Leveraging COVID-19 to sustain regulatory flexibility in the treatment of opioid use disorder

Highlights

• In light of the COVID-19 pandemic, seemingly intractable structural barriers have temporarily been removed through regulatory flexibility.

• The greater flexibility to initiate buprenorphine via telehealth platforms has resulted in improved access to care, which in turn has led to increased treatment uptake.

• Researchers can take advantage of this natural experiment to demonstrate the feasibility, acceptability, and safety of delivering treatment for OUD through a low-threshold approach.

• Quantitative, qualitative, and mixed-methods implementation research to support sustained regulatory flexibility following the COVID-19 pandemic is needed.

Abstract

The U.S. government declared the opioid epidemic as a national public health emergency in 2017, but regulatory frameworks that govern the treatment of opioid use disorder (OUD) through pharmaceutical interventions have remained inflexible. The emergence of the COVID-19 pandemic has effectively removed regulatory restrictions that experts in the field of medications for opioid use disorder (MOUD) have been proposing for decades and has expanded access to care. The regulatory flexibilities implemented to avoid unnecessary COVID-related death must be made permanent to ensure that improved access to evidence-based treatment remains available to vulnerable individuals with OUD who otherwise face formidable barriers to MOUD. We must seize this moment of COVOD-19 regulatory flexibilities to demonstrate the feasibility, acceptability, and safety of delivering treatment for OUD through a low-threshold approach.