2023
_PUBLIC HEALTH Policy

_Opioid Improvements

Pandemic-era changes to prescribing guidelines for the lifesaving drug buprenorphine led to improved treatment outcomes for patients with opioid use disorder.

_Kathleen Ward

Ward is a doctorial research fellow.

_Alexis M. Roth

Roth is an associate professor in the Urban Health Collaborative.

For those being treated for opioid use disorder, the pandemic had at least one positive outcome: Changes in prescribing guidelines made it easier for patients to obtain the lifesaving drug buprenorphine, enhancing many treatment outcomes.

That was the conclusion of a study of Philadelphia patients, published in Drug and Alcohol Dependence Reports by researchers in the Dana and David Dornsife School of Public Health.

The authors analyzed data from medical records and the Pennsylvania Prescription Drug Monitoring Program for 506 patients who received buprenorphine for opioid use disorder at Prevention Point Philadelphia from September 2018 to June 2020.

Patient retention improved during the pandemic after the Drug Enforcement Agency (DEA) reduced barriers to accessing treatment. The changes permitted telemedicine visits, longer prescriptions and fewer drug screening requirements.

Improved_Outcomes

Patients using telemedicine resources at Prevention Point stayed enrolled an average of 78 days, and those using telemedicine offsite stayed in care an average of 180 days — extending the length of treatment 3–8 times.

“We treated the policy changes as a natural experiment and compared treatment outcomes before and after they took effect,” says lead author Kathleen Ward. “The lessened restrictions were associated with people remaining in care for a longer period time. This is a really important finding in support of these policy changes.”

The findings could help policymakers improve treatment options for 1.7 million Americans with opioid use disorder.

“For most patients, there are many barriers to accessing and staying engaged in treatment,” says senior author and associate professor Alexis M. Roth. “These policy shifts are lifesaving and should remain in place.”