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Opioid use disorder treatment disruptions during the early COVID-19 pandemic and other emergent disasters: a scoping review addressing dual public health emergencies.
Henderson, Rita; McInnes, Ashley; Mackey, Leslee; Bruised Head, Myles; Crowshoe, Lindsay; Hann, Jessica; Hayward, Jake; Holroyd, Brian R; Lang, Eddy; Larson, Bonnie; Leonard, Ashley Jane; Persaud, Steven; Raghavji, Khalil; Sarin, Chris; Virani, Hakique; Wadsworth, Iskotoahka William; Whitman, Stacey; McLane, Patrick.
  • Henderson R; Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. rihender@ucalgary.ca.
  • McInnes A; Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
  • Mackey L; Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.
  • Bruised Head M; Blood Tribe, Stand Off, Canada.
  • Crowshoe L; Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
  • Hann J; Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.
  • Hayward J; Addiction Recovery and Community Health (ARCH) Team, Royal Alexandra Hospital, 10240 Kingsway NW, Edmonton, AB, T5H 3V9, Canada.
  • Holroyd BR; Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.
  • Lang E; Department of Emergency Medicine, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada.
  • Larson B; Emergency Strategic Clinical Network, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada.
  • Leonard AJ; Emergency Strategic Clinical Network, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada.
  • Persaud S; Department of Emergency Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
  • Raghavji K; Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
  • Sarin C; Knowledge Resource Service, Alberta Health Services, 10030 - 107 St NW, Edmonton, AB, T5J 3E4, Canada.
  • Virani H; Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
  • Wadsworth IW; Metro City Medical Clinic, 150 - 909 5 Ave SW, Calgary, AB, T2P 3G5, Canada.
  • Whitman S; Indigenous Services Canada, Suite 730, 9700 Jasper Avenue, Edmonton, AB, T5J 4C3, Canada.
  • McLane P; Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
BMC Public Health ; 21(1): 1471, 2021 07 28.
Article in English | MEDLINE | ID: covidwho-1331935
ABSTRACT

BACKGROUND:

During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions. How do public health emergencies impact PWOUD? How can health systems respond to novel public health emergencies to serve PWOUD? How can the results of this scoping review be contextualized to the province of Alberta to inform local stakeholder responses to the pandemic?

METHODS:

We conducted a scoping review using the 6-stage Arksey and O'Malley framework to analyse early-pandemic and pre-pandemic disaster literature. The results of the scoping review were contextualized to the local pandemic response, through a Nominal Group Technique (NGT) process with frontline providers and stakeholders in Alberta, Canada.

RESULTS:

Sixty one scientific journal articles and 72 grey literature resources were included after full-text screening. Forty sources pertained to early COVID-19 responses, and 21 focused on OUD treatment during other disasters. PWOUD may be more impacted than the general population by common COVID-19 stressors including loss of income, isolation, lack of rewarding activities, housing instability, as well as fear and anxiety. They may also face unique challenges including threats to drug supplies, stigma, difficulty accessing clean substance use supplies, and closure of substance use treatment centres. All of these impacts put PWOUD at risk of negative outcomes including fatal overdose. Two NGT groups were held. One group (n = 7) represented voices from urban services, and the other (n = 4) Indigenous contexts. Stakeholders suggested that simultaneous attention to multiple crises, with adequate resources to allow attention to both social and health systems issues, can prepare a system to serve PWOUD during disasters.

CONCLUSION:

This scoping review and NGT study uncovers how disasters impact PWOUD and offers suggestions for better serving PWOUD.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Disasters / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11495-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Disasters / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11495-0