Take home injectable opioids for opioid use disorder during and after the COVID-19 Pandemic is in urgent need: a case study

Case study
by
Oviedo-Joekes, Eugenia et al

Release Date

2021

Geography

Canada

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

In this case it is presented and discussed that if a carry was possible during the pandemic, then the carry could continue post COVID-19 to address a gap in our approach to individualize care for people with OUD receiving iOAT.

Findings/Key points

Demonstrates that it is feasible to provide iOAT outside the community clinic with no apparent negative consequences. Improving upon and making permanent these recently introduced risk mitigating guidance during COVID, we have the potential not just to protect during the pandemic, but also to address long-overdue barriers to access evidence-based care in addiction tx. This presents an opportunity to consider carries for clients that have shown (1) willingness to record or adhering to meds (2) evidence the pt will tolerate the dose for the time consumed and (3) pts needs and preferences re coming to clinic due to physical health, in this case, that makes it difficult to daily access the site where trusted connections w the HC system are located. ED providing as close to a pharmaceutical agent to what pts are using in the street can be a way to support them staying engaged. This might allow to meet patient’s most immediate medical needs. Flexibility and pt centred care deployed here were crucial. While most of the emphasis in research and policy has been around tougher measures of control or increased pt monitoring, it has come at the expense of pt autonomy. Understand the specific circumstances of the pt as a whole and addressing other needs (when possible) that could be interfering w the tx and leading to the diversion of the med would be pt centred strategy. Lack of equity, restrictive policies (leaves iOAT out). Allowing flexibility based on indiv assessment anchored in PCC can support pts’ needs and qual of care. A public health emergency requires a comprehensive response that embraces innovation while exhausting evidence-based approaches. As long as processes are in place to support pt and community, in a sustainable way. Pandemic bringing us opportunities to reduce OD by improving tx and enhancing linkage to care & address long-overdue barriers to access evidence-based care in addiction tx

Design/methods

n=1 Case study: DCM to self isolate in appproved side w COVID during visit to ED (cellulitis admitted)

Keywords

Harm reduction
Policy/Regulatory
Safer supply
Outcomes
Injecting drugs
Diversion
Carries/take-home doses