Considering Bio/Pharma Reformulation Strategies

[...]of the significant cost of development, companies seek to recoup finances through data exclusivity and patent protection of intellectual property, such as the drug product's formulation. Bio/pharma companies reformulate existing therapies for a whole host of reasons, such as treating underserved or neglected disease areas, improving patient adherence (particularly for target patient groups, such as paediatrics), reducing the potential of drug abuse, and providing alternative options in crisis situations-as has been apparent during the COVID-19 pandemic. Pentamidine is an anti-infective agent that can be used to treat an earlier stage of the disease;however, it is unable to penetrate the blood-brain barrier sufficiently to treat the secondary stage of HAT. [...]it was hypothesized that a combined pentamidine-Pluronic formulation may be a suitable approach to provide patients with a single therapeutic option for treatment of all stages of HAT. [...]it was concluded that the pharmacokinetic data attained supports the use of safety and tolerability data from the conventional risperidone formulation for further testing of VAL401 (4).

Perceived Change in Quality of Life Related to Treatment of Hepatitis C Infection among People with Substance Use Disorder: A Qualitative Study

Background. The hepatitis C virus (HCV) is often associated with people who inject drugs, and with a reduction in quality of life. While earlier forms of HCV treatment had low treatment uptake, newer HCV treatment integrated with opioid maintenance treatment appears to increase treatment uptake among those who inject drugs. The aim was to explore how people who inject drugs perceive changes in quality of life after treatment of HCV infection. Methods. Four focus group discussions, and 19 individual interviews were conducted with people who inject drugs or who had previously injected drugs and received opioid agonist therapy. All participants were successfully treated for and "cured” for HCV. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results. The HCV treatment helped participants to let go of negative thoughts and break destructive patterns of interaction. This facilitated the restoration of social relationships with family and others. Furthermore, some participants reported a general improvement in their health. Feeling healthy meant fewer worries such as infecting others. Also, interactions with health professionals were experienced as less stigmatizing. These physical, social, and psychological improvements led to a form of "awakening” and being treated for HCV gave participants hope for the future. Conclusion. HCV treatment improves the mental and physical health in addition to play an important social function. Successful HCV treatment was associated with a greater sense of hope for the future, reconnection with significant others, and reduced feeling of stigma. Overall, improved health and social relationships contributed to improved quality of life.

No Single Path: Review of Amy Sullivan's Opioid Reckoning

According to this framework, the pandemic is a two-part problem: one part virus, one part social resistance to the cure for the disease. [...]we hear that medical scientists have developed "gold standard" treatments for addiction, but that for reasons of bureaucratic lethargy, public skepticism, or sheer hopelessness among those suffering from addiction, the treatments are not adequately made available and sought out. The stories in the book are drawn from oral-history interviews that the author conducted with family members of people with addictions, doctors, community organizers, and treatment-center directors over a period of four years. Chapter Two reconstructs the life of a single man from the memories of his surviving family members, from the moment of his first exposure to opioids through fourteen separate rounds of addiction treatment and up to the moment of his fatal fentanyl overdose.

Payer Strategies to Ensure Access to Care for Individuals With Opioid Use Disorder During COVID-19

[...]increase access to care by reimbursing virtual visits. [...]leverage data to identify and intervene when patients are at risk for recurrence or overdose. In practice, expanded access to buprenorphine reduces diversion and misuse because they occur commonly among individuals seeking relief from withdrawal.2 Compared with buprenorphine monotherapy, buprenorphine-naloxone is associated with lower rates of misuse.2 Mark et al demonstrate that among Medicare beneficiaries, removal of prior authorization for buprenorphine-naloxone doubled treatment rates and significantly reduced emergency department (ED) visits and hospitalizations.4 Ultimately, the lifesaving benefits of expanded access to buprenorphine far outweigh the associated risks. In a time of social distancing, limited personal protective equipment, and transportation barriers, payment and delivery of telehealth is imperative to ensuring access to care. Because many patients do not have reliable access to broadband connection or smartphones, audio-only visits must be reimbursed as well.

