Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis
•After COVID-19, enrolment in MOUD increased immediately followed by a gradual decline.•The impact of COVID-19 policies on enrolment in individual MOUD was mixed.•RMG practices may have contributed to support retention in MOUD. In anticipation of COVID-19 related disruptions to opioid use disorder (...
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| Veröffentlicht in: | The International journal of drug policy 2023-08, Vol.118, p.104075-104075, Article 104075 |
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| container_title | The International journal of drug policy |
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| creator | Eugenia Socias, M. Choi, Jin Cheol Fairbairn, Nadia Johnson, Cheyenne Wilson, Dean Debeck, Kora Brar, Rupinder Hayashi, Kanna |
| description | •After COVID-19, enrolment in MOUD increased immediately followed by a gradual decline.•The impact of COVID-19 policies on enrolment in individual MOUD was mixed.•RMG practices may have contributed to support retention in MOUD.
In anticipation of COVID-19 related disruptions to opioid use disorder (OUD) care, new provincial and federal guidance for the management of OUD and risk mitigation guidance (RMG) for prescription of pharmaceutical opioids were introduced in British Columbia, Canada, in March 2020. This study evaluated the combined impacts of the COVID-19 pandemic and counteracting OUD policies on enrollment in medications for OUD (MOUD).
Using data from three cohorts of people with presumed OUD in Vancouver, we conducted an interrupted time series analysis to estimate the combined effects impact of the COVID-19 pandemic and counteracting OUD policies on the prevalence of enrollment in MOUD overall, as well as in individual MOUDs (methadone, buprenorphine/naloxone, slow-release oral morphine) between November 2018 and November 2021, controlling for pre-existing trends. In sub-analysis we considered RMG opioids together with MOUD.
We included 760 participants with presumed OUD. In the post-COVID-19 period, MOUD and slow-release oral morphine prevalence rates showed an estimated immediate increase in level (+7.6%, 95% CI: 0.6%, 14.6% and 1.8%, 95% CI: 0.3%, 3.3%, respectively), followed by a decline in the monthly trend (-0.8% per month, 95% CI: −1.4%, −0.2% and −0.2% per month, 95% CI: −0.4, −0.1, respectively). There were no significant changes in the prevalence trends of enrollment in methadone, buprenorphine/naloxone, or when RMG opioids were considered together with MOUD.
Despite immediate improvements in MOUD enrollment in the post-COVID-19 period, this beneficial trend reversed over time. RMG opioids appeared to have provided additional benefits to sustain retention in OUD care. |
| doi_str_mv | 10.1016/j.drugpo.2023.104075 |
| format | Article |
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In anticipation of COVID-19 related disruptions to opioid use disorder (OUD) care, new provincial and federal guidance for the management of OUD and risk mitigation guidance (RMG) for prescription of pharmaceutical opioids were introduced in British Columbia, Canada, in March 2020. This study evaluated the combined impacts of the COVID-19 pandemic and counteracting OUD policies on enrollment in medications for OUD (MOUD).
Using data from three cohorts of people with presumed OUD in Vancouver, we conducted an interrupted time series analysis to estimate the combined effects impact of the COVID-19 pandemic and counteracting OUD policies on the prevalence of enrollment in MOUD overall, as well as in individual MOUDs (methadone, buprenorphine/naloxone, slow-release oral morphine) between November 2018 and November 2021, controlling for pre-existing trends. In sub-analysis we considered RMG opioids together with MOUD.
We included 760 participants with presumed OUD. In the post-COVID-19 period, MOUD and slow-release oral morphine prevalence rates showed an estimated immediate increase in level (+7.6%, 95% CI: 0.6%, 14.6% and 1.8%, 95% CI: 0.3%, 3.3%, respectively), followed by a decline in the monthly trend (-0.8% per month, 95% CI: −1.4%, −0.2% and −0.2% per month, 95% CI: −0.4, −0.1, respectively). There were no significant changes in the prevalence trends of enrollment in methadone, buprenorphine/naloxone, or when RMG opioids were considered together with MOUD.
