Table 2.

OUD treatment and harm reduction service adaptations in response to COVID-19; Peer-reviewed literature, 2020

Author, month, location	Name of clinic/organization	Care setting	Primary OUD services discussed	Innovative strategies to adapt to COVID-19
Samuel et al., May, 2020 Rhode Island, United States	Brown University and Rhode Island Department of Health	Substance Use Treatment	Buprenorphine	24-h telehealth-based bridge program for buprenorphine initiation and referral to ongoing care
Peavy et al., September, 2020 Washington, USA	Evergreen Treatment Services	Substance Use Treatment	Methadone	Increased take-homes for methadone provided along with smartphone application to allow video-directly observed therapy
Hazan et al., September, 2020 London, United Kingdom	Department of Addiction Psychiatry, Barnet & Haringey Mental Health Trust and Camden & Islington Foundation Trust	Substance Use Treatment	Buprenorphine, Methadone	Extended take-home supplies and lengths of prescriptions; removed supervised consumption and suspended psychosocial services; offered delivery of medications to isolated patients
Straub et al., September, 2020 Victoria, Australia	Long-Acting Injectable Buprenorphine (LAIB) Program St. Vincents Hospital Melbourne	Substance Use Treatment	Buprenorphine	Establishment of rapid access clinic to administer long-acting injectable buprenorphine to reduce travel and crowding
Ghosh, October, 2020 India	National Healthcare System Opioid Agonist Treatment (OAT) Services	Substance Use Treatment	Buprenorphine	Increased number of take-home buprenorphine doses; Increased days and hours of operation; dispensed buprenorphine to family member
Trujols et al., October, 2020 Catelonia, Spain	Methadone Center at Santa Creu i Sant Pau Hospital	Substance Use Treatment	Methadone	Increased number of take-home doses per patient
Basu et al., May, 2020 Chandigarh, India	Drug De-addiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER)	Substance Use Treatment	Buprenorphine, Methadone	Suspended group counseling and urine drug screening; switched psychosocial services to virtual platforms; Increased number of take-home buprenorphine doses prescribed to patients; suspended initiations of new patients;
Vecchio et al., July, 2020 Piedmont, Italy	SUD Specialist Treatment Centre in Biella	Substance Use Treatment	Buprenorphine, Methadone	Suspended or switched psychosocial services to virtual platform; conducted patient assessments and triage via phone/video calls; Increased take home doses of medications for OUD
Quinones et al., November, 2020 Puerto Rico	Corporacion SANOS Clinic, Coalicio´n de Coaliciones Clinic, Clinica Pitirre Iniciativa Comunitaria Clinic	Substance Use Treatment	Buprenorphine, Methadone	Provided psychosocial services via telemedicine; home delivery for medications for OUD; Increased number of days that OUD care was provided to reduce crowding; allowed for telemedicine appointments through patients and providers sitting in separate rooms
Komaromy et al., December, 2020 Massachusetts, USA	The Grayken Center for Addiction at Boston Medical Center-affiliated SUD programs	Substance Use Treatment	Buprenorphine, naloxone, sterile syringe equipment	Offered buprenorphine visits via telehealth; offered harm-reduction interventions for overdose prevention and sterile injection equipment Distributed donated phones to patients who lacked access for telehealth; Extended length of buprenorphine prescriptions; Increased use of extended-release injectable buprenorphine; Created 24-h call-line for addiction treatment; Text messaging or ‘‘on the fly’’ telehealth visits to stay connected with young patients; Addiction consult services switched to telehealth consultations
Hughto et al., October, 2020 Rhode Island, USA	VICTA—Privately owned outpatient substance abuse and mental health treatment program	Substance Use Treatment	Counseling for MOUD patients	Switched counseling of OUD patients to virtual platforms; provided clinicians with laptops to engage in telehealth
