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Author Notes:

Minhee L. Sung, MD, VA Health Services Research & Development Fellow; 950 Campbell Avenue, Bldg. 35A, Room 2-234, West Haven, CT 06516. E-mail: minhee.sung@yale.edu; Twitter: @ sung_minhee

We would like to acknowledge E. Chandra Fincke for his contributions in survey design and implementation.

The authors report no conflicts of interest.

Subjects:

Research Funding:

Dr. Levin was funded by NIDA (grant #K24 DA029647) and Dr. Henry was funded through NIDA (grant T32DA037801) during the conduct of this work.

Keywords:

  • Adult
  • Analgesics, Opioid
  • Buprenorphine
  • COVID-19
  • Female
  • Humans
  • Male
  • Naltrexone
  • Opiate Substitution Treatment
  • Opioid-Related Disorders
  • Pandemics

Adaptations to Opioid Use Disorder Care During the COVID-19 Pandemic: A National Survey of Prescribers

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Journal Title:

Journal of Addiction Medicine

Volume:

Volume 16, Number 5

Publisher:

, Pages 505-513

Type of Work:

Article | Final Publisher PDF

Abstract:

Objectives: Among opioid use disorder (OUD)-treating providers, to characterize adaptations used to provide medications for OUD (MOUD) and factors associated with desire to continue virtual visits post-COVID-19 pandemic. Methods: In a national electronic survey of OUD-treating prescribers (July-August 2020), analyses restricted to X-waivered buprenorphine prescribers providing outpatient, longitudinal care for adults with OUD, quantitative and qualitative analyses of survey items and free text responses were conducted. Results: Among 797 respondents, 49% were men, 57% ≥50 years, 76% White, 68% physicians. Respondents widely used virtual visits to continue prescribing existing MOUD regimens (79%), provide behavioral healthcare (71%), and initiate new MOUD prescriptions (49%). Most prescribers preferred to continue/expand use of virtual visits after COVID-19. In multivariable models, factors associated with preference to continue/expand virtual visits to initiate MOUD postpandemic were treating a moderate number of patients prepandemic (aOR = 1.67; 95%[CI] = 1.06,2.62) and practicing in an urban setting (aOR = 2.17; 95%[CI] = 1.48,3.18). Prescribing buprenorphine prepandemic (aOR = 2.06; 95%[CI] = 1.11,3.82) and working in an academic medical center (aOR = 2.47; 95%[CI] = 1.30,4.68) were associated with preference to continue/expand use of virtual visits to continue MOUD postpandemic. Prescribing naltrexone extended-release injection prepandemic was associated with preference to continue/expand virtual visits to initiate and continue MOUD (aOR = 1.51; 95%[CI] = 1.10,2.07; aOR = 1.74; 95%[CI] = 1.19,2.54). Qualitative findings suggest that providers appreciated virtual visits due to convenience and patient accessibility, but were concerned about liability and technological barriers. Conclusions: Surveyed prescribers widely used virtual visits to provide MOUD with overall positive experiences. Future studies should evaluate the impact of virtual visits on MOUD access and retention and clinical outcomes.

Copyright information:

© 2022 American Society of Addiction Medicine

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