COVID & Opioid-Use Disorder (OUD)
In 2015, Dr. D'Onofrio and her team at Yale published a landmark article in JAMA (https://jamanetwork.com/journals/jama/fullarticle/2279713) and paved the way for initiating buprenorphine in the ED for patients with opioid use disorder (OUD). In this recently published article in NEJM Catalyst, the authors describe the impact COVID 19 has had on patients with OUD and highlight opportunities to accelerate reform to end the quality gap that currently exists in ED-based treatment of OUD.
Article link
Highlights:
COVID-19 is correlated with an increase in opioid-related mortality across the US based on data from May 2020
Access to care, treatment options, and harm-reduction strategies for patients with opioid use disorder (OUD) have been severely limited due to the pandemic
Due to limited access to resources during the pandemic, more patients are likely to turn to the ED for access to care, and it is imperative that addressing OUD in the ED with evidence-based treatments is no longer optional
Efforts to eliminate barriers to treatment need to be taken, such as eliminating mandatory X-waiver training to prescribe buprenorphine, supporting telemedicine visits for medication assisted therapy (i.e. buprenorphine, methadone) and mental health outreach, and streamlining protocols in a quality improvement framework
National adoption of quality and accountability measures, residency education, and institutional, regulatory, and legislative support are required for this much-needed practice change to address the quality gap in current ED-based OUD treatment