Challenges in maintaining treatment services for people who use drugs during the COVID-19 pandemic
Challenges in maintaining treatment services for people who use drugs during the COVID-19 pandemic
复制标题
DOI：
10.1186/s12954-020-00370-7
复制
发表时间：
2020-05-06
影响因子：
4.4
通讯作者：
Maher, Lisa
中科院分区：
文献类型：
--
作者：
Dunlop, Adrian;Lokuge, Buddhima;Maher, Lisa
COVID-19对卫生服务的影响，包括对吸毒者的治疗服务，正在显现，但可能会产生很大影响。对吸毒者的治疗服务提供基本治疗服务，包括阿片类激动剂治疗和针头注射器方案，以及包括戒断和咨询服务在内的所有物质类型的其他重要治疗方案。药物和酒精医院咨询联络临床医生支持急诊科和医院环境中提供的其他服务，有效管理使用药物和其他健康问题的患者。COVID-19将影响员工因病工作的可用性。患者可能需要居家隔离和检疫期。要确保在这些时期持续提供阿片类药物治疗，就需要对提供治疗的方式作出重大改变。对于接受舌下丁丙诺啡和美沙酮治疗的患者，需要使用每月长效丁丙诺啡以及从监督给药框架中转移。确保患者随时获得带回家的纳洛酮对于降低过量风险至关重要。可能需要向确诊的COVID-19感染者家中提供美沙酮和丁丙诺啡，以支持居家隔离。在COVID-19疫情期间，使用毒品的人可能更容易受到伤害，因为他们的健康知识水平较低，而且对这一群体存在污名和歧视。吸毒者可能会将吸毒置于其他健康问题之上。供应充足的清洁注射设备对于防止血液传播病毒的爆发非常重要。阿片类药物使用者可能会将SARS-CoV 2症状误解为阿片类药物戒断，并通过使用阿片类药物进行管理。确保吸毒者能够获得药物治疗，并在有需要时获得SARS-CoV 2筛查和检测，这一点很重要。
The impact of COVID-19 across health services, including treatment services for people who use drugs, is emerging but likely to have a high impact. Treatment services for people who use drugs provide essential treatment services including opiate agonist treatment and needle syringe programmes alongside other important treatment programmes across all substance types including withdrawal and counselling services. Drug and alcohol hospital consultation-liaison clinicians support emergency departments and other services provided in hospital settings in efficiently managing patients who use drugs and present with other health problems. COVID-19 will impact on staff availability for work due to illness. Patients may require home isolation and quarantine periods. Ensuring ongoing supply of opiate treatment during these periods will require significant changes to how treatment is provided. The use of monthly depot buprenorphine as well as moving from a framework of supervised dosing will be required for patients on sublingual buprenorphine and methadone. Ensuring ready access to take-home naloxone for patients is crucial to reduce overdose risks. Delivery of methadone and buprenorphine to the homes of people with confirmed COVID-19 infections is likely to need to occur to support home isolation. People who use drugs are likely to be more vulnerable during the COVID-19 epidemic, due to poorer health literacy and stigma and discrimination towards this group. People who use drugs may prioritise drug use above other health concerns. Adequate supply of clean injecting equipment is important to prevent outbreaks of blood-borne viruses. Opiate users may misinterpret SARS-CoV2 symptoms as opiate withdrawal and manage this by using opioids. Ensuring people who use drugs have access to drug treatment as well as access to screening and testing for SARS-CoV2 where this is indicated is important.