Review of the adaptations in opioid agonist treatment during the COVID-19 pandemic: Focus on buprenorphine-based treatment

Abhishek Ghosh, MD, DM; Chandrima Naskar, MD; Fazl-e Roub, MD, DM; Debasish Basu, MD, DNB, MAMS

doi:10.5055/jom.2021.0649

Authors

Abhishek Ghosh, MD, DM
Chandrima Naskar, MD
Fazl-e Roub, MD, DM
Debasish Basu, MD, DNB, MAMS https://orcid.org/0000-0002-3643-5984

DOI:

https://doi.org/10.5055/jom.2021.0649

Keywords:

COVID-19, buprenorphine, opioid agonist treatment, review

Abstract

Background: Availability and access to opioid agonist treatment (OAT) are limited despite its evidence of effectiveness in treating opioid use disorders (OUDs). COVID-19 pandemic has inadvertently exacerbated the problems of restricted access to OAT and, at the same time, has increased odds of harm due to opioid use.

Objectives: We examined (a) adaptations conceived or implemented in the buprenorphine (BPN)-based OAT service delivery at the national, regional, or local level during the COVID-19 pandemic and (b) the impact of such transformations on the quantitative and qualitative aspects of service delivery. We focused exclusively on BPN-based OAT.

Methods: We carried out a systematic electronic database search in PubMed and Google Scholar. We included all types of articles. Additionally, we looked up relevant websites of international and national government agencies working in the field of drug abuse.

Results: We included 21 articles from 10 countries in the review and summarized the results in a narrative format. The majority of literature was from developed countries. We observed changes in the BPN initiation, dosing, and dispensing protocols, and particular emphasis on telemedicine. There was limited literature on service provisions for the vulnerable population. The changing modes of service delivery have possibly increased the number of new patients and reduced the risk of exposure owing to limited in-person contact.

Conclusion: Newer adaptations to meet with the challenges of COVID-19 pandemic in the BPN-based OAT delivery tend to be innovative, flexible, and patient centered. Although it is too early to comment on these newer adaptations’ impact, the outcome's directions appear to be positive.

Author Biographies

Abhishek Ghosh, MD, DM

Department of Psychiatry, Drug Deaddiction & Treatment Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Chandrima Naskar, MD

Senior Resident, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Fazl-e Roub, MD, DM

Senior Resident, Department of Psychiatry, Drug Deaddiction & Treatment Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Debasish Basu, MD, DNB, MAMS

Professor and Head, Department of Psychiatry, Drug Deaddiction & Treatment Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India

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