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AATOD asked Board members to provide preliminary information about patient and staff COVID-19 infection and to report on current conditions in obtaining PPE. The survey was extremely brief and its intent was to provide a snapshot of patient and staff infection rates. AATOD will be working with research organizations in an effort to obtain more detailed and scientifically accurate data. **********************************
Patient Infection Rates
28 Board members responded from the member states of AATOD. The clear majority of the Board members' programs reported patient infections of 5 or less. Some programs reported zero patient infection. Please keep in mind that these data typically represented information from one or two programs and did not represent statewide reporting. While it is too early to draw any conclusions from such data, it does represent an encouraging finding as of May 15, 2020.

Staff Infections
COVID-19 staff infections also appear to be low. As of May 15, 2020, 4 AATOD Board members reported comparatively higher staff infection rates in Missouri, Connecticut, Washington State and New York State. Once again, these are early numbers and are expected to change. Additionally, these data do not represent statewide findings. This clearly reflects the risks that are associated among healthcare workers in the OTP environment.

PPE
As many of you know, obtaining PPE for OTPs was a critical challenge in the first four to six weeks of COVID-19 reporting, beginning in mid-March 2020. The HHS/SAMHSA Assistant Secretary, Dr. Elinore McCance-Katz wrote a letter on March 25, 2020, which declared OTPs as essential medical services, providing greater access to personal protective equipment. Director James Carroll of the White House ONDCP released a letter on April 23, 2020 to the substance use treatment community, indicating that our treatment facilities represented front line healthcare workers, needing immediate access to PPE. Based on the AATOD informal Board member survey, it would appear that their tx programs are currently able to obtain personal protective equipment with some exceptions, including face shields and gowns. ➡️ https://bit.ly/3eKLh6R⬅️ ...

ACT NOW: The #COVID19 crisis has left many OTPs struggling to provide the treatment and social supports their patients rely on. Tell Congress to include opioid #recovery in the next COVID-19 relief package! ➡️http://ow.ly/FS9z50zRzVu #RecoveryNow⬅️ ...

Mark Parrino, the president of the American Association for the Treatment of Opioid Dependence, a group that largely represents methadone providers, recalled that one of his board members had recently mused that there had never been more of the drug in patients’ hands. “We have to hope that most of it is being used as dispensed, and not being sold on the black market or being misused by the patient,” he said, adding that he had heard a small number of anecdotal reports that some patients had overdosed on take-home medications.

Parrino stressed that those reports were only anecdotal — but that he also expects federal regulators, including the Substance Abuse and Mental Health Services Administration, to return to a more typical regulatory structure in the future.
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➡️https://www.statnews.com/2020/05/12/coronavirus-addiction-medicine-reforms-future/⬅️ #opioids #opiodcrisis #covid19 ...

Dr. Jason Kletter, AATOD’s CA Board delegate, expresses his concerns to @washingtonpost about the impact that COVID-19 is having on the opioid epidemic.
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Kletter noted that “opioid use disorder is fundamentally a disease characterized by isolation and hopelessness.”
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“There is evidence that epidemic is being exacerbated by this pandemic, so we need to make sure as a country we are continuing to provide recovery services to folks who need it to prevent a fourth wave of the opioid epidemic,” he added.
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To read more: ➡️https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2020/05/11/the-health-202-coronavirus-could-worsen-the-opioid-abuse-epidemic/5eb5ab2388e0fa17cddf6673/⬅️ ...

A: Curbside dosing should be considered if you are concerned about a symptomatic patient coming to the clinic. This should be in accordance with instruction per your SOTA. Suggestions for curbside dosing include:
• The nurse can prepare the dose, put it in a locked box, and with the escort of security, dose the patient outside of the clinic area.
• Prepare take-home doses consistent with your clinic protocols and provide them to patients in this same way with appropriate ID verification.
• For patients who you deem ineligible to manage take home doses safely, consider identifying a patient’s family member or stable support and, with the patient’s informed consent, provide education about safe storage, chain of custody procedures, and dosing instructions for them to administer the patient’s dose.
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We are sharing Q&A from the COVID-19 FAQ document which provides guidance to OTPs on a wide scope of topics: patient care, telehealth, PPE and employees. AATOD worked with our associates in the American Academy of Addiction Psychiatry and the University of Missouri-Kansas City in developing such responses. We hope that you find this resource to be helpful. #covid19 #opioidcrisis ➡️https://bit.ly/2x7vNKc⬅️ ...

