Trends of Buprenorphine Prescribing for Opioid Dependence Before, and During the Early and Later Part of the COVID-19: A Study from a Large Publicly-Funded Opioid Agonist Treatment Services in India.
Abhishek Ghosh, Debasish Basu, Simranjit Kaur, Shalini S Naik, Subodh Bn, S K Mattoo
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Abstract
Background: The COVID-19 pandemic has affected the availability and access to medications for opioid dependence (OD). We examined the monthly trends in new buprenorphine/naloxone (BNX) treatment episodes, number of clinical visits for BNX, BNX dispensed per person, and BNX prescription over 56-month, which included pre-pandemic, during early, and later part of pandemic (Jan 2017 - Aug 2022).
Methods: Research data were collected from the pharmacy database of a large publicly funded treatment center in India. A flexible, low-threshold service was adopted in April 2020 in response to the lockdown implemented on 25 March 2020. Change Point analyses were performed to examine monthly trends visually and statistically. We used Autoregressive integrated moving averages to forecast trends from April to Aug 2020 and March to August 2022, using Jan 2017 to March 2020 and March 2020 to February 2022 as training datasets.
Results: 993 patients were started on BNX treatment, 40452 BNX clinic attendances were made, 1401393 BNX tablets were dispensed, and 6795 new patients with OD were registered. The observed data for clinic attendance for BNX was significantly lower than the projected estimates in April -Aug 2020; however, observed new treatment episodes and monthly BNX prescriptions were within the 95% projected estimates; BNX dispensed per person was significantly more than the projected estimate. In contrast, observed BNX prescription trends surpassed the upper limit of 95% CI in March-Aug 2022.
Conclusion: A low-threshold and flexible treatment service could mitigate the unintended consequences of pandemic-induced restrictions.
期刊介绍：
The Journal of Studies on Alcohol and Drugs began in 1940 as the Quarterly Journal of Studies on Alcohol. It was founded by Howard W. Haggard, M.D., director of Yale University’s Laboratory of Applied Physiology. Dr. Haggard was a physiologist studying the effects of alcohol on the body, and he started the Journal as a way to publish the increasing amount of research on alcohol use, abuse, and treatment that emerged from Yale and other institutions in the years following the repeal of Prohibition in 1933. In addition to original research, the Journal also published abstracts summarizing other published documents dealing with alcohol. At Yale, Dr. Haggard built a large team of alcohol researchers within the Laboratory of Applied Physiology—including E.M. Jellinek, who became managing editor of the Journal in 1941. In 1943, to bring together the various alcohol research projects conducted by the Laboratory, Dr. Haggard formed the Section of Studies on Alcohol, which also became home to the Journal and its editorial staff. In 1950, the Section was renamed the Center of Alcohol Studies.
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