Patient and Clinician Perspectives on Adolescent Opioid Use Disorder Treatment During a Pandemic: One Step Back, but Two Forward?

Samuel W Stull,Andrea E Bonny,Erin R Mcknight

doi:10.2196/23463

Abstract

Opioid use disorder (OUD) is one of the most pressing public health problems in the United States and is highly prevalent among adolescents and young adults (AYAs). However, only a small percentage of AYAs with OUD ever receive treatment. Further, among those that do receive treatment, a substantial proportion of patients continue to struggle with OUD, and many prematurely drop out of treatment. These challenges have only been heightened in the face of the COVID-19 pandemic, but greater utilization of telehealth and mobile technologies by OUD patients may help counter these barriers, which ultimately may improve AYA OUD treatment in the postpandemic period. This viewpoint presents the perspective of a person in OUD recovery using online and mobile technology to support his own OUD recovery combined with thoughts from two clinicians supporting AYAs with OUD. Their perspectives may provide insights to help counter COVID-19–related consequences and offer clues to improving AYA OUD treatment in the long term.

Highlights

Over the last decade, opioid use disorder (OUD) has been among the most pressing public health problems for adolescents and young adults (AYAs) in the United States [1,2]
Recent changes in the OUD treatment landscape may help counter the negative impact of COVID-19, including federal policy changes decreasing restrictions on buprenorphine prescribing [6] and increased availability of online OUD recovery services
We focus our viewpoint piece on the implications of changes in treatment from in-person to online clinical care, telehealth, and peer support, as well as specific aspects of entering versus maintaining OUD recovery

Summary

Introduction

Opioid use disorder (OUD) has been among the most pressing public health problems for adolescents and young adults (AYAs) in the United States [1,2]. There is increased risk of severe COVID-19 illness among AYAs with OUD because many are immunocompromised due to smoking, chronic hepatitis, and HIV [5]. Recent changes in the OUD treatment landscape may help counter the negative impact of COVID-19, including federal policy changes decreasing restrictions on buprenorphine prescribing [6] and increased availability of online OUD recovery services. In understanding the implications of these policy-level changes, it is important to garner the perspective of stakeholders on the “ground level,” including clinicians providing OUD treatment and individuals in recovery. We focus our viewpoint piece on the implications of changes in treatment from in-person to online clinical care, telehealth, and peer support, as well as specific aspects of entering versus maintaining OUD recovery. JMIR Pediatr Parent 2020 | vol 3 | iss. 2 | e23463 | p. 1 (page number not for citation purposes)

Patient Perspective

Clinician Perspective

Findings

Conclusion