3 - (SYM 93) Engaging Community Representatives to Improve Our Approach and Understanding of the Impact of COVID-19 on Opioid Use Disorder Treatment

Introduction: The COVID-19 pandemic occurred in the midst of a national opioid crisis and posed significant risk for individuals with opioid use disorder (OUD). The federal government temporarily eased regulations for medications for opioid use disorder (MOUD) (e.g., buprenorphine, methadone). Changes included reimbursement for telehealth, initiation of buprenorphine without in-person exams, and expanded take-home medications. Our mixed-method study used a Community Research Panel (CoRP) to guide an examination of the impact of these changes on access to and engagement in treatment.

Methods: Our CoRP initially included 6 individuals engaged in OUD treatment and was later expanded to include 6 additional people including family members, harm reduction specialists, and a clinical pharmacist. Beginning in May 2021, we met monthly for 6 months to: 1) review interview guides for policymakers, providers, and patients; 2) develop recruitment materials and approaches. We then moved to quarterly meetings, which focused on providing input on treatment access and engagement data. With input from the CoRP, we interviewed 16 federal and state decision-makers, 30 providers, and 27 patients to assess perspectives on MOUD policy changes. Framework Analysis was used to identify common and unique themes across participants. 

Results: CoRP members provided critical insights into the changing nature of OUD treatment through different waves of the pandemic. Their lived experiences informed questions to include in our interviews, assistance connecting to agencies for patient recruitment, and interpretation of data across treatment settings. Qualitative data highlighted support for MOUD policy changes. State policymakers and providers noted implementation challenges, including stigma associated with MOUD, limited infrastructure for telehealth staffing shortages, and lack of clarity over temporary policy changes. Patients’ experiences varied depending on the extent to which flexibilities were implemented and preferences for treatment. Patients also reported a range of stressors that undermined treatment adherence and recovery.  

Conclusions. Policymakers, providers, and patients supported policy changes to improve person-centered OUD treatment. Policymakers and providers need data to assess quality and treatment outcomes. Our data collection approach was greatly enhanced by our CoRP, which led to the collection of valuable qualitative data to inform a holistic understanding of OUD treatment during the COVID-19 pandemic.