Substance Use Disorder Treatment in the Age of COVID-19: Challenges, Responses, and Lessons for the Future

Measures to control the spread of COVID-19 infections, such as restrictions on movement, social distancing regulations, lockdowns, and curfews, are being applied intermittently around the globe. The application of these control measures has had far-reaching effects on the health of patients with Substance Use Disorder and how services and treatment are being provided to them. In the first part of this chapter, we focus on the health and contextual effects of COVID-19 on people with Substance Use Disorder. We then present current evidence of the effects of COVID-19 on Substance Use Disorder treatment services and providers. Studies from around the globe suggest that COVID-19 has increased the vulnerability and stigma toward people who use drugs and substantially decreased their ability to access needed treatment. The second part of this chapter discusses future models for service provision and their possible benefit to Substance Use Disorder patients, emphasizing the use of telemedicine, e-prescribing, dosing flexibility, take-home medicine, and reach-out initiatives. We suggest that models of care based on remote patient management might benefit some patients, but their universal adoption with insufficient evidence could be detrimental to others needing closer clinical supervision. Using hybrid models, incorporating both person-to-person and remote treatment delivery, changing reimbursement schemes, and using new technologies may increase the benefits of remote patient care.