Griffiths, P
影响因子：
9.7
作者：
Powell, David;Alpert, Abby;Pacula, Rosalie L.
通讯作者：
Pacula, Rosalie L.
影响因子：
2.3
作者：
Davstad, Ingrid;Stenbacka, Marlene;Romelsjo, Anders
通讯作者：
Romelsjo, Anders