A PRESCRIPTION FOR CALAMITY: WHY THE DEPARTMENT OF LABOR'S PHARMACY BENEFIT MANAGEMENT PROGRAM FALLS SHORT AS A SINGULAR SOLUTION TO THE U.S. OPIOID CRISIS

The purpose of this Note is to create a holistic solution for the U.S. Department of Labor to apply amidst the United States ongoing opioid crisis, which will serve to both prevent addiction before it can develop and treat existing cases of addiction. To this aim, this Note examines and analyzes the connections between the opioid crisis and another co-existing public health crisis, the COVID-19 pandemic, and the procurement procedures taken to resolve them. The argument is developed throughout three sections. First, this Note provides background information demonstrating the detrimental impact of opioid misuse and addiction, as well as the impact that COVID-19 in particular has had on rates of misuse and addiction in the United States. ally, this section introduces efforts taken to resolve the crisis, including the Department of Labors Pharmacy Benefit Management program, which is the subject of this Note. Second, this Note examines the Department of Labors Pharmacy Benefit Program, addressing the singularly preventative nature of the program, which fails to support a holistic solution. Additionally, this Note addresses concerns relating to the use of pharmacy benefit management services in general, particularly the cost-increasing nature of such mechanisms. In the final section, following an examination of the procurement procedure used to acquire COVID-19 vaccines, this Note proposes the application of a similar pharmaceutical procurement approach to combatting the opioid crisis. To conclude, this Note argues that by contracting with pharmaceutical companies to develop a safer and less addictive treatment plan, the Department of Labor would be able to prevent, as well as treat, opioid addiction.

Substance Use and Mental Health Disorders: Psychologists' Role in Bridging the Gap

Given the frequency with which substance use and mental health disorders co-occur, it is incumbent on mental health professionals to understand the implications of substance use on the assessment, treatment, and outcomes of mental health disorders. The 2016 National Survey on Drug Use and Health revealed that only 6.9% of adults with concurrent disorders received treatment that addressed both conditions, over half (51.9%) of adults with concurrent disorders did not receive any treatment at all, 38.2% received mental health treatment only, and 2.9% received treatment specifically targeting their substance use (Substance Abuse and Mental Health Services Administration, 2017). Additionally, a recent review of alcohol use following the global crisis such as the COVID-19 pandemic reported that increases in alcohol use were partially mediated by increases in mental health distress (Gonçalves et al., 2020). [...]it is likely that the rates of concurrent disorders will increase due to the negative impacts of the COVID-19 pandemic. [...]many psychologists are already trained in the therapeutic modalities that have been shown to be evidence-based for concurrent mental health and substance use disorders, such as motivational interviewing, cognitive-behavioral therapy, and trauma-informed care (Institute of Medicine, 2015).

Comment on: "Risk of Erectile Dysfunction in Male Patients with Gout Treated with Febuxostat or Allopurinol: A Propensity Score-Matched Cohort Study"/Authors' Reply to Huang and Zhang: Comment on "Risk of Erectile Dysfunction in Male Patients with Gout Treated with Febuxostat or Allopurinol: A Propensity Score-Matched Cohort Study"

[...]a time frame could be set before the Covid-19 epidemic attack in January 2020, owing to the association between Covid-19 infection (ICD-10-CM B34.2, U07.1, U07.2, J12.81, J12.82, B97.29) and new-onset ED, which was recently detected in the same database [6]. According to the National Institute for Health and Care Excellence (NICE) guideline [15], treat-to-target (T2T) approach should be adhered to with serum urate level of at least < 360

COVID-19, usages de drogues et réduction des risques Analyse croisée des expériences et de l'impact de la pandémie en France et au Québec