Despite immediate improvements in MOUD enrollment in the post-COVID-19 period, this beneficial trend reversed over time. RMG opioids appeared to have provided additional benefits to sustain retention in OUD care.</description><identifier>ISSN: 0955-3959</identifier><identifier>EISSN: 1873-4758</identifier><identifier>DOI: 10.1016/j.drugpo.2023.104075</identifier><identifier>PMID: 37271070</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Buprenorphine/naloxone ; COVID-19 ; Medications for opioid use disorder ; Methadone ; Research Paper ; Safer supply ; Slow-release oral morphine</subject><ispartof>The International journal of drug policy, 2023-08, Vol.118, p.104075-104075, Article 104075</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.</rights><rights>2023 The Author(s). Published by Elsevier B.V. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-6004bf2a78b578859b626fd087098916943b688de2f80fe3a9ea757ace426aba3</citedby><cites>FETCH-LOGICAL-c464t-6004bf2a78b578859b626fd087098916943b688de2f80fe3a9ea757ace426aba3</cites><orcidid>0000-0003-2556-7049 ; 0000-0003-2045-1653 ; 0000-0003-3843-2928</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0955395923001238$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37271070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eugenia Socias, M.</creatorcontrib><creatorcontrib>Choi, Jin Cheol</creatorcontrib><creatorcontrib>Fairbairn, Nadia</creatorcontrib><creatorcontrib>Johnson, Cheyenne</creatorcontrib><creatorcontrib>Wilson, Dean</creatorcontrib><creatorcontrib>Debeck, Kora</creatorcontrib><creatorcontrib>Brar, Rupinder</creatorcontrib><creatorcontrib>Hayashi, Kanna</creatorcontrib><title>Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis</title><title>The International journal of drug policy</title><addtitle>Int J Drug Policy</addtitle><description>•After COVID-19, enrolment in MOUD increased immediately followed by a gradual decline.•The impact of COVID-19 policies on enrolment in individual MOUD was mixed.•RMG practices may have contributed to support retention in MOUD.
In anticipation of COVID-19 related disruptions to opioid use disorder (OUD) care, new provincial and federal guidance for the management of OUD and risk mitigation guidance (RMG) for prescription of pharmaceutical opioids were introduced in British Columbia, Canada, in March 2020. This study evaluated the combined impacts of the COVID-19 pandemic and counteracting OUD policies on enrollment in medications for OUD (MOUD).
Using data from three cohorts of people with presumed OUD in Vancouver, we conducted an interrupted time series analysis to estimate the combined effects impact of the COVID-19 pandemic and counteracting OUD policies on the prevalence of enrollment in MOUD overall, as well as in individual MOUDs (methadone, buprenorphine/naloxone, slow-release oral morphine) between November 2018 and November 2021, controlling for pre-existing trends. In sub-analysis we considered RMG opioids together with MOUD.
We included 760 participants with presumed OUD. In the post-COVID-19 period, MOUD and slow-release oral morphine prevalence rates showed an estimated immediate increase in level (+7.6%, 95% CI: 0.6%, 14.6% and 1.8%, 95% CI: 0.3%, 3.3%, respectively), followed by a decline in the monthly trend (-0.8% per month, 95% CI: −1.4%, −0.2% and −0.2% per month, 95% CI: −0.4, −0.1, respectively). There were no significant changes in the prevalence trends of enrollment in methadone, buprenorphine/naloxone, or when RMG opioids were considered together with MOUD.
Despite immediate improvements in MOUD enrollment in the post-COVID-19 period, this beneficial trend reversed over time. RMG opioids appeared to have provided additional benefits to sustain retention in OUD care.</description><subject>Buprenorphine/naloxone</subject><subject>COVID-19</subject><subject>Medications for opioid use disorder</subject><subject>Methadone</subject><subject>Research Paper</subject><subject>Safer supply</subject><subject>Slow-release oral morphine</subject><issn>0955-3959</issn><issn>1873-4758</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kd1u1DAQhSMEotvCGyDkyyKRxXZ-bHMBqrb8rFS0N7S3lmNPWq8SO9jOSn0RnrdepVRww5Ulzzdn5swpijcErwkm7Yf92oT5dvJrimmVv2rMmmfFinBWlTVr-PNihUXTlJVoxElxGuMeY1yTmrwsTipGGcEMr4rf23FSOkXke5TuAG12N9vLkgg0KWdgtBp5h8AFPwwjuISsQyMYq1Wy3kXU-4D8ZL01aI6AjI0-GAjo_Mfu-vLdkb5RTvv5AOE92iinjPqILlwuJAhhnhIYlOwIKEKwEFEmhvto46viRa-GCK8f37Pi-uuXn5vv5dXu23ZzcVXquq1T2WZHXU8V413DOG9E19K2N5gzLLggrairruXcAO057qFSAhRrmNJQ01Z1qjorPi-609xlXzpbDGqQU7CjCvfSKyv_rTh7J2_9QRJMMakIzwrnjwrB_5ohJjnaqGEYlAM_R0k5pXkb2oiM1guqg48xQP80h2B5zFTu5ZKpPGYql0xz29u_d3xq-hNiBj4tAORLHSwEGbUFp3NOAXSSxtv_T3gAQ822Iw</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Eugenia Socias, M.