Literature Collection

Background: A scoping review was conducted to examine the breadth of evidence related to telehealth innovations being utilized in the treatment of opioid use disorder (OUD) with buprenorphine and its effect on patient outcomes and health care delivery. Materials and Methods: The authors systematically searched seven databases and websites for peer-reviewed and gray literature related to telehealth solutions for buprenorphine treatment published between 2008 and March 18, 2021. Two reviewers screened titles and abstracts for articles that met the inclusion criteria, according to the scoping review study protocol. The authors included studies if they specifically examined telehealth interventions aimed at improving access to and usage of buprenorphine for OUD. Results: After screening 371 records, the authors selected 69 for full review. These studies examined the effect of telehealth on patient satisfaction, treatment retention rates, and buprenorphine accessibility and adherence. Conclusion: According to the reviewed literature, incorporation of telehealth technology with medication-assisted treatment for OUD is associated with higher patient satisfaction, comparable rates of retention, an overall reduction in health care costs, and an increase in both access to and usage of buprenorphine. This has been made possible through the expansion of telehealth technologies and a substantial push toward relaxed federal guidelines, both of which were quickly escalated in response to the COVID-19 pandemic. Future research is needed to fully quantify the effect of these factors; however, the results appear promising thus far and should urge policymakers to consider making these temporary policy changes permanent.

Substance use-related harms including drug overdose deaths and new cases of human immunodeficiency virus (HIV) and hepatitis C (HCV) are increasing in the US. Syringe services programs (SSPs) started in the 1980s as community-based efforts to distribute sterile syringes and provide safe injection information to people who inject drugs (PWID) in response to rising HIV infection rates. SSPs are guided by harm reduction principles, which aim to mitigate the negative consequences of drug use. The term SSP broadly refers to the provision of sterile syringes and other supplies and is inclusive of any setting that provides these supplies for the intended injection of drugs. The present report is an attempt to provide an overall picture of what is known about the benefits and potential harms of SSPs, which has been an active area of research for the past 4 decades. This report was requested by the VA Offices of Mental Health and Suicide Prevention, Research and Development, and Specialty Care Services to inform VA efforts to meet the goals of the Office of National Drug Control Policy and to implement best practices for harm reduction in VHA settings.