Following the classification of the Coronavirus disease (COVID-19) as a pandemic by the World Health Organization (WHO), countries were encouraged to implement urgent and aggressive actions to change the course of the disease spread while also protecting the physical and mental health and well-being of all people. The challenges and solutions of providing prevention, treatment, and care for those affected with issues related to substance use and addictive behaviors are still being discussed by the global community. Several international documents have been developed for service providers and public health professionals working in the field of addiction medicine in the context of the pandemic, however, less is known about country-level responses. The Network of Early Career Professionals working in Addiction Medicine (NECPAM) discussed emerging country-level guidelines developed in the 6 months following the outbreak. They identified and summarized country-level briefing notes, practice documents, guidelines, discussion papers and other documents containing recommendations on prevention, harm reduction, treatment, and care for people who use drugs. Documents developed in Indonesia discuss the use of personal and protective equipment (PPE), outlined strategies for maintaining physical distance in clinics and Standard Operating Procedures (SOP), increased use of telemedicine, as well as advocates for increased take-home doses (TADs) of opioid agonist maintenance treatment (OAMT) to 7 days, 14 days and 1 month, respectively. So from 17 countries including Indonesia, range of practices have been suggested at the country-level to deal with the challenges brought about by the ongoing pandemic. These include those around mitigating the spread of the corona virus, managing the risks associated with lockdown policies and changing trends in substance use and addictive behaviours. Several potential negative effects associated with the pandemic and resulting lockdown procedures have been identified which may require service adaptions. These include increased risks of substance withdrawal, access to service issues and potential changes in trends related to gambling, gaming, and internet related disorders. Several guidance documents discuss meeting these challenges through increased availability of online based self-help groups and other services like telemedicine. There are also concerns regarding the implementation of COVID-19-related policy documents as a recent global survey indicates that among 130 countries, 60% reported disruptions to mental health services for vulnerable people, 67% reported disruptions to counseling and psychotherapy, 35% reported disruptions to emergency interventions, and 30% reported disruptions to access for medications for mental, neurological, and substance use disorders.

link  https://www.frontiersin.org/article/10.3389/fpsyt.2021.634309

source :Journal Frontiers in psychiatry.