A rapid review of Opioid Substitution Therapy during major disruptions to medical care
Background The recent months have seen a collision of two severe and complex health crises: the novel COVID‑19 pandemic and the persistent epidemic of opioid related harms. Individuals living with opioid use disorder (OUD) are vulnerable to the pandemic and the changes it has caused. Opioid substitution therapy (OST) is first-line therapy for OUD and can be life-saving. It requires regular and frequent visits with health care providers, and thus has been affected by the requirements for physical distancing. Medication and drug supplies have also be disrupted during this pandemic. The risks of withdrawal, overdose, and diversion of opioids have increased so there is an urgent need to change existing ways to provide OST and support people with OUD. Research goals We aim to examine the perspectives and experience of opioid users and providers during times of disruptions to medical care. We also will look at how other OST programs have adapted during disruptions to care and alternative ways OST can be provided, such as virtual visits. Methods Because there is a lack of studies that examine the perspectives and experiences of people with OUD and providers of OST during COVID-19, we will do a rapid review of the literature on the impact of medical disruptions such as natural disasters or human conflicts on OST. Instead of launching a new search, we will instead use relevant data sets that we and our collaborators have already created for other reviews about OST. This non-traditional approach will improve the speed of the review and allow us to be more responsive to the pandemic. Impact We will work closely with government and health care decision makers from multiple provinces to apply lessons about how to change OST during and after the pandemic to better improve the health of people who use opioids. We will share our findings through multiple channels, including publishing in scientific journals.