A: There will not be any way to do so ethically until the supply is vastly increased. For now this
equipment is much more desperately needed by health care providers working in emergency rooms and
inpatient hospitals. OTPs are having difficulty in getting access to personal protective equipment. AATOD
is working with key suppliers to get this equipment to the programs. We obtained a letter from the
Assistant Secretary of Health and Human Services, which has been sent to suppliers. •
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We are sharing Q&A from the COVID-19 FAQ document which provides guidance to OTPs on a wide scope of topics: patient care, telehealth, PPE and employees. AATOD worked with our associates in the American Academy of Addiction Psychiatry and the University of Missouri-Kansas City in developing such responses. We hope that you find this resource to be helpful. #covid19 #opioidcrisis ➡️https://bit.ly/2x7vNKc⬅️ ...

A: If the clinic has a secure portal, documents can be moved between patient and clinic via such a portal. In most instances this approach is probably not practical. Thus, the best practice is to provide informed consent orally over telephone or video link and document in the chart notes that this process was conducted. SAMSHA has temporarily removed some 42 CFR Part 2 restrictions so that providers can communicate without a release for anything considered a medical emergency during this national emergency. If communication is important for the patient’s health or well-being, it is reasonable to consider that an “emergency” under the current circumstances. It is wise to document the reasoning behind the communication that occurs without a release.
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We are sharing Q&A from the COVID-19 FAQ document which provides guidance to OTPs on a wide scope of topics: patient care, telehealth, PPE and employees. AATOD worked with our associates in the American Academy of Addiction Psychiatry and the University of Missouri-Kansas City in developing such responses. We hope that you find this resource to be helpful. #covid19 #opioidcrisis ➡️https://bit.ly/2x7vNKc⬅️ ...

A: •Screen patients and visitors for symptoms of acute respiratory illness (e.g., fever, cough, difficulty breathing) before entering your healthcare facility. Keep up to date on the recommendations for preventing spread of COVID-19 on CDC’s website.
• Ensure proper use of personal protection equipment (PPE). Healthcare personnel who come in close contact with confirmed or possible patients with COVID-19 should wear the appropriate personal protective equipment.
• Conduct an inventory of available PPE. Consider conducting an inventory of available PPE supplies. Explore strategies to optimize PPE supplies.
• Encourage sick employees to stay home. Personnel who develop respiratory symptoms (e.g., cough, shortness of breath) should be instructed not to report to work. Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
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Continue to remind staff that their primary role is to support their clients in making the best decisions for themselves and their families. With OTPs, some essential staff functions will remain and services will need to be provided onsite. Those staff and clients need to be protected as best as possible from potential exposure to COVID-19. For staff that continue to interface with clients in-person on-site, they should follow CDC guidelines. If clients are presenting with symptoms and are asking for testing, assuming that OTPs do not have full primary care services and are not able to test, you should direct them to your local non-emergency hotline for more information about where they can go for testing.
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We are sharing Q&A from the COVID-19 FAQ document which provides guidance to OTPs on a wide scope of topics: patient care, telehealth, PPE and employees.
AATOD worked with our associates in the American Academy of Addiction Psychiatry and the University of Missouri-Kansas City in developing such responses. We hope that you find this resource to be helpful. #covid19 #opioidcrisis ➡️https://bit.ly/2x7vNKc⬅️ ...

