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Trevitt BT, Hayes V, Deacon R, Mills L, Demirkol A, Lintzeris N. The impact of changes in opioid dependency treatment upon COVID-19 transmission in Sydney, Australia: a retrospective longitudinal observational study. BMC Public Health 2024; 24:349. [PMID: 38308232 PMCID: PMC10835853 DOI: 10.1186/s12889-024-17827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND In April 2020, in response to the COVID-19 public health emergency, South Eastern Sydney Local Health District (SESLHD) Drug and Alcohol services modified their delivery of opioid dependency treatment (ODT) to reduce spread of COVID-19 and maintain continuity of care by increasing use of takeaway doses (TADs), transferring clients to local community pharmacies for dosing and encouraging the use of long-acting depot buprenorphine (LADB) which enabled once a month dosing. METHODS This study was a retrospective longitudinal case-control study conducted from August 1st, to November 30th, 2021. Eligible clients were those admitted for treatment with SESLHD ODT Services prior to August 1st,2021 and who remained in treatment beyond November 30th, 2021. COVID-19 diagnoses were determined by a COVID-19 PCR and extracted from the electronic Medical Records (eMR) Discern Reporting Portal. Demographic, clinical and dosing related data were collected from eMR and the Australian Immunisation Register (AIR). RESULTS Clients attending SESLHD ODT services had significantly greater odds of acquiring COVID-19 than the NSW adult population at large (OR: 13.63, 95%CI: 9.64,18.88). Additionally, amongst SESLHD ODT clients, being of Aboriginal and Torres Strait Islander origin was associated with greater odds of acquiring COVID-19 (OR = 2.18, CI: 1.05,4.53); whilst being employed (OR = 0.06, CI:0.01,0.46), receiving doses at pharmacy (OR = 0.43, CI: 0.21,0.89), and being vaccinated (OR = 0.12, CI: 0.06,0.26) were associated with lower odds. Every additional day of attendance required for dosing was associated with a 5% increase in odds of acquiring COVID-19 (OR = 1.05, CI: 1.02,1.08). CONCLUSIONS Clients attending SESLHD ODT services are significantly more likely to acquire COVID-19 than the NSW population at large. Promoting vaccination uptake, transferring clients to pharmacy, and reducing the frequency of dosing (by use of takeaway doses or long-acting depot buprenorphine) are all potential methods to reduce this risk.
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Affiliation(s)
- Benjamin T Trevitt
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia.
| | - Victoria Hayes
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, NSW, Australia
| | - Rachel Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- Speciality Addiction Medicine, Faculty Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, NSW, Australia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- Speciality Addiction Medicine, Faculty Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, NSW, Australia
| | - Apo Demirkol
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, NSW, Australia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- Speciality Addiction Medicine, Faculty Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, NSW, Australia
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