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Background: During public health emergencies, disruptions to social landscapes and amplification of inequities for people with opioid use disorder raise important questions about reducing harms and providing treatment accountability to support this population during disasters including COVID-19. This research aims to a) identify how disasters impact persons with opioid use disorder (OUD) and their access to healthcare, with specific attention to COVID-19, and b) inform ongoing responses to the pandemic and future disaster-mitigation plans related to healthcare disruptions affecting persons with opioid use disorder (PWOUD).
Methods: We conducted knowledge synthesis based on a 6-stage scoping review framework methodology. Stakeholder consultation was completed using a Nominal Group Technique with two groups, each composed of including providers in primary, emergency and community-based care. One group (n=7) represented voices from urban services, and the other (n=4) Indigenous contexts allowing for attention to healing the whole person, beyond OAT.
Results: 61 scientific journal articles and 72 grey literature resources were included after full-text screening. Stakeholder NGT process revealed three contextual factors affecting system and service accountability for responsive OUD care during disaster-driven disruptions: (1) disasters focus attention on single risks and generalized solutions; (2) data-poor decision-making perpetuates stigma and produces policy inattentive to social determinants of health; and (3) harm reduction and contextually-tailored care prepare a system for future disasters.
Conclusion: COVID-19 public health efforts require a coordinated systemic approach to serving PWOUD, based on accountability to patients and support for providers.
Keywords
Coronavirus, Disaster Planning, Opioid Epidemic, Health Services, Review
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- AdditionalFile1.docx
1. Additional File 1 (.docx): Supplementary Methods; this document provides the full search strategy including search terms.
- AdditionalFile2.docx
2. Additional File 2 (.docx) Supplementary Results of Scientific Literature; this document provides a full list of the included scientific literature and brief overview of sources in a table with descriptions of pertinent findings
- AdditionalFile3.docx
3. Additional File 3 (.docx) Supplementary Results of Grey Literature, this document provides a brief summary of the grey literature, highlighting critical documents.
- AdditionalFile4.pdf
4. Additional File 4 (.pdf) Literature Summary Sheet, this document provides infographics synthesizing the academic and grey literature according to three thematic areas (increased risk, risk mitigation, and cross-systems issues) that guided the NGT discussions.
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CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 1
Posted 18 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 25 Feb, 2021
Review #1 received
Received 22 Feb, 2021
Review #3 received
Received 20 Feb, 2021
Reviewer #3 agreed
On 19 Feb, 2021
Review #2 received
Received 19 Feb, 2021
Reviewer #2 agreed
On 18 Feb, 2021
Editor assigned
On 17 Feb, 2021
Reviewers invited
Invitations sent on 17 Feb, 2021
Reviewer #1 agreed
On 17 Feb, 2021
Submission checks complete
On 16 Feb, 2021
Editor invited
On 15 Feb, 2021
First submitted
On 24 Jan, 2021
Metrics
Comments: 0
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 1
Posted 18 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 25 Feb, 2021
Review #1 received
Received 22 Feb, 2021
Review #3 received
Received 20 Feb, 2021
Reviewer #3 agreed
On 19 Feb, 2021
Review #2 received
Received 19 Feb, 2021
Reviewer #2 agreed
On 18 Feb, 2021
Editor assigned
On 17 Feb, 2021
Reviewers invited
Invitations sent on 17 Feb, 2021
Reviewer #1 agreed
On 17 Feb, 2021
Submission checks complete
On 16 Feb, 2021
Editor invited
On 15 Feb, 2021
First submitted
On 24 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: During public health emergencies, disruptions to social landscapes and amplification of inequities for people with opioid use disorder raise important questions about reducing harms and providing treatment accountability to support this population during disasters including COVID-19. This research aims to a) identify how disasters impact persons with opioid use disorder (OUD) and their access to healthcare, with specific attention to COVID-19, and b) inform ongoing responses to the pandemic and future disaster-mitigation plans related to healthcare disruptions affecting persons with opioid use disorder (PWOUD).
Methods: We conducted knowledge synthesis based on a 6-stage scoping review framework methodology. Stakeholder consultation was completed using a Nominal Group Technique with two groups, each composed of including providers in primary, emergency and community-based care. One group (n=7) represented voices from urban services, and the other (n=4) Indigenous contexts allowing for attention to healing the whole person, beyond OAT.
Results: 61 scientific journal articles and 72 grey literature resources were included after full-text screening. Stakeholder NGT process revealed three contextual factors affecting system and service accountability for responsive OUD care during disaster-driven disruptions: (1) disasters focus attention on single risks and generalized solutions; (2) data-poor decision-making perpetuates stigma and produces policy inattentive to social determinants of health; and (3) harm reduction and contextually-tailored care prepare a system for future disasters.
Conclusion: COVID-19 public health efforts require a coordinated systemic approach to serving PWOUD, based on accountability to patients and support for providers.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- AdditionalFile1.docx
1. Additional File 1 (.docx): Supplementary Methods; this document provides the full search strategy including search terms.
- AdditionalFile2.docx
2. Additional File 2 (.docx) Supplementary Results of Scientific Literature; this document provides a full list of the included scientific literature and brief overview of sources in a table with descriptions of pertinent findings
- AdditionalFile3.docx
3. Additional File 3 (.docx) Supplementary Results of Grey Literature, this document provides a brief summary of the grey literature, highlighting critical documents.
- AdditionalFile4.pdf
4. Additional File 4 (.pdf) Literature Summary Sheet, this document provides infographics synthesizing the academic and grey literature according to three thematic areas (increased risk, risk mitigation, and cross-systems issues) that guided the NGT discussions.
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