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. 2022 Jul;41(5):1009-1019.
doi: 10.1111/dar.13382. Epub 2021 Sep 14.

Opioid agonist treatment and patient outcomes during the COVID-19 pandemic in south east Sydney, Australia

Nicholas Lintzeris  1   2   3 , Rachel M Deacon  1   2   3 , Victoria Hayes  2   3   4 , Tracy Cowan  2   3 , Llewellyn Mills  1   2   3 , Laila Parvaresh  2   3   5 , Lucy Harvey Dodds  2   3   4 , Louisa Jansen  2   3 , Raelene Dojcinovic  2   3 , Man Cho Leung  2   3 , Apo Demirkol  2   3   4   6 , Therese Finch  2   3 , Kristie Mammen  2   3
Affiliations

Opioid agonist treatment and patient outcomes during the COVID-19 pandemic in south east Sydney, Australia

Nicholas Lintzeris et al. Drug Alcohol Rev. 2022 Jul.

Abstract

Introduction: In early 2020, many services modified their delivery of opioid treatment in response to the COVID-19 pandemic, to limit viral spread and maintain treatment continuity. We describe the changes to treatment and preliminary analysis of the association with patients' substance use and well-being.

Methods: A pre-post comparison of treatment conditions and patient self-reported outcomes using data extracted from electronic medical records in the 5 months before (December 2019-April 2020) and after (May 2020-September 2020) changes were implemented in three public treatment services in South Eastern Sydney Local Health District.

Results: Data are available for 429/460 (93%) patients. Few (21, 5%) dropped out of treatment. In the 'post' period there was significantly more use of depot buprenorphine (12-24%), access to any take-away doses (TAD; 24-69%), access to ≥6 TAD per week (7-31%), pharmacy dosing (24-52%) and telehealth services. There were significant reductions in average opioid and benzodiazepine use, increases in cannabis use, with limited group changes in social conditions, or quality of life, psychological and physical health. At an individual level, 22% of patients reported increases in their use of either alcohol, opioids, benzodiazepines or stimulants of ≥4 days in the past 4 weeks. Regression analysis indicates increases in substance use were associated with higher levels of supervised dosing.

Discussion and conclusions: These preliminary findings suggest that the modified model of care continued to provide safe and effective treatment, during the pandemic. Notably, there was no association between more TAD and significant increases in substance use. Limitations are discussed and further evaluation is needed.

Keywords: clinical protocol; health care; opiate substitution treatment; organisational innovation; outcome assessment.

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Conflict of interest statement

NL has received research funding from Camurus for unrelated research. VH has received money from Camurus and Viiv for providing education and training sessions. TC has received money from Camurus for providing education sessions.

Figures

Figure 1
Figure 1
CONSORT patient flow diagram for the evaluation of the impact of COVID‐19 on patients attending opioid agonist treatment services in South‐Eastern Sydney. ATOP, Australian Treatment Outcome Profile; OST, opioid substitution treatment.
See this image and copyright information in PMC

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