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Table 1 Categorization and descriptions of evidence

From: The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review


Study Design(s)

Data Source(s)

Key findings

Service delivery (n = 7, 47%)

Prescriptions filled (n = 3)

  McIlveen et al. [17] (U.S./Oregon)


Electronic medical record of outpatient OUD treatment centers in Oregon

In-person medication dosing visits declined 33%, and take home medication increased 97% as intended.

  Jones et al. [18] (U.S./Nationwide)


IQVIA Total Patient Tracker


Buprenorphine was dispensed at an expected rate, but intramuscular naloxone was not.

  Thornton et al. [19] (U.S./Texas)


Texas Prescription Monitoring Program dataset

Filling of daily buprenorphine prescriptions remained steady.

EMSa and EDb utilization (n = 4)

  Glober et al. [20] (U.S./Indiana)


EMS and coroner’s office record in Marion County, Indiana

47% increase in calls for overdose.

  Holland et al. [21] (U.S./Nationwide)


Center for Disease Control and Prevention’s National Syndromic Surveillance Program

ED visits for reasons of opioid overdose were significantly higher