Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder

•Patients receiving medication for opioid use disorder are vulnerable to COVID-19 impacts.•Negative impacts include increased drug use and difficulty accessing healthcare.•Subgroup analysis identified three distinct subgroups of substance use at enrolment.•Polysubstance use subgroup had greatest dif...

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Bibliographic Details
Published in:Drug and alcohol dependence Vol. 221; p. 108617
Main Authors: Jacka, Brendan P., Janssen, Tim, Garner, Bryan R., Yermash, Julia, Yap, Kimberly R., Ball, Elizabeth L., Hartzler, Bryan, Becker, Sara J.
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.04.2021
Elsevier Science Ltd
Subjects:
Access
Adult
Buprenorphine
Buprenorphine - therapeutic use
Clinical Trials as Topic
Coronaviruses
COVID-19
COVID-19 - epidemiology
Cross-Sectional Studies
Drug addiction
Drug use
Drugs
Female
Harm Reduction
Health care
Health Services Accessibility - statistics & numerical data
Health Services Accessibility - trends
Healthcare access
Humans
Latent Class Analysis
Male
Methadone
Methadone - therapeutic use
Multiple drugs
Naloxone
Naloxone - therapeutic use
Narcotics
New England - epidemiology
Opiate Substitution Treatment - statistics & numerical data
Opiate Substitution Treatment - trends
Opioids
Pandemics
Patients
Polls & surveys
Polysubstance use
Short Communication
Subgroups
Substance use
Substance use disorder
Substance-Related Disorders - drug therapy
Syringe service programs
Treatment programs
Wraparound programmes
New England
Healthcare access
Polysubstance use
Syringe service programs
Methadone
Buprenorphine
Opioids
ISSN:0376-8716, 1879-0046, 1879-0046
Online Access:Get full text
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Summary:•Patients receiving medication for opioid use disorder are vulnerable to COVID-19 impacts.•Negative impacts include increased drug use and difficulty accessing healthcare.•Subgroup analysis identified three distinct subgroups of substance use at enrolment.•Polysubstance use subgroup had greatest difficulty accessing harm reduction services. The COVID-19 pandemic significantly altered treatment delivery for opioid treatment programs (OTPs) dispensing medications for opioid use disorder (MOUD). We aimed to identify patterns of substance use among MOUD patients and examine whether COVID-19-related impacts on access to healthcare varied across subgroups. This analysis was embedded within a type 3 hybrid trial that enrolled patients across eight OTPs at the start of the pandemic. Enrolled patients reported on past-30 day use of multiple substances during their baseline assessment. Participants re-contacted in May–July 2020 completed a survey about COVID-19-related impacts on various life domains. Using latent class analysis we identified patient subgroups, and then examined group differences on a set of negative and positive COVID-19 impacts related to healthcare access. Of the 188 trial participants, 135 (72 %) completed the survey. Latent class analysis identified three MOUD patient subgroups: minimal use (class probability: 0.25); opioid use (class probability: 0.34); and polysubstance use (class probability: 0.41). Compared to the minimal use group, the polysubstance use group reported increased substance use and difficulty accessing sterile needles, naloxone, and preferred substance. The opioid use group reported increased substance use and difficulty accessing their preferred substance. There were no significant group differences related to accessing routine or specialized healthcare or medication; or paying attention to their health. During COVID-19, many MOUD patients reported challenges accessing care, particularly harm reduction services for patients with polysubstance use. Additional efforts, like providing wraparound support, may be necessary to serve the needs of MOUD patients.
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ISSN:0376-8716
1879-0046
1879-0046
DOI:10.1016/j.drugalcdep.2021.108617