Article ; Online: Low Barrier Tele-Buprenorphine in the Time of COVID-19: A Case Report.
Journal of addiction medicine
2020 Volume 14, Issue 4, Page(s) e136–e138
Abstract: ... naloxone provider, but access was limited due to COVID-19, so he was using diverted buprenorphine/naloxone ... follow-up 16 days later.: Conclusions: COVID-19-related regulatory changes allow buprenorphine ... Background: To reduce the spread of coronavirus disease 2019 (COVID-19 ...
| Abstract | Background: To reduce the spread of coronavirus disease 2019 (COVID-19), many substance use disorder treatment programs have transitioned to telemedicine. Emergency regulatory changes allow buprenorphine initiation without an in-person visit. We describe the use of videoconferencing for buprenorphine initiation combined with street outreach to engage 2 patients experiencing homelessness with severe opioid use disorder (OUD). Case presentation: Patient 1 was a 30-year-old man with severe OUD who had relapsed to injection heroin/fentanyl after incarceration. A community drop-in center outreach harm reduction specialist facilitated a videoconference with an addiction specialist at an OUD bridge clinic. The patient completed a community buprenorphine/naloxone initiation and self-titrated to his prior dose, 8/2 mg twice daily. One week later, he reconnected with the outreach team for a follow-up videoconference visit. Patient 2, a 36-year-old man with severe OUD, connected to the addiction specialist via a syringe service program harm reduction specialist. He had been trying to connect to a community buprenorphine/naloxone provider, but access was limited due to COVID-19, so he was using diverted buprenorphine/naloxone to reduce opioid use. He was restarted on his previous dose of 12/3 mg daily which was continued via phone follow-up 16 days later. Conclusions: COVID-19-related regulatory changes allow buprenorphine initiation via telemedicine. We describe 2 cases where telemedicine was combined with street outreach to connect patients experiencing homelessness with OUD to treatment. These cases highlight an important opportunity to provide access to life-saving OUD treatment for vulnerable patients in the setting of a pandemic that mandates reduced face-to-face clinical interactions. |
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| MeSH term(s) | Adult ; Betacoronavirus ; Buprenorphine/administration & dosage ; Buprenorphine, Naloxone Drug Combination/therapeutic use ; COVID-19 ; Coronavirus Infections/epidemiology ; Homeless Persons ; Humans ; Male ; Narcotic Antagonists/administration & dosage ; Opiate Substitution Treatment/methods ; Opioid-Related Disorders/therapy ; Organizational Innovation ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Substance Abuse Treatment Centers/methods ; Substance Abuse Treatment Centers/organization & administration ; Telecommunications/organization & administration ; Telemedicine/methods ; Telemedicine/organization & administration |
| Chemical Substances | Buprenorphine, Naloxone Drug Combination ; Narcotic Antagonists ; Buprenorphine (40D3SCR4GZ) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-04-30 |
| Publishing country | United States |
| Document type | Case Reports ; Journal Article |
| ISSN | 1935-3227 |
| ISSN (online) | 1935-3227 |
| DOI | 10.1097/ADM.0000000000000682 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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