Editorial: Opioids in the time of the COVID-19 pandemic: from cellular mechanisms to public health policy
Year: 2023
Type: editorial
Abstract: there was also a posi�ve correla�on between cardiovascular inflamma�on and opioid presence in blood, possibly from upregulated inflammatory cytokines (4,5). This effect could work in tandem with the 'inflammatory storm' well known to nega�vely impact the outcome of Covid-19.Another effect of COVID-19 was the ini�al change in the supply, pricing and use of illicit substances (6) and a con�nuing shi� away from the abuse of prescrip�on opioids in the early days of the pandemic (7). Weng et al., mined data from the Na�onal Health Interview Survey and showed that pa�ents in the USA with cardiac condi�ons reduced their use of prescrip�on opioids to relieve acute pain. This could reflect both the emphasis by medical teams in trea�ng Covid-19 pa�ents coupled with the reluctance of these pa�ents to seek care during this ini�al stage of the pandemic. The need for opioids to treat pain is highlighted by Palamin et al., who describe a necessity to use these medica�ons in the Brazilian healthcare system that should be implemented with care given the effects of both opioids and Covid-19 on respiratory and cardiac func�on.Against this backdrop of not seeking care or limited care being available, has been the drive by healthcare teams to put protocols in place that could be used during such a pandemic. These protocols would maintain/improve access to care while protec�ng the 'frontline' workers addressing the pandemic. Teck et al., presented 5 case studies of the use of buprenorphine micro-dosing while transferring pa�ents to a long-ac�ng depot buprenorphine that could be used for a broader range of pa�ents when access to healthcare may be limited. More work is needed to examine this approach but the ini�al case studies show how such a protocol may be used where tradi�onal approaches such as inpa�ent detoxifica�on are not feasible. Soyka used a literature review to examine this approach further focusing on transferring pa�ents from methadone, a high efficacy opioid receptor agonist, to buprenorphine, a par�al opioid receptor agonist while minimizing withdrawal. This study concluded that buprenorphine microdosing during methadone treatment allows a reduc�on in methadone administra�on, a novel approach worthy of further study.Whilst the pandemic was ini�ally associated with mul�ple areas of misinforma�on and broad misconcep�on, less s�gma was atached to those suffering from Covid-19 as those suffering from OUD (Okobi et al.,). This is an interes�ng dichotomy that may relate to an implicit bias against those with SUD/OUD compared to those with a transmissible disease. This study, in addi�on to the study by Guo et al., that examined the perceived effect of lockdown in Wuhan on viral transmission in other ci�es, has highlighted areas of public confidence, or lack thereof, and percep�ons, that may have abated over the course of the pandemic.Over �me we have learned much about the pandemic, the policies and systems that will be needed for future scenarios, and, as outlined by Radfar et al., the ac�ons of policymakers and healthcare organiza�ons required to generate business con�nuity plans. These will ideally maintain and strengthen harm reduc�on approaches and other provisions needed for the safety and support of SUD/OUD pa�ents at all �mes.
Source: Frontiers in Pharmacology
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,295
OpenAlex ID: W4384406425