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Abstract
BackgroundCitizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks.Main bodyRenewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three “best buys” of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information.ConclusionThe heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.
Highlights
How to prevent new stigmatization and even take advantage of the new opportunities: seven pillars New clinical approaches implemented during the pandemic have helped to mitigate its impact on substance use disorders (SUDs) treatment
A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs
Will they remain after the COVID-19 pandemic? We strongly advocate taking advantage of innovations initiated during the pandemic and continuing to develop them in a post-COVID-19 world
Summary
The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. The COVID-19 pandemic and associated economic recession are causing isolation, unemployment, boredom, and emotional distress, factors that we know impact negatively and increase alcohol and other drug use [21,22,23]. Elective surgery and other interventions that have been put on hold during the pandemic will require increased resources to clear the backlog In this scenario, governing politicians may be tempted to relegate SUD treatment to the end of the queue, even though this would be a “false economy,” as the problems are likely to be displaced onto already overstretched emergency services and acute hospitals [32]
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