I am a 4th year medical student at Queen’s University Belfast, who recently completed a BSc in Neuroscience and Mental Health at Imperial College London. To further my interest in psychiatry, my BSc project investigated the effect and management of alcohol use in patients on Opiate Substitution Therapy (OST). The widespread effects of the COVID-19 pandemic presented urgent research questions relating to patients on OST, which myself and other members of the department spent the summer investigating. I am grateful to have been invited to present key findings from this research at The Society for the Study of Addiction’s annual conference. I hope in the future to finish my medical training and pursue a career in the field of neuroscience and psychiatry, both as a clinician and researcher.
COVID-19 and Opiate Dependence: The effect of lockdown restrictions on the referral and management of patients starting on Opiate Substitution Therapy
Aim: This study aimed to investigate how COVID-19 restrictions impacted upon the referral and management of patients starting opiate substitution therapy (OST).
Methods: A retrospective design was used to analyse data from the New Beginnings service (Brent, London), collected for the National Drug Treatment Monitoring System. Patients referred between 23/03/2019 – 30/06/2019 (n=43) and 23/03/2020 – 30/06/2020 (n=52) were selected, forming two cohorts which were compared using SPSS. The variables investigated included: number and source of referrals, time to assessment, early dropouts from treatment and the type, dose and supervision of prescribed OST.
Results: Compared with patients referred in 2019, those referred in 2020 had a significantly shorter interval between referral and assessment (5.5 v 14.5 days, ‘P=’0.031), and were more likely to have their OST prescribed without supervised consumption (59% v 25%, ‘P’=0.002). Methadone was more commonly prescribed than buprenorphine in both years. Although, the proportion of methadone prescriptions decreased in 2020 (54% v 70%, ‘P=0.149). ‘There were no significant differences between the two cohorts regarding new referrals, referral source, early dropouts or the type or dose of OST prescribed.
Conclusions: Our findings illustrate how addiction services have adapted in response to COVID-19 restrictions. The switch from in-person to telemedical interactions likely underpins the shorter assessment waiting times and the increase in prescriptions being issued without supervised consumption. In keeping with guidance, more buprenorphine was prescribed in 2020, although methadone remained most common. These changes in service delivery may have long-term implications on the management and outcomes of patients on OST.
Poster link: FinnH Poster Covid-19 And Opiate Dependence