States take action to ensure safe use of drugs for opioid use disorders during pandemic
This article is one in a series exploring the state’s efforts to ensure that people with OCD continue to receive safe treatment during the pandemic.
As states grapple with an opioid crisis that can get worse Due to the COVID-19 pandemic, policymakers are introducing innovative approaches to ensure that treatment for people with opioid use disorder (OUD) can be provided safely. For example, some states are taking steps to help patients access these FDA-approved drugs despite physical distancing requirements that have forced changes in treatment regimens and people’s interactions with the healthcare system.
For example, Indiana announcement in March that it will provide safes for the increased number of people who now take longer-term doses of OUD drugs at home so that they no longer have to risk exposure to the coronavirus by picking up their treatment daily. The boxes, intended to ensure that this larger amount of medication does not fall into the hands of anyone other than the patient, are supplied with the naloxone overdose reversal medication as an additional safety measure.
Colorado, meanwhile, plans to use federal grants to pay for PO boxes and take-out medicine bottles provide similar guarantees while also encouraging the distribution of naloxone. And Massachusetts has promised to support opioid treatment programs (OTPs) – state and federally regulated establishments that offer certain OUD drugs – by providing safes.
As the coronavirus continues to spread nationwide, OUD patients need to minimize the time spent traveling to and within their OTPs. Before the public health emergency, federal regulations required many people to take their daily dose of medication under supervision at these clinics. Nonetheless, as determined by the medical directors of the Office of the Prosecutor and in accordance with federal guidelines, patients could take home a multi-day or week-long supply, known as take-home doses, under specific circumstances.
In response to the pandemic, the federal government has given states more flexibility with OTP rules to ensure that people with OUD can still receive treatment. Essentially, the pool of patients eligible for take-home doses has grown. OTP practitioners can now give patients in the early stages of their recovery up to two weeks of medication. Patients who are stable on their medications may receive up to 28 days of take-home doses.
The new rules reflect the dangers posed by COVID-19. When determining how many doses to take home, clinicians should also consider whether patients have been diagnosed with the disease, have been exposed to it, or have any co-morbidities that put them at high risk if they become ill. Patients need to make frequent phone recordings and attend some in-person meetings, depending on how often they met their practitioners before the pandemic.
How safes work
In general, the take-home dosage allows providers to tailor treatment to the needs of the patient. Expanding these policies during the pandemic means greater flexibility to protect patient health and safety. However, it also means they have to accept more risk by storing drugs at home, a risk comparable to having prescription pain relievers in a residence. Federal Substance Abuse and Mental Health Services Administration (SAMHSA) requirements for home dosing assesses the risk of drug diversion and recommends that patients take steps to prevent accidental ingestion, including by children.
Safes should help reduce these risks. In Indiana, the state provides OTPs with specially designed medicine boxes with four-digit combination locks to be set by each patient. In other states, PO boxes can be any container that the patient locks with a key or combination code. Either way, the boxes can keep prescriptions, including OUD medications, safe from people other than the patient, whether at home or while traveling to and from the OTP.
Before the government increased flexibility in response to the COVID-19 public health emergency, medical directors in the Prosecutor’s Office weighed factors such as length of treatment, regular clinic attendance, lack of criminal activity, the ability to safely store drugs, and the stability of the home environment to decide whether or not to allow take-out doses. Providers now have more options to tailor treatment in addition to these factors.
The process and reduced visits to the CNP may require additional insurance for patients. For example, Dr Robert Sherrick, Chief Medical Officer of Community Medical Services (CMS) in Kalispell, MT, said his office takes “a highly individualized approach” with each OUD patient to decide on the best dosing schedule and how to proceed. make sure that person does. not to feel abandoned during the pandemic. CMS requires PO boxes for doses of one week or more, in accordance with SAMHSA guidelines.
The goal is continuous and consistent care. “We’re not going anywhere,” Sherrick said.
Jennifer Mason, vice president of CMS in Peoria, Ariz., Said the safes could help people feel more comfortable taking medication home. “Our priority,” she said, “is to ensure the safety of people.”
The ability of states such as Indiana, Colorado, and Massachusetts to provide safes and other security measures may depend on federal guidance during and beyond the pandemic, but these are important strategies for supporting patients in their recovery as the nation continues the dual fight against opioid abuse and COVID-19.
Beth Connolly is the project director and Alaina McBournie is the Pew Substance Abuse Prevention and Treatment Initiative Officer.