Table 1.
Changes in Monthly Supply of Medications for Opioid Use Disorder (in thousands) in Prisons/Jails and Other Types of Facilities Before and During the COVID-19 Pandemica.
| Mean Monthly Volume, in thousands (95% CI) |
|||||
|---|---|---|---|---|---|
| Prisons and Jails | Hospitals/Clinics/HMOs | Long-Term Care | Home Health Care | All Other Facilities | |
| All MOUDs | |||||
| Prepandemic Volume | 77.62 (65.86–89.38) | 8666.29 (8308.01–9024.57) | 3014.37 (2858.03–3170.71) | 89.53 (83.89–95.16) | 295.58 (277.79–313.36) |
| Prepandemic Trend | 3.11 (1.69–4.53) | -21.99 (−62.88 to 18.89) | -15.42 (−27.72 to −3.12) | 0.15 (−0.49 to 0.78) | -0.39 (−1.24 to 0.45) |
| Pandemic Month Immediate changeb | 82.69 (42.35–123.03) | 485.60 (−1445.92–2417.12) | 70.81 (−104.40 to 246.03) | 59.54 (43.29–75.78) | 24.02 (−11.76 to 59.79) |
| Trend change during pandemicc | 21.87 (12.43–31.31) | -103.36 (−510.11 to 303.38) | -8.97 (−57.08 to 39.14) | -2.17 (−4.62 to 0.29) | -7.12 (−15.59 to 1.34) |
| Buprenorphine/Naloxone | |||||
| Prepandemc Volume | 19.74 (13.02–26.46) | 1596.87 (1483.86–1709.89) | 932.61 (870.06–995.16) | 23.38 (21.64–25.12) | 61.65 (58.06–65.24) |
| Prepandemic Trend | 1.86 (1.10–2.63) | 29.32 (25.32–33.33) | -3.86 (−12.32 to 4.60) | 0.19 (−0.06 to 0.45) | 0.72 (0.50–0.94) |
| Pandemic Month Immediate change | 81.93 (59.04–104.82) | -21.69 (−366.55 to 323.17) | 57.75 (−47.77 to 163.26) | 4.31 (−1.36 to 9.97) | 5.99 (−2.61 to 14.60) |
| Trend change during pandemic | 24.01 (19.53–28.49) | -58.17 (−126.88 to 10.54) | 2.08 (−30.11 to 34.28) | 0.23 (−1.20 to 1.67) | -3.31 (−4.97 to −1.65) |
| Buprenorphine | |||||
| Prepandemic Volume | 10.06 (5.35–14.77) | 380.12 (352.12–408.13) | 294.40 (280.05–308.75) | 10.38 (5.56–15.21) | 12.87 (12.00–13.74) |
| Prepandemic Trend | 1.03 (0.31–1.76) | 7.12 (5.90–8.35) | 0.80 (−0.28 to 1.88) | 1.07 (0.23–1.91) | 0.11 (0.02–0.21) |
| Pandemic Month Immediate change | 9.51 (−4.52 to 23.54) | -42.87 (−133.80 to 48.07) | -25.97 (−56.90 to 4.95) | 50.62 (28.36–72.87) | -0.24 (−2.02 to 1.53) |
| Trend change during pandemic | -0.06 (−2.43 to 2.31) | -8.73 (−26.13 to 8.66) | -1.29 (−6.85 to 4.26) | -3.33 (−6.45 to −0.21) | -0.43 (−0.68 to −0.18) |
| Naloxone | |||||
| Prepandemic Volume | 5.03 (2.31–7.75) | 316.76 (295.76–337.77) | 26.28 (20.32–32.23) | 0.85 (0.67–1.02) | 94.32 (83.22–105.42) |
| Prepandemic Trend | 0.27 (−0.05 to 0.60) | 1.88 (−0.59 to 4.34) | 0.17 (−0.54 to 0.88) | -0.02 (−0.03 to 0.00) | -0.44 (−1.59 to 0.72) |
| Pandemic Month Immediate change | -7.45 (−20.56 to 5.66) | 18.60 (−119.19 to 156.38) | -15.81 (−42.67 to 11.05) | 0.98 (0.56–1.41) | -2.86 (−34.88 to 29.15) |
| Trend change during pandemic | -0.55 (−3.04 to 1.94) | -9.95 (−34.16 to 14.26) | 2.43 (−1.17 to 6.03) | -0.13 (−0.19 to −0.08) | 2.85 (−3.74 to 9.44) |
| Naltrexone | |||||
| Prepandemic Volume | 9.40 (7.91–10.89) | 242.59 (227.60–257.58) | 363.17 (342.51–383.83) | 2.46 (2.20–2.71) | 41.94 (38.46–45.41) |
| Prepandemic Trend | 0.36 (0.19–0.54) | 3.79 (3.44–4.15) | -0.79 (−3.49 to 1.90) | 0.01 (−0.03 to 0.04) | 0.22 (−0.11 to 0.55) |
| Pandemic Month Immediate change | -0.68 (−5.26 to 3.90) | -15.66 (−37.53 to 6.21) | 59.25 (1.23–117.27) | -0.30 (−1.09 to 0.49) | 4.78 (−9.79 to 19.36) |
| Trend change during pandemic | -0.58 (−1.33 to 0.17) | -4.02 (−8.56 to 0.53) | -3.86 (−10.63 to 2.91) | 0.00 (−0.13 to 0.14) | -1.56 (−4.18 to 1.05) |
| Methadone | |||||
| PrepandemicVolume | 33.39 (30.41–36.37) | 6129.94 (5772.72–6487.17) | 1397.91 (1324.53–1471.29) | 52.46 (47.85–57.07) | 84.79 (74.94–94.64) |
| Prepandemic Trend | -0.42 (−0.81 to −0.04) | -64.11 (−104.93 to −23.29) | -11.73 (−13.50 to −9.96) | -1.11 (−1.56 to −0.65) | -1.01 (−2.39 to 0.37) |
| Pandemic Month Immediate change | -0.62 (−25.92 to 24.68) | 547.23 (−943.04 to 2037.49) | -4.40 (−50.21 to 41.41) | 3.93 (−8.45 to 16.31) | 16.35 (−12.29 to 44.99) |
| Trend change during pandemic | -0.96 (−5.63 to 3.70) | -22.49 (−339.55 to 294.56) | -8.33 (−18.63 to 1.98) | 1.06 (−0.97 to 3.10) | -4.67 (−9.86 to 0.52) |
MOUD = medications for opioid use disorder; COVID-19 = coronavirus disease 2019; CI = confidence interval.
a
Data source is IQVIA National Sales Perspective (NSP) monthly projections of the total volume of medicines purchased by facility type; All data in bold represent a statistically significant change at P < 0.05; Volume is reported in thousands.
b
Refers to the level change immediately after the intervention (treatment effect).
c
Refers to the difference between the pre/COVID-19 slopes of the outcome or the treatment effect over time (in months) (i.e., slope change).