"How will I get my next week's script?" Reactions of Reddit opioid forum users to changes in treatment access in the early months of the coronavirus pandemic.


Journal

The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759

Informations de publication

Date de publication:
06 2021
Historique:
received: 20 10 2020
revised: 19 01 2021
accepted: 21 01 2021
pubmed: 10 2 2021
medline: 29 7 2021
entrez: 9 2 2021
Statut: ppublish

Résumé

The COVID-19 pandemic poses significant challenges to people with opioid use disorder (OUD). As localities enforce lockdowns and pass emergency OUD treatment regulations, questions arise about how these changes will affect access and retention in care. In this study, we explore the influence of COVID-19 on access to, experiences with, and motivations for OUD treatment through a qualitative analysis of public discussion forums on Reddit. We collected data from Reddit, a free and international online platform dedicated to public discussions and user-generated content. We extracted 1000 of the most recent posts uploaded between March 5th and May 13th, 2020 from each of the two most popular opioid subreddits "r/Opiates" and "r/OpiatesRecovery" (total 2000). We reviewed posts for relevance to COVID-19 and opioid use and coded content using a hybrid inductive-deductive approach. Thematic analysis identified common themes related to study questions of interest. Of 2000 posts reviewed, 300 (15%) discussed topics related to the intersection of opioid use and COVID-19. Five major themes related to OUD treatment were identified: Concern about closure of OUD treatment services; transition to telehealth and virtual care; methadone treatment requirements and increased exposure to COVID-19; reactions to changing regulations on medications for OUD; and influences of the pandemic on treatment motivation and progress. In the face of unprecedented challenges due to COVID-19, reactions of Reddit opioid forum users ranged from increased distress in accessing and sustaining treatment, to encouragement surrounding new modes of treatment and opportunities to engage in care. New and less restrictive avenues for treatment were welcomed by many, but questions remain about how new norms and policy changes will be sustained beyond this pandemic and impact OUD treatment access and outcomes long-term.

Sections du résumé

BACKGROUND
The COVID-19 pandemic poses significant challenges to people with opioid use disorder (OUD). As localities enforce lockdowns and pass emergency OUD treatment regulations, questions arise about how these changes will affect access and retention in care. In this study, we explore the influence of COVID-19 on access to, experiences with, and motivations for OUD treatment through a qualitative analysis of public discussion forums on Reddit.
METHODS
We collected data from Reddit, a free and international online platform dedicated to public discussions and user-generated content. We extracted 1000 of the most recent posts uploaded between March 5th and May 13th, 2020 from each of the two most popular opioid subreddits "r/Opiates" and "r/OpiatesRecovery" (total 2000). We reviewed posts for relevance to COVID-19 and opioid use and coded content using a hybrid inductive-deductive approach. Thematic analysis identified common themes related to study questions of interest.
RESULTS
Of 2000 posts reviewed, 300 (15%) discussed topics related to the intersection of opioid use and COVID-19. Five major themes related to OUD treatment were identified: Concern about closure of OUD treatment services; transition to telehealth and virtual care; methadone treatment requirements and increased exposure to COVID-19; reactions to changing regulations on medications for OUD; and influences of the pandemic on treatment motivation and progress.
CONCLUSION
In the face of unprecedented challenges due to COVID-19, reactions of Reddit opioid forum users ranged from increased distress in accessing and sustaining treatment, to encouragement surrounding new modes of treatment and opportunities to engage in care. New and less restrictive avenues for treatment were welcomed by many, but questions remain about how new norms and policy changes will be sustained beyond this pandemic and impact OUD treatment access and outcomes long-term.

Identifiants

pubmed: 33558165
pii: S0955-3959(21)00038-4
doi: 10.1016/j.drugpo.2021.103140
pmc: PMC8994991
mid: NIHMS1792123
pii:
doi:

Substances chimiques

Analgesics, Opioid 0
Buprenorphine 40D3SCR4GZ

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

103140

Subventions

Organisme : NIDA NIH HHS
ID : R25 DA037190
Pays : United States
Organisme : NIDA NIH HHS
ID : T32 DA007233
Pays : United States
Organisme : AHRQ HHS
ID : T32 HS026120
Pays : United States

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of Interest None.

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Auteurs

Noa Krawczyk (N)

Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA. Electronic address: noa.krawczyk@nyulangone.org.

Amanda M Bunting (AM)

Section on Tobacco, Alcohol, & Drug Use, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA.

David Frank (D)

Behavioral Science Training in Drug Abuse Research, NYU Rory Meyers College of Nursing, 433 1st Avenue, New York, NY 10010, USA.

Joshua Arshonsky (J)

Section on Health Choice, Policy, and Evaluation, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA.

Yuanqi Gu (Y)

Department of Public Health Nutrition, NYU School of Global Public Health, 26 Broadway, New York, NY 10012, USA.

Samuel R Friedman (SR)

Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA.

Marie A Bragg (MA)

Section on Health Choice, Policy, and Evaluation, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA; Department of Public Health Nutrition, NYU School of Global Public Health, 26 Broadway, New York, NY 10012, USA.

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