</creator><creator>Choi, Jin Cheol</creator><creator>Fairbairn, Nadia</creator><creator>Johnson, Cheyenne</creator><creator>Wilson, Dean</creator><creator>Debeck, Kora</creator><creator>Brar, Rupinder</creator><creator>Hayashi, Kanna</creator><general>Elsevier B.V</general><general>The Author(s). Published by Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2556-7049</orcidid><orcidid>https://orcid.org/0000-0003-2045-1653</orcidid><orcidid>https://orcid.org/0000-0003-3843-2928</orcidid></search><sort><creationdate>20230801</creationdate><title>Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis</title><author>Eugenia Socias, M. ; Choi, Jin Cheol ; Fairbairn, Nadia ; Johnson, Cheyenne ; Wilson, Dean ; Debeck, Kora ; Brar, Rupinder ; Hayashi, Kanna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-6004bf2a78b578859b626fd087098916943b688de2f80fe3a9ea757ace426aba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Buprenorphine/naloxone</topic><topic>COVID-19</topic><topic>Medications for opioid use disorder</topic><topic>Methadone</topic><topic>Research Paper</topic><topic>Safer supply</topic><topic>Slow-release oral morphine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eugenia Socias, M.</creatorcontrib><creatorcontrib>Choi, Jin Cheol</creatorcontrib><creatorcontrib>Fairbairn, Nadia</creatorcontrib><creatorcontrib>Johnson, Cheyenne</creatorcontrib><creatorcontrib>Wilson, Dean</creatorcontrib><creatorcontrib>Debeck, Kora</creatorcontrib><creatorcontrib>Brar, Rupinder</creatorcontrib><creatorcontrib>Hayashi, Kanna</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The International journal of drug policy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eugenia Socias, M.</au><au>Choi, Jin Cheol</au><au>Fairbairn, Nadia</au><au>Johnson, Cheyenne</au><au>Wilson, Dean</au><au>Debeck, Kora</au><au>Brar, Rupinder</au><au>Hayashi, Kanna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis</atitle><jtitle>The International journal of drug policy</jtitle><addtitle>Int J Drug Policy</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>118</volume><spage>104075</spage><epage>104075</epage><pages>104075-104075</pages><artnum>104075</artnum><issn>0955-3959</issn><eissn>1873-4758</eissn><abstract>•After COVID-19, enrolment in MOUD increased immediately followed by a gradual decline.•The impact of COVID-19 policies on enrolment in individual MOUD was mixed.•RMG practices may have contributed to support retention in MOUD.
In anticipation of COVID-19 related disruptions to opioid use disorder (OUD) care, new provincial and federal guidance for the management of OUD and risk mitigation guidance (RMG) for prescription of pharmaceutical opioids were introduced in British Columbia, Canada, in March 2020. This study evaluated the combined impacts of the COVID-19 pandemic and counteracting OUD policies on enrollment in medications for OUD (MOUD).
Using data from three cohorts of people with presumed OUD in Vancouver, we conducted an interrupted time series analysis to estimate the combined effects impact of the COVID-19 pandemic and counteracting OUD policies on the prevalence of enrollment in MOUD overall, as well as in individual MOUDs (methadone, buprenorphine/naloxone, slow-release oral morphine) between November 2018 and November 2021, controlling for pre-existing trends. In sub-analysis we considered RMG opioids together with MOUD.
We included 760 participants with presumed OUD. In the post-COVID-19 period, MOUD and slow-release oral morphine prevalence rates showed an estimated immediate increase in level (+7.6%, 95% CI: 0.6%, 14.6% and 1.8%, 95% CI: 0.3%, 3.3%, respectively), followed by a decline in the monthly trend (-0.8% per month, 95% CI: −1.4%, −0.2% and −0.2% per month, 95% CI: −0.4, −0.1, respectively). There were no significant changes in the prevalence trends of enrollment in methadone, buprenorphine/naloxone, or when RMG opioids were considered together with MOUD.
Despite immediate improvements in MOUD enrollment in the post-COVID-19 period, this beneficial trend reversed over time. RMG opioids appeared to have provided additional benefits to sustain retention in OUD care.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37271070</pmid><doi>10.1016/j.drugpo.2023.104075</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2556-7049</orcidid><orcidid>https://orcid.org/0000-0003-2045-1653</orcidid><orcidid>https://orcid.org/0000-0003-3843-2928</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elsevier ScienceDirect Journals |
| subjects | Buprenorphine/naloxone COVID-19 Medications for opioid use disorder Methadone Research Paper Safer supply Slow-release oral morphine |
| title | Impacts of the COVID-19 pandemic on enrollment in medications for opioid use disorder (MOUD) in Vancouver, Canada: An interrupted time series analysis |
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