McKiever et al., August, 2020 Ohio, USA	Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine	Substance Use Treatment	Psychosocial services for pregnant women receiving OUD treatment	Switched to telehealth for individual and group therapy
Singh and Tikka, October, 2020 Chhattisgarh, India	The Opioid Substitution Clinic at the All India Institute of Medical Sciences (AIIMS), Raipur	Substance Use Treatment	Buprenorphine	Suspended intakes and managed new patients via telehealth; Suspended random urine screening; implemented COVID-19 safety precautions in clinic
Crowley et al., April, 2020 Ireland	The Irish College of General Practitioners and the National Health Service Executive office for Social Inclusion	Primary Care/General Practitioner	Buprenorphine, Methadone	Telephone-based assessment and triage to general practitioner who conducts remote medical management of MOUD following a single in-person visit
Tringale et al., October, 2020 California, United States	Homeless Health Care Los Angeles	Outreach/Harm Reduction Program	Buprenorphine	Telehealth-based buprenorphine treatment through access to sanitized glass telephone booths
Harris et al., May, 2020 Massachusetts, USA	Boston Medical Center-affiliated community drop-in center	Outreach/Harm Reduction Program	Buprenorphine	Telehealth-based buprenorphine initiation through smartphone provided by harm reduction specialist at drop-in clinic
Marcus et al., August, 2020 Tshwane, South Africa	University of Pretoria’s Department of Family Medicine	Outreach/Harm Reduction Program	Methadone	Provided methadone doses in temporary pandemic homeless shelter; Moving stable patients from daily observed treatment to weekly take home dosing
MacKinnon et al., October, 2020 British Columbia, Canada	Medical services within supportive housing units in Vancouver, affiliated with University of British Columbia	Outreach/Harm Reduction Program	Safe supply of opioids, Supervised injection, Methadone, Buprenorphine	Provided pharmaceutical grade alternative to toxic illicit drug supply termed ‘pandemic withdrawal management’; modified supervised injection spaces; Longer MOUD prescriptions; Increasing the number of take-home MOUD doses; switched to virtual platforms for clinical encounters
Castillo et al., November, 2020 Florida, USA	TeleMOUD, University of Miami Miller School of Medicine	Outreach/Harm Reduction Program	Buprenorphine	Telehealth-based buprenorphine treatment initiation advertised via a syringe exchange program and online platform
Courser et al., December, 2020 Ohio, USA	Community Based Take Home Naloxone Programs	Outreach/Harm Reduction Program	Naloxone	Provided individual and group naloxone trainings via telephone and video conferences; promoted naloxone via social media, offered drive through events for naloxone education and distribution, sent mail-order naloxone kits
Nordeck et al., November, 2020 Maryland, USA	Behavioral Health Leadership Institute	Outreach/Harm Reduction Program	Buprenorphine, Naloxone	Telehealth for buprenorphine initiation and maintenance, daily distribution of naloxone kits via a drop-off basket
Wenzel and Fishman, September, 2020 Maryland, USA	Youth Opioid Recovery Support (YORS) NIH HEAL Initiative	Mobile Clinic	Buprenorphine, Naltrexone	Delivered extended-release buprenorphine and extended-release naltrexone via a mobile van that traveled to patient homes
Warrington et al., September, 2020 Vermont, USA	Commercial Laboratory, Aspenti Health	Mobile Clinic	Urine drug testing for OUD patients	Deployed mobile unit to patient homes to conduct urine drug testing on the mobile van
Duncan et al., October, 2020 Minnesota, United States	Hennepin County Jail	Correctional Facility	Buprenorphine	Telehealth-based buprenorphine encounters using a computer in jail medical unit
Roberts et al., September, 2020 New South Whales, Australia	New South Whales Correctional Centers	Correctional Facility	Buprenorphine	Began offering injectable long-acting buprenorphine to people in detention to reduce movement

OUD Opioid use disorder; MOUD: Medications for opioid use disorder; OAT Opioid agonist therapies, LAIB Long acting injectable buprenorphine