COVID-19 and substance use disorders: a review of international guidelines for frontline healthcare workers of addiction services

• Main Authors: Cipriani, A. (Author), Hong, J.S.W (Author), Lingford-Hughes, A.R (Author), Macdonald, O. (Author), Ostacher, M.J (Author), Ostinelli, E.G (Author), Smith, K. (Author), Zangani, C. (Author)
• Format: Article
• Language: English
• Published: BioMed Central Ltd 2022
• Subjects: Alcohol; alcoholism; Alcoholism; Article; Australia; Canada; caregiver; child; Child; child safety; coronavirus disease 2019; COVID-19; detoxification; disease transmission; drug dependence; Evidence-base recommendations; family service; governmental organization; Guidelines; health care access; health care delivery; health care personnel; Health Personnel; human; Humans; infection prevention; mental health service; Needle and syringe programme; New Zealand; opiate substitution treatment; Opioid substitution treatment; pandemic; Pandemics; practice guideline; psychology; publication; risk factor; Singapore; Substance use disorder; Substance-Related Disorders; United Kingdom; United States
• Online Access: View Fulltext in Publisher

 Background: People with substance use disorders may be at a greater risk of contracting COVID-19 infection and developing medical complications. Several institutional and governmental health agencies across the world developed ad hoc guidance for substance use disorder services and care of individuals misusing substances. We aimed to synthesise the best available recommendations on management and care of people with or at risk of substance use disorders during the COVID-19 pandemic from existing guidelines published in UK, USA, Australia, Canada, New Zealand, and Singapore. Methods: We systematically searched existing guidelines and websites from 28 international institutions and governmental bodies in the context of the COVID-19 pandemic (May 4th 2021). We summarized the extracted data as answers to specific clinical questions. Results: We organised the available recommendations from 19 sources in three sections. First, we focused on general advice and recommendations for people who misuse alcohol or drugs during the COVID-19 pandemic, the design of contingency plans, safeguarding issues for children and families of service users and advice to the public, patients, and carers. Then, we summarised specific guidelines for people who use illicit drugs and related services, such as opioid substitution treatment and needle and syringe programmes. Finally, we provided a synthesis on specific recommendations for services supporting people who misuse alcohol and key topics in the field, such as management of alcohol detoxification and safe transition between supervised and unsupervised consumption. Conclusions: Available guidance reflected different approaches, ranging from being extremely cautious in providing recommendations other than generic statements to proposing adaptation of previously available guidelines to confront the challenges of the COVID-19 pandemic. After the early phase, guidance focused on reduction of infection transmission and service delivery. Guidance did not provide advice on infection prevention via vaccination programmes and service access strategies tailored to individuals with substance use disorders. © 2022, The Author(s).