A: *Stay up-to-date on the best ways to manage patients with COVID-19.
*Separate patients with respiratory symptoms so they are not waiting among other patients seeking care and have them wear a mask. Arrange for symptomatic patients to get COVID-19 testing. *Consider the strategies to prevent patients who can be cared for at home from coming to your facility potentially exposing themselves or others to germs, like:

1. Using your telephone system to deliver messages to incoming callers about when to seek medical care at your facility, when to seek emergency care, and where to go for information about caring for a person with COVID at home.

2. Adjusting your hours of operation to include telephone triage and follow-up of patients during a community outbreak.

3. Leveraging telemedicine technologies and self-assessment tools .
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We are sharing Q&A from the COVID-19 FAQ document which provides guidance to OTPs on a wide scope of topics: patient care, telehealth, PPE and employees.
AATOD worked with our associates in the American Academy of Addiction Psychiatry and the University of Missouri-Kansas City in developing such responses. We hope that you find this resource to be helpful. #covid19 #opioidcrisis ➡️https://bit.ly/2x7vNKc⬅️ ...

It's #GivingTuesdayNow, a global day of unity and contribution for COVID-19 relief. Your generosity allows AATOD to provide continued support and guidance to OTPs and other partners during this unprecedented time.
OTPs provide essential medical services. Our treatment programs are under considerable stress, especially in responding to the evolving needs of our patients. OTPs are also working to ensure that the program environment is as safe as possible for both patients and staff. We anticipate that there will be considerable reporting of patient and staff infection. We are in the early stages of collecting such information over the next several weeks in conjunction with our policy partners.
Together, we will ensure that AATOD continues the critical work in organizing treatment providers, advocates, and all interested stakeholders throughout the epidemic within this global pandemic. Without any question, difficult days lie ahead and OTPs will continue to serve as a vital resource to our patients and their families.
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Please give if you can ➡️http://www.aatod.org/give/⬅️ ...

“When you have reports from news organizations applauding first responders, police or firefighters as heroes, you don’t see that kind of reporting on the staff of OTPs,” Parrino said. “That may be related to stigma.” ➡️https://www.thedailybeast.com/opioid-deaths-surge-during-coronavirus-in-americas-overdose-capitals⬅️ #opioidepidemic #opioids #covid19 ...

Check out our newest blog post! 😷 How are Opioid Treatment Programs Combatting COVID-19? ➡️http://www.aatod.org/2020/05/how-are-opioid-treatment-programs-combatting-covid-19/⬅️
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#covid19 #otps #opioidepidemic #blog ...

New 🎥 Release: The Pew Charitable Trusts has created a video sharing a patient’s experience receiving outpatient treatment in Maryland for Opioid Use Disorder, which allowed him to recover while still going to school, working, and living his daily life. We encourage you to view and pass along as a way to encourage policymakers, providers, and patients to recognize outpatient programs as an important treatment option during this pandemic and beyond. ➡️https://youtu.be/2N-s0C_0z2Y⬅️ ...

“You don’t want to cause patients … greater exposure because it’s such a contagious virus and it does have a fair amount of mortality in a vulnerable population, but on the other hand you don’t want to give a lot of unstable patients a lot of take-homes because there is a risk,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence. His association issued guidance for providers in response to COVID-19 that include screening patients for symptoms when they arrive, and using clean water when mopping floors. • “Keep in mind some programs are not getting access to cleaning materials … because they are not seen as a priority,“ Parrino said. “So when a patient may say ‘hey, there’s not a lot of disinfecting going on,’ you have to question, does the program have access to the necessary disinfection agents?” ➡️https://theappeal.org/methadone-rules-requiring-in-person-visits-are-putting-patients-at-risk-of-coronavirus/⬅️ ...

“The concern is that, for a number of patients, the anxiety caused by this pandemic may push them over the edge. The potential for relapsing is high, and we’re trying to offset that,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, which represents about 1,200 of the country’s 1,700 opiate treatment centers. ➡️https://elemental.medium.com/the-heartbreaking-struggle-to-stay-sober-under-lockdown-e3aa4989deb3⬅️ #covid_19 #opioidcrisis ...