According to an Ideas and Opinions article published in the Annals of Internal Medicine (2 April 2020), the government needs to do more to help patients with opioid use disorder (OUD) to weather the COVID-19 pandemic. William Becker, MD, and David Fiellen, MD, both of the Yale Program in Addiction Medicine and Yale School of Medicine, argue that “Treatment systems need to facilitate uninterrupted access to the most effective medications for OUD treatment: methadone and buprenorphine.” Important changes they suggest include: expanded methadone via mobile teams for quarantined patients; increased use of buprenorphine because of its more favorable safety profile; temporary removal on the limit of number of buprenorphine patients an individual prescriber may treat; and elimination of federal training requirements “to allow emergency medicine and hospitalist clinicians without waivers to write buprenorphine prescriptions at discharge to provide enough medication for patients to become engaged in outpatient treatment.”
“Bold efforts are needed to reduce the adverse effect that COVID-19 will have on progress in addressing opioid-related morbidity and mortality,” the authors write. “In the absence of such efforts, we risk more catastrophic effects from these colliding epidemics.”
Becker WC, Fiellin DA. When epidemics collide: coronavirus disease 2019 (COVID-19) and the opioid crisis. Ann Intern Med. April 2, 2020 [Epub ahead of print]. doi: 10.7326/M20-1210.