Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies

BMC Public Health

Stacey Whitman¹  Myles Bruised Head²  Iskotoahka William Wadsworth³  Leslee Mackey⁴  Jake Hayward⁴  Jessica Hann⁵  Brian R. Holroyd⁶  Patrick McLane⁶  Lindsay Crowshoe⁷  Ashley McInnes⁷  Steven Persaud⁷  Rita Henderson⁷  Bonnie Larson⁷  Eddy Lang⁸  Chris Sarin⁹  Ashley Jane Leonard^1,10  Khalil Raghavji^1,11  Hakique Virani^1,12 

[1] Addiction and Mental Health, Alberta Health Services, 10030 – 107 St NW, T5J 3E4, Edmonton, AB, Canada;Blood Tribe, Stand Off, Canada;Blood Tribe, Stand Off, Canada;Treaty 7 Chiefs Alliance, 206 - 8408 Elbow Drive SW, T2V 1K7, Calgary, Alberta, Canada;Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, T6G 2R7, Edmonton, AB, Canada;Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, T6G 2R7, Edmonton, AB, Canada;Addiction Recovery and Community Health (ARCH) Team, Royal Alexandra Hospital, 10240 Kingsway NW, T5H 3V9, Edmonton, AB, Canada;Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, T6G 2R7, Edmonton, AB, Canada;Emergency Strategic Clinical Network, Alberta Health Services, 10030 – 107 St NW, T5J 3E4, Edmonton, AB, Canada;Department of Family Medicine, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada;Emergency Strategic Clinical Network, Alberta Health Services, 10030 – 107 St NW, T5J 3E4, Edmonton, AB, Canada;Department of Emergency Medicine, University of Calgary, 3330 Hospital Dr NW, T2N 4N1, Calgary, AB, Canada;Indigenous Services Canada, Suite 730, 9700 Jasper Avenue, T5J 4C3, Edmonton, AB, Canada;Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada;Knowledge Resource Service, Alberta Health Services, 10030 – 107 St NW, T5J 3E4, Edmonton, AB, Canada;Metro City Medical Clinic, 150 - 909 5 Ave SW, T2P 3G5, Calgary, AB, Canada;Metro City Medical Clinic, 150 - 909 5 Ave SW, T2P 3G5, Calgary, AB, Canada;Department of Medicine, University of Alberta, 8440 112 St. NW, T6G 2R7, Edmonton, AB, Canada;

关键词: Coronavirus;    Disaster planning;    Opioid epidemic;    Emergency;    Health services;    Opioid agonist treatment;    Medication assisted treatment;    Review;   

DOI  :  10.1186/s12889-021-11495-0

来源: Springer

【 摘 要 】

BackgroundDuring public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions. How do public health emergencies impact PWOUD? How can health systems respond to novel public health emergencies to serve PWOUD? How can the results of this scoping review be contextualized to the province of Alberta to inform local stakeholder responses to the pandemic?MethodsWe conducted a scoping review using the 6-stage Arksey and O’Malley framework to analyse early-pandemic and pre-pandemic disaster literature. The results of the scoping review were contextualized to the local pandemic response, through a Nominal Group Technique (NGT) process with frontline providers and stakeholders in Alberta, Canada.ResultsSixty one scientific journal articles and 72 grey literature resources were included after full-text screening. Forty sources pertained to early COVID-19 responses, and 21 focused on OUD treatment during other disasters. PWOUD may be more impacted than the general population by common COVID-19 stressors including loss of income, isolation, lack of rewarding activities, housing instability, as well as fear and anxiety. They may also face unique challenges including threats to drug supplies, stigma, difficulty accessing clean substance use supplies, and closure of substance use treatment centres. All of these impacts put PWOUD at risk of negative outcomes including fatal overdose. Two NGT groups were held. One group (n = 7) represented voices from urban services, and the other (n = 4) Indigenous contexts. Stakeholders suggested that simultaneous attention to multiple crises, with adequate resources to allow attention to both social and health systems issues, can prepare a system to serve PWOUD during disasters.ConclusionThis scoping review and NGT study uncovers how disasters impact PWOUD and offers suggestions for better serving PWOUD.

【 授权许可】

CC BY