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MOUD Provision in Correctional Settings During Time of COVID-19: Prevention and Solutions
Nickolas Zaller1, Lauren Brinkley-Rubinstein
1College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR (NZ); School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC (LBR).
Insights
Correctional facilities face high COVID-19 risks. This commentary outlines strategies for maintaining medication for opioid use disorder (MOUD) services during the pandemic and future health crises.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Correctional Healthcare
Background:
- Correctional facilities are high-risk environments for infectious disease transmission due to overcrowding and limited social distancing capabilities.
- COVID-19 outbreaks in US jails demonstrated infection rates significantly higher than in community settings.
- Incarcerated populations have a higher prevalence of underlying health conditions, increasing their risk for severe COVID-19 outcomes.
Purpose of the Study:
- To highlight essential risk mitigation practices for delivering medication for opioid use disorder (MOUD) in correctional settings during the COVID-19 pandemic.
- To ensure the continuity and quality of MOUD services despite facility-level policies aimed at stemming viral transmission.
- To provide guidance for preparing correctional facilities for potential future pandemics while maintaining critical healthcare programs.
Main Methods:
- This commentary reviews existing literature and public health recommendations relevant to infectious disease control in correctional settings.
- It analyzes the impact of COVID-19 response measures on the delivery of essential healthcare services, specifically MOUD.
- It synthesizes best practices for adapting MOUD protocols to maintain patient safety and treatment efficacy.
Main Results:
- Implementing facility-level policies to control COVID-19 spread can strain resources for other vital programs like MOUD.
- Risk mitigation strategies are crucial for the safe and effective delivery of MOUD during public health emergencies.
- Adapting MOUD delivery models can help maintain treatment access for individuals with opioid use disorder in correctional facilities.
Conclusions:
- Maintaining MOUD services in correctional settings during pandemics requires proactive planning and adaptable strategies.
- Ensuring quality of care for opioid use disorder is critical, even when resources are reoriented for infectious disease control.
- Correctional agencies must develop resilient healthcare delivery systems to prepare for future pandemics and ensure continuity of care.
Abstract:
: Correctional settings can be vectors of infectious diseases due to overcrowding, unsanitary living conditions, and very little capacity to engage in social distancing. In the US, COVID-19 outbreaks were first identified in the New York City and Cook County jails, with infection rates far exceeding community rates. Each day new cases are being identified across the country in correctional facilities. People who are incarcerated are at increased risk of experiencing severe COVID-19 symptoms because of the increased prevalence of other underlying illnesses. Jails and prisons have begun initiating facility-level policies to help stop the spread of COVID-19. As a result, correctional agencies have reoriented staff to stem transmission in their facilities. This could translate into limited resources for other programming such as medications for opioid use disorder (MOUD) programs. In this commentary, we highlight risk mitigation practices for delivering MOUD in correctional settings during COVID-19 and note how to ensure quality of care while still preparing for the possibility of future pandemics.
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