Journal
SYSTEMS
Volume 11, Issue 8, Pages -Publisher
MDPI
DOI: 10.3390/systems11080391
Keywords
agent-based modelling; opioid agonist therapy; COVID-19-related public health order; methadone; buprenorphine/naloxone; retention in opioid agonist therapy; opioid-related harms
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Modified opioid agonist therapy (OAT) guidelines during the COVID-19 pandemic allowed increased take-home doses for social distancing. Evaluating the impact on treatment retention and opioid-related harms is crucial for post-pandemic recommendations.
Modified opioid agonist therapy (OAT) guidelines that were initially introduced during the COVID-19 pandemic allow prescribers to increase the number of take-home doses to fulfill their need for physical distancing and prevent treatment discontinuation. It is crucial to evaluate the consequence of administering higher take-home doses of OAT on treatment retention and opioid-related harms among OAT recipients to decide whether the new recommendations should be retained post-pandemic. This study used an agent-based model to simulate individuals dispensed daily or weekly OAT (methadone or buprenorphine/naloxone) with a prescription over a six-month treatment period. Within the model simulation, a subset of OAT recipients was deemed eligible for receiving increased take-home doses of OAT at varying points during their treatment time course. Model results demonstrated that the earlier dispensing of increased take-home doses of OAT were effective in achieving a slightly higher treatment retention among OAT recipients. Extended take-home doses also increased opioid-related harms among buprenorphine/naloxone-treated individuals. The model results also illustrated that expanding naloxone availability within OAT patients' networks could prevent these possible side effects. Therefore, policymakers may need to strike a balance between expanding access to OAT through longer-duration take-home doses and managing the potential risks associated with increased opioid-related harms.
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