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Published Online: 5 June 2024

Considerations for Opioid Use Disorder Treatment From Policy Makers’ Experiences With COVID-19 Policy Flexibilities

Lavonia Smith LeBeau, Ph.D., Mackenzie C. White, B.A. [email protected], Rachel Mosher Henke, Ph.D., Justeen Hyde, Ph.D., Alexis Sarpong, M.P.H., Risa B. Weisberg, Ph.D., Nicholas A. Livingston, Ph.D., and Norah Mulvaney-Day, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 11
https://doi.org/10.1176/appi.ps.20230260
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Abstract

Objective:

This qualitative study aimed to examine how states implemented COVID-19 public health emergency–related federal policy flexibilities for opioid use disorder treatment from the perspective of state-level behavioral health policy makers. Recommendations are given for applying lessons learned to improve the long-term impact of these flexibilities on opioid use disorder treatment.

Methods:

Eleven semistructured interviews were conducted with 13 stakeholders from six state governments, and transcripts were qualitatively coded. Data were analyzed by grouping findings according to state-, institution-, and provider-level barriers and facilitators and were then compared to identify overarching themes.

Results:

Policy makers expressed positive opinions about the opioid use disorder treatment flexibilities and described benefits regarding treatment access, continuity of care, and quality of care. No interviewees reported evidence of increased adverse events associated with the relaxed medication protocols. Challenges to state-level implementation included gaps in the federal flexibilities, competing state policies, facility and provider liability concerns, and persistent systemic stigma.

Conclusions:

As the federal government considers permanent adoption of COVID-19–related flexibilities regarding opioid use disorder treatment policies, the lessons learned from this study are crucial to consider in order to avoid continuing challenges with policy implementation and to effectively remove opioid use disorder treatment barriers.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 11 • November 01, 2024
Pages: 1109 - 1116
PubMed: 38835255

History

Received: 7 June 2023
Revision received: 5 October 2023
Revision received: 5 February 2024
Accepted: 19 March 2024
Published online: 5 June 2024
Published in print: November 01, 2024

Keywords

  1. drug use
  2. drug treatment/psychopharmacology
  3. coronavirus/COVID-19
  4. public policy issues

Authors

Details

Lavonia Smith LeBeau, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Mackenzie C. White, B.A. [email protected]
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Rachel Mosher Henke, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Justeen Hyde, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Alexis Sarpong, M.P.H.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Risa B. Weisberg, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Nicholas A. Livingston, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Norah Mulvaney-Day, Ph.D.
Customer Value Partners, Washington, D.C. (Smith LeBeau); IBM Consulting, Bethesda (White); The Lewin Group, Optum Serve, Boston (Henke); Chobanian & Avedisian School of Medicine, Boston University, Boston (Hyde, Weisberg, Livingston); Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts (Hyde); Boston VA Research Institute, Boston (Sarpong); Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston (Livingston); Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts (Mulvaney-Day).
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Notes

Send correspondence to Ms. White ([email protected]).

Competing Interests

Dr. Weisberg is the chief clinical officer of and holds stock options in RealizedCare, a digital therapeutics company that makes interventions for behavioral health problems, including opioid use disorder. The other authors report no financial relationships with commercial interests.

Funding Information

This work was supported by the Patient-Centered Outcomes Research Institute (grant COVID-2020C2-11081).The funding source was not involved in study design; data collection, analysis, or interpretation; or the writing of the manuscript. The views expressed in this article are those of the authors and do not necessarily reflect those of the VA or the U.S. government.

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