Les personnes utilisatrices de substances qui fréquentent les services d'addictologie et de réduction des risques font partie des publics en situation de précarité dont les vulnérabilités sont aggravées en temps de pandémie. Notre article étudie l'expérience de la pandémie par ces personnes et l'impact de celle-ci sur les pratiques professionnelles et l'action publique, comme productrice d'inégalités mais aussi d'innovations et de solidarités. La collecte de données a été réalisée en France et au Québec, incluant des entretiens semi-directifs auprès de personnes usagères de substances (France, n = 25 ;Québec, n = 15) et de professionnels en addictologie et réduction des risques (France, n = 25 ;Québec, n = 18). Une approche théorique pragmatiste a été mise en oeuvre et analyse les niveaux macro et micro ensemble et de manière réflexive. Dès le premier confinement, les dispositifs professionnels ont tenté au mieux d'organiser une continuité de services afin de répondre aux besoins des usagers dans un contexte d'urgence sanitaire : par le déploiement de l'accès à l'hébergement, le développement de la téléconsultation afin d'assurer la continuité des soins. Des innovations ont été réalisées par des collaborations entre acteurs sur l'hébergement ou sur l'inclusion accélérée de la réduction des risques (alcool et approvisionnement sécuritaire) dans les centres d'hébergement. Des difficultés ont été également observées en lien avec des contraintes organisationnelles. Les usagers se sont bien approprié les mesures de prévention. Ils ont subi des logiques de contrôle social dans les champs sanitaire et répressif. Au-delà des vulnérabilités apportées par la COVID-19, des adaptations peuvent également constituer des opportunités de création de solidarités entre usagers et professionnels, des espaces favorables aux innovations professionnelles, et des nouveaux modes de collaboration et d'organisation entre acteurs.Alternate :People who use psychoactive substances and who attend drug treatment and harm reduction services represent groups whose vulnerabilities are exacerbated during a pandemic. We study the pandemic experience of people with problematic substance use and its impact on professional practices and policies, with an eye towards vulnerability and innovations. This comparative study was conducted in France and Quebec via semi-structured interviews with substance users (France, n=25 ;Quebec, n=15) and care and harm reduction providers (France, n=25 ;Quebec, n=18). We employ a pragmatist theoretical approach that reflexively analyzes the macro and micro levels together. During the first lockdown, professionals tried their best to organize a continuity of service to meet the needs of people in a context of a health emergency via the deployment of access to accommodation and the development of teleconsultation to ensure continuity of care. Innovative collaborations between actors occurred related to accommodation or the inclusion of harm reduction (alcohol and safe supply) in shelters. Difficulties were observed stemming from organizational constraints. Individuals adopted the preventive measures and had to endure social control both in the health and repressive fields. Beyond the vulnerabilities produced by COVID-19, adaptations also constitute opportunities for : solidarity between users and professionals, professional innovations, as well as new modes of collaboration and inter-actor organization.Alternate :Las personas que consumen sustancias y acuden a los servicios de adicción y reducción de riesgos se encuentran entre los grupos de población en situación de precariedad cuya vulnerabilidad se ha agravado durante la pandemia. Nuestro artículo estudia cómo estas personas han vivido la pandemia y el impacto de ésta en las prácticas profesionales y la acción pública, como productora de desigualdades, pero también de innovaciones y de solidaridad. La recogida de datos se llevó a cabo en Francia y en Quebec, incluyendo e trevistas semidirectivas con usuarios de sustancias (Francia, n=25 ;Quebec, n=15) y con profesionales del ámbito de la adicción y la reducción de riesgos (Francia, n=25 ;Quebec, n=18). Se utilizó un enfoque teórico pragmático, analizando conjuntamente los niveles macro y micro de forma reflexiva. Desde el primer confinamiento, los dispositivos profesionales trataron de organizar una continuidad de los servicios para responder a las necesidades de los usuarios en un contexto de emergencia sanitaria : se impulsó el acceso al alojamiento y se desarrolló la teleconsulta para garantizar la continuidad de los cuidados. Las innovaciones se han producido a través de la colaboración de los actores del sector del alojamiento o mediante la inclusión acelerada de la reducción de riesgos (alcohol y suministro seguro) en los centros de alojamiento. También se observaron dificultades en relación con las limitaciones organizativas. Los usuarios han integrado las medidas de prevención. Han sido sometidos a lógicas de control social en el ámbito sanitario y represivo. Más allá de las vulnerabilidades producidas por el COVID-19, las adaptaciones también pueden constituir oportunidades para la solidaridad entre usuarios y profesionales, espacios favorables a las innovaciones profesionales y nuevos modos de colaboración y organización entre los actores.

