High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine
The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (...
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Published in | Frontiers in public health Vol. 11; p. 1231581 |
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30.11.2023
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Abstract | The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown.
In early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress.
Overall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15-1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18-1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02-1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04-1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs.
During a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support. |
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AbstractList | BackgroundThe COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown.MethodsIn early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress.ResultsOverall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15-1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18-1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02-1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04-1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs.ConclusionDuring a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support. Background The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown. Methods In early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress. Results Overall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15–1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18–1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02–1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04–1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs. Conclusion During a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support. The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown. In early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress. Overall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15-1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18-1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02-1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04-1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs. During a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support. |
Author | Fomenko, Tetiana Galvez, Samy J Ivasiy, Roman Islam, Zahedul Madden, Lynn M Meteliuk, Anna Altice, Frederick L Farnum, Scott O Machavariani, Eteri |
AuthorAffiliation | 1 Yale School of Medicine, Section of Infectious Diseases , New Haven, CT , United States 2 Division of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, CT , United States 3 Alliance for Public Health of Ukraine , Kyiv , Ukraine 4 APT Foundation , New Haven, CT , United States |
AuthorAffiliation_xml | – name: 1 Yale School of Medicine, Section of Infectious Diseases , New Haven, CT , United States – name: 2 Division of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, CT , United States – name: 4 APT Foundation , New Haven, CT , United States – name: 3 Alliance for Public Health of Ukraine , Kyiv , Ukraine |
Author_xml | – sequence: 1 givenname: Samy J surname: Galvez fullname: Galvez, Samy J organization: Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States – sequence: 2 givenname: Frederick L surname: Altice fullname: Altice, Frederick L organization: Alliance for Public Health of Ukraine, Kyiv, Ukraine – sequence: 3 givenname: Anna surname: Meteliuk fullname: Meteliuk, Anna organization: APT Foundation, New Haven, CT, United States – sequence: 4 givenname: Roman surname: Ivasiy fullname: Ivasiy, Roman organization: Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States – sequence: 5 givenname: Eteri surname: Machavariani fullname: Machavariani, Eteri organization: Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States – sequence: 6 givenname: Scott O surname: Farnum fullname: Farnum, Scott O organization: Alliance for Public Health of Ukraine, Kyiv, Ukraine – sequence: 7 givenname: Tetiana surname: Fomenko fullname: Fomenko, Tetiana organization: APT Foundation, New Haven, CT, United States – sequence: 8 givenname: Zahedul surname: Islam fullname: Islam, Zahedul organization: APT Foundation, New Haven, CT, United States – sequence: 9 givenname: Lynn M surname: Madden fullname: Madden, Lynn M organization: Alliance for Public Health of Ukraine, Kyiv, Ukraine |
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Copyright | Copyright © 2023 Galvez, Altice, Meteliuk, Ivasiy, Machavariani, Farnum, Fomenko, Islam and Madden. Copyright © 2023 Galvez, Altice, Meteliuk, Ivasiy, Machavariani, Farnum, Fomenko, Islam and Madden. 2023 Galvez, Altice, Meteliuk, Ivasiy, Machavariani, Farnum, Fomenko, Islam and Madden |
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Keywords | COVID-19 stress opioid agonist therapies buprenorphine methadone Ukraine |
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Snippet | The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use... Background The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid... BackgroundThe COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid... |
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SubjectTerms | Analgesics, Opioid - therapeutic use buprenorphine COVID-19 COVID-19 - epidemiology Humans methadone opioid agonist therapies Opioid-Related Disorders - drug therapy Opioid-Related Disorders - epidemiology Pandemics Public Health stress Stress, Psychological Substance Abuse, Intravenous Ukraine Ukraine - epidemiology |
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Title | High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine |
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