April 24, 2020
The Royal Australasian College of Physicians warns that without the right support, some Australians being treated for opioid dependence face the risk of relapsing into addiction, and related health and social problems, including overdoses, during the COVID-19 pandemic.
This week, the RACP and other lead health professional and consumer groups have endorsed a new clinical guidance document created by a range of health professionals to support opioid-dependent patients and their health practitioners during the COVID-19 pandemic.
The guidance has been endorsed by groups including the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Faculty of Addiction Psychiatry, Drug and Alcohol Nurses Australasia (DANA), the Pharmaceutical Society of Australia (PSA), the Australian Injecting and Illicit Drug Users League (AIVL), the Australasian Professional Society for Alcohol and other Drugs (APSAD).
Professor Nicholas Lintzeris, President-elect of the Chapter of Addiction Medicine and an RACP spokesperson said, “The COVID-19 outbreak has greatly impacted how patients access treatment and interact with their usual support networks.
“Approximately 50,000 Australians currently access methadone or buprenorphine as part of a program to reduce the problems associated with their opioid use. This involves seeing their doctor about once a month and going to a chemist several times a week to collect their medication, along with counselling and peer-supports.
“With people being encouraged to stay home as often as possible – it means that many patients are visiting their doctor and pharmacy less.
“We therefore need to adjust treatment to maintain access to medication while managing the risks. Health professionals might need to change medication plans, adapt our practices for consultations, and change how medications are dispensed to support patients during this time.”
Dr Shalini Arunogiri, President of the Faculty of Addiction Psychiatry, added, “Adapting our practice will ensure continuity of care to essential treatment.
“This will alleviate anxiety and uncertainty for our patients at this stressful and challenging time, promoting stability and mental wellbeing.” Dr Arunogiri said.
Professor Lintzeris said “Telehealth has been a really important step in supporting these patients but unfortunately there are still some risks that patients with opioid dependence could struggle to stay in treatment due to travel restrictions, resulting in relapse and undoing all the hard work they’ve done to improve their lives.
“For the average patient, it means reducing their trips to the chemist from four times a week down to one and having more doses of medicine at home with them.
“Many patients will now have increased access to unsupervised doses and they need to have the right support to manage this.
“We recommend mitigation techniques such as patient education about safe use of these drugs, access to take-home naloxone, engaging carers and loved ones in supervision of the medications, and regular phone review and consults with their doctor.
“It’s about having the right medications, taking account of the risks, working together with pharmacists and utilising available social supports for our patients.”