An examination of peer recovery support specialist work roles and activities within the recovery ecosystems of Central Appalachia

BackgroundSubstance use/misuse is a leading public health concern in the United States. In the midst of the COVID-19 pandemic, drug-related deaths exceeded 100,000 in a 12-month period for the first time in history. There is currently an urgent need for empirical evidence to inform community leaders and policy makers on the benefits of recovery-informed approaches to SUD prevention and treatment. The peer recovery support specialist (PRSS) is a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorder and may play an important role in positively affecting outcomes for persons with SUD. However, the evidence for PRSS services is limited in part due to methods that are ill-fitted to measure the dynamic process of recovery across time and within a complex service continuum.MethodsThis sequential exploratory mixed-methods study queried PRSS in five Central Appalachian states regarding their work roles and activities within the context of regional service networks also known as 'recovery ecosystems.'Results565 Central Appalachian PRSS respondents indicate that they frequently provide emotional support in a broad array of regional service settings but have few professional advancement opportunities. PRSS also report that their role is frequently misunderstood.ConclusionsThis study expands the existing literature providing information about training, remuneration, job satisfaction, work roles and activities within the context of existing recovery ecosystems. Inclusion of peer recovery support specialist's perspectives improved measurement of peer service delivery and should be considered when working with this vital recovery-supporting workforce.

Reducing Problematic Substance Use under Exceptional Circumstances-Effects of the COVID-19 Restrictions on Inpatient Substance Use Disorder Treatment in Finland.

The COVID-19 pandemic has affected people's daily lives on multiple levels. At highest risk are the most vulnerable members of the society, whose lives were already affected by various risks even before the pandemic. This study investigates how clients in inpatient substance use disorder treatment experienced the COVID-19 restrictions and their influence on recovery. The research data consists of six focus group interviews conducted remotely using a semi-structured thematic interview method. The focus group clients (N = 19) were currently in inpatient substance abuse treatment during the pandemic and the ensuring restrictions. The data were analyzed using qualitative content analysis. The results show that the COVID-19 restrictions have influenced the clients' desistance processes throughout the pandemic. The restrictions seemed to exacerbate substance abuse problems before treatment initiation and highlight the importance of peer support during treatment. Moreover, the restrictions seemed to change the function and hamper the management of social capital, raise concerns about returning home, as well as intensifying the inter-municipal segregation of services. To conclude, attention should be paid to facilitating and ensuring informal support and managing social capital. In light of this study, it seems necessary to explore the social conditions among clients in inpatient substance abuse treatment during the pandemic.

Policing the largest drug market on the eastern seaboard: officer perspectives on enforcement and community safety

Purpose>The Kensington transit corridor runs between Huntingdon and Allegheny stations in the Kensington area of Philadelphia, Pennsylvania, and is one of the largest illicit drug areas in the country. The authors report qualitative findings from ride-alongs with transit police officers assigned to a vehicle patrol dedicated to reducing the response time to opioid overdoses in and around the transit system (trains and buses) in this large open-air drug market. This study's focus was on management and mitigation of the criminogenic harms associated with the illicit drug environment.Design/methodology/approach>For ten months, transit officers patrolled the Kensington transit corridor in a dedicated vehicle (callsign “Oscar One”). Oscar One operated during either an early (8 a.m. to 4 p.m.) or late (4 p.m. to midnight) shift, between September 2020 and June 2021. 269 shifts were randomly selected for Oscar One from 574 possible shifts. Researchers accompanied Oscar One for 51 observations (19%), 45 of which were completed by the authors. Semi-structured interviews occurred during these shifts, as well as ethnographic field observations.Findings>Four main themes emerged from the study. These centered on the role of law enforcement in a large drug market, the politics of enforcement within the city of Philadelphia, the policing world around risk and proactive engagement post–George Floyd, and the sense of police being overwhelmed on the front-line of community safety.Originality/value>Police officers have a community safety as well as a law enforcement mandate, and this study explores the community safety and harm mitigation role from their perspective. The article draws on their words, based on approximately 400 h of field observation.

