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. 2020 Jul 31;18(1):241.
doi: 10.1186/s12916-020-01693-9.

"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic

Hugo López-Pelayo  1   2 , Henri-Jean Aubin  3   4   5 , Colin Drummond  6   7 , Geert Dom  8   9   10   11 , Francisco Pascual  12   13   14   15 , Jürgen Rehm  16   17   18   19 , Richard Saitz  20   21   22 , Emanuele Scafato  23   24 , Antoni Gual  25   26
Affiliations

"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic

Hugo López-Pelayo et al. BMC Med. .

Abstract

Background: Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks.

Main body: Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three "best buys" of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information.

Conclusion: The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.

Keywords: Addictions; COVID-19; Harm-reduction; Stigma; Substance use disorder; Telemedicine.

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Conflict of interest statement

Dr. Pascual received research grants (Camurus) and lectures/training programs (Lundbeck, Gilead, Abbvie, Neuraxpharm, Pfizer).

Dr. Aubin reported being a member of advisory boards or DSMB for Bioprojet, CV Sciences, and Ethypharm, and has received sponsorship to attend scientific meetings, speaker honoraria, or consultancy fees from Bioprojet, D&A Pharma, Ethypharm, Kinnov Pharmaceuticals, and Lundbeck. He is also a member of the American Society of Clinical Psychopharmacology’s Alcohol Clinical Trials Initiative (ACTIVE), which was supported in the last 3 years by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka.

Dr. Gual received a grant from Novartis for a trial on cocaine that ended in April 2020.

Dr. López-Pelayo received training grants (Exeltis, Lundbeck).

Dr. Saitz declares that Alkermes provides medication to Boston University for a trial supported by the US National Institutes of Health for which Dr. Saitz is the principal investigator. Dr. Saitz consults for various non-profit institutions and universities as a lecturer, expert, researcher, and editor in the area of addiction. He is the Editor-in-Chief of Journal of Addiction Medicine and the President of International Society of Addiction Journal Editors. He is an investigator for studies supported by the National Institutes of Health and faculty for a training program supported by the Burroughs Wellcome Foundation.

Dr. Dom is a member of the scientific advisory board of Janssen-Cilag NV, Belgium.

None of the previous conflicts of interest has relationship with this work.

Others authors do not report any conflict of interest.

References

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