Addiction Treatment Pivots for Coronavirus
Helping patients stay in recovery from an opioid addiction was never easy. The coronavirus crisis made it harder.
Nationwide, addiction treatment clinics are expanding their hours, hiring more staff to take people’s temperatures, providing home delivery and curbside pickup for medication, and revamping procedures to limit human contact in what has been a high-touch health care service.
Without more money, the cost of retooling their services could put some providers out of business.
At West Midtown Medical Group, a methadone clinic in Manhattan, New York, the once-routine business of providing roughly 900 patients a daily cup of lifesaving addiction medicine has been upended.
Allegra Schorr, one of the clinic’s owners, predicts much more change in the weeks ahead.
“The reality is that there are just no good answers here,” Schorr said. “Every day we use our best clinical judgement to limit transmission of the virus. But at the same time, we’re trying to keep our patients in treatment and protect them from overdose. It’s a balancing act, and it’s extremely challenging.”
In mid-March, the federal agencies that regulate addiction treatment medications methadone and buprenorphine temporarily loosened some long-standing rules.
The two medications, both narcotics, have been shown to be at least twice as effective at helping people stay in recovery from opioid addiction as therapies that do not include medications. (A third medication approved by the U.S. Food and Drug Administration, naltrexone, sold in injectable form as Vivitrol, is not a controlled substance and doctors do not need a special license to prescribe it.)
The Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration ruled that methadone clinics could allow most patients to take home several days’ or weeks’ worth of medication, packaged in individual doses, instead of requiring them to show up at a clinic every day and risk exposure to the virus.
And the DEA gave physicians and nurses authorized to prescribe buprenorphine, which patients can take at home, the flexibility to begin patients on the drug using telemedicine and phones instead of an in-person visit, which has been required.
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