Notes from the Field: Responsive Continuing Education: Using a Virtual Platform to Address SUDs in the Context of the COVID-19 Pandemic

Individuals with substance use disorders are at an increased risk for developing and suffering worse outcomes from the coronavirus disease. Increasing access to innovative substance use treatment that considers the changes to behavioral health services caused by COVID-19 is critical. This paper describes one university's virtual training series on innovative responses to the changing clinical and access needs in the field of SUD care for social workers and other behavioral health professionals. Training satisfaction and considerations for virtual training implementation are discussed.

Mixed-methods study to examine the response of opioid addiction treatment programmes to COVID-19: a study protocol

IntroductionThe COVID-19 pandemic is forcing changes to clinical practice within traditional addiction treatment programmes, including the increased use of telehealth, reduced restrictions on methadone administration (eg, increased availability of take-home doses and decreased requirements for in-person visits), reduced reliance on group counselling and less urine drug screening. This paper describes the protocol for a mixed-methods study analysing organisational-level factors that are associated with changes in clinic-level practice changes and treatment retention.Methods and analysisWe will employ an explanatory sequential mixed-methods design to study the treatment practices for opioid use disorder (OUD) patients in New York State (NYS). For the quantitative aim, we will use the Client Data System and Medicaid claims data to examine the variation in clinical practices (ie, changes in telehealth, pharmacotherapy, group vs individual counselling and urine drug screening) and retention in treatment for OUD patients across 580 outpatient clinics in NYS during the pandemic. Clinics will be categorised into quartiles based on composite rankings by calculating cross-clinic Z scores for the clinical practice change and treatment retention variables. We will apply the random-effects modelling to estimate change by clinic by introducing a fixed-effect variable for each clinic, adjusting for key individual and geographic characteristics and estimate the changes in the clinical practice changes and treatment retention. We will then employ qualitative methods and interview 200 key informants (ie, programme director, clinical supervisor, counsellor and medical director) to develop an understanding of the quantitative findings by examining organisational characteristics of programmes (n=25) representative of those that rank in the top quartile of clinical practice measures as well as programmes that performed worst on these measures (n=25).Ethics and disseminationThe study has been approved by the Institutional Review Board of NYU Langone Health (#i21-00573). Study findings will be disseminated through national and international conferences, reports and peer-reviewed publications.

Are Substance Dependent Struggling for Utilizing the Services during COVID-19

COVID-19 infection and lockdown strategies both are impacted to the human life negatively. Treatment modes, techniques and accessibility to the Healthcare system became compromising during the pandemic. This article aims to understand different problematic aspect in service utilization of addiction services. Due to lockdown people with substance abuse leads to relapse and resulting use of multiple substance, that can be cause severe health complications like withdrawal and worsen to death. So, these conditions are making them prone to procure drugs in illegal way. This crisis has paved the path towards development and acceptance of digital psychiatry as a mode of treatment.

Professionals' Views on Challenges in Inpatient Substance Abuse Treatment during COVID-19 Pandemic in Finland

The pandemic caused by COVID-19 (an acute respiratory illness caused by a coronavirus) has had harmful effects on people in need of special support. People with problematic substance use are recognized as such a group. The pandemic has raised the need for sufficient treatment and services during these unpredictable conditions. At the same time, it poses severe challenges to their production and provision. The purpose of the study was to use content analysis to qualitatively examine Finnish professionals' (N = 22) views on (1) the challenges posed by COVID-19 in working in inpatient substance abuse treatment, (2) how these challenges have been addressed, and (3) what the consequences of the challenges and the solutions to them are. The findings confirmed that COVID-19 has caused drastic changes in the organization of treatment and daily practices. Professionals experience challenges in preventing infection from spreading into and within treatment units. They also describe difficulties in applying social distancing in treatment that is based on therapeutic communities. The pandemic has also challenged communication and co-worker support among professionals. These challenges have led to practical solutions that, in turn, have their own consequences for treatment practices. We conclude that the quality of treatment has to some extent been impaired because of the pandemic. [ FROM AUTHOR] Copyright of Challenges (20781547) is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Perceptions and Concerns of SUD Treatment Organizations Regarding the CARES Act's Alterations to Patient Confidentiality Regulations

Keywords: Part 2, CARES Act Sec. 3221, substance use disorder treatment organizations, confidentiality, coordination of care Introduction In March 2020, Section 3221 of the Coronavirus Aid, Relief, and Economic Security Act (hereinafter referred to as Sec. 3221) became law, calling for substantial changes in longstanding privacy and confidentialityregulations (42 U.S.C. 290dd-2), which had protected the personal health information of patients withsubstance use disorder (SUD) who are treated by federallyassisted SUD treatment organization providers. Illustrating the problem, one study found that use ofelectronic health information exchange (HIE) on discharge from acute care hospitals was 88 percent, while the frequency from psychiatric units was only 56 percent.8 More expansive consent would also facilitate such activities as quality improvement,claims management, patient safety, training, and strengthening of program integrity. Sec. 3221 attempts to mitigate risks associated with relaxed limitations on disclosure through several other vital provisions: 1) tracking of disclosures of Part 2information;2) continued emphasis that Part 2 information may not be used in criminal, civil, oradministrative proceedings against the person suffering from SUD;3) breach notification reporting requirements;4) shifting of enforcement awayfrom the US Department of Justice (DOJ) to HHS with new civil penalties and strengthened criminalpenalties for violation of those protections;and 5) an express prohibition against using Part 2information to discriminate against a person with respect to that person's treatment, employment,worker's compensation, housing, court access, social services, or benefits-known issues forpeople with SUD.11-13 The CARES Act, containing Sec. 3221, became law on March 27, 2020. Following approval from the Arizona State University Internal Review Board (IRB) (Study 11902), researchers began recruitment of persons occupying positions within SUD organizations.Information sought included: (1) their organization's policies concerning confidentiality and sharing of patient records, and (2) planning for possible changes in those policies.

Civil Commitment for Substance Use Disorders: Coercion or Compassion?

The article addresses clinical ethics arguments for and against civil commitment for substance use disorders (SUDs). Topics discussed include legal basis of civil commitment, explanation on civil commitment for SUD in state law, and ethical analysis and recommendations about civil commitment for SUD.

Virtual Reality Behavioral Activation for Adults With Major Depressive Disorder: Feasibility Randomized Controlled Trial

Background: Major depressive disorder (MDD) is a global crisis with increasing incidence and prevalence. There are many established evidence-based psychotherapies (EBPs) for depression, but numerous barriers still exist;most notably, access and dissemination. Virtual reality (VR) may offer some solutions to existing constraints of EBPs for MDD. Objective: We aimed to examine the feasibility, acceptability, and tolerability of using VR as a method of delivering behavioral activation (BA) for adults diagnosed with MDD during a global pandemic and to explore for signs of clinical efficacy by comparing VR-enhanced BA (VR BA) to a standard BA treatment and a treatment as usual control group for individuals diagnosed with MDD. Methods: A feasibility trial using a 3-armed, unblinded, randomized controlled pilot design was conducted. The study took place remotely via Zoom telehealth visits between April 8, 2020, and January 15, 2021. This study used a 3-week, 4-session protocol in which VR BA participants used a VR headset to complete their BA homework. Feasibility was measured using dropout rates, serious adverse events, completion of homework, an adapted telepresence scale, the Simulator Sickness Questionnaire, the Brief Agitation Measure, and an adapted Technology Acceptance Model. Efficacy was assessed using the Patient Health Questionnaire–9. Results: Of the 35 participants assessed for eligibility, 13 (37%) were randomized into VR BA (n=5, 38%), traditional BA (n=4, 31%), or a treatment as usual control (n=4, 31%). The mean age of the 13 participants (5/13, 38% male;7/13, 54% female;and 1/13, 8% nonbinary or third gender) was 35.4 (SD 12.3) years. This study demonstrated VR BA feasibility in participants with MDD through documented high levels of acceptability and tolerability while engaging in VR-induced pleasurable activities in conjunction with a brief BA protocol. No adverse events were reported. This study also illustrated that VR BA may have potential clinical utility for treating MDD, as the average VR BA participant’s clinical severity decreased by 5.67 points, signifying a clinically meaningful change in severity from a moderate to a mild level of depression as per the Patient Health Questionnaire–9 score. Conclusions: The findings of this study demonstrate that VR BA is safe and feasible to explore for the treatment of MDD. This study documented evidence that VR BA may be efficacious and justifies further examination in an adequately powered randomized controlled trial. This pilot study highlights the potential utility that VR technology may offer patients with MDD, especially those who have difficulty accessing real-world pleasant activities. In addition, for those having difficulty accessing care, VR BA could be adapted as a first step to help people improve their mood and increase their motivation while waiting to connect with a health care professional for other EBPs. Trial Registration: ClinicalTrials.gov NCT04268316;https://clinicaltrials.gov/ct2/show/NCT04268316 International Registered Report Identifier (IRRID): RR2-10.2196/24331

Understanding the Effect of the COVID-19 Pandemic on Substance Use Disorder Treatment Facility Operations and Patient Success: Evidence From Mississippi.

Background: The COVID-19 pandemic has led to disruptions in the provision of care at substance use disorder (SUD) treatment facilities. Stresses associated with the pandemic could also negatively impact treatment outcomes for clients. The aim of this study is to evaluate how SUD treatment facilities in Mississippi changed their operations following the start of the pandemic. The change in client success rates at the facilities is also assessed. Methods: An online survey was completed by 12 SUD treatment facilities in Mississippi between February and May 2021. Results: Generally, the facilities' capacity to provide treatment to clientele was moderately affected by the pandemic. Facilities in the sample also adapted a variety of policies to limit the spread of COVID-19. Changes in the services provided by facilities was observed in the survey responses. For client success rates reported by the facilities, there was a decrease in the number of facilities stating that more than 80% of their clients completed treatment across the pre- and post-pandemic periods. However, the number of facilities with more than 80% of their clients successfully finishing treatment has increased in recent months. Conclusions: To continue serving their clientele during the pandemic, facilities enacted COVID-19-related policies and began offering new services such as telehealth. Although client success rates decreased at the beginning of the pandemic, they have returned to pre-pandemic levels in recent months. Our results indicate that SUD treatment facilities and clients have improved in terms of giving and receiving care as the pandemic has progressed.

Investigating and addressing the immediate and long-term consequences of the COVID-19 pandemic on patients with substance use disorders: a scoping review and evidence map protocol

IntroductionThe COVID-19 pandemic has driven unprecedented social and economic reform in efforts to curb the impact of disease. Governments worldwide have legislated non-essential service shutdowns and adapted essential service provision in order to minimise face-to-face contact. We anticipate major consequences resulting from such policies, with marginalised populations expected to bear the greatest burden of such measures, especially those with substance use disorders (SUDs).Methods and analysisWe aim to conduct (1) a scoping review to summarise the available evidence evaluating the impact of the COVID-19 pandemic on patients with SUDs, and (2) an evidence map to visually plot and categorise the current available evidence evaluating the impact of COVID-19 on patients with SUDs to identify gaps in addressing high-risk populations.Ethics and disseminationEthics approval is not required for this scoping review as we plan to review publicly available data. This is part of a multistep project, whereby we intend to use the findings generated from this review in combination with data from an ongoing prospective cohort study our team is leading, encompassing over 2000 patients with SUDs receiving medication-assisted therapy in Ontario prior to and during the COVID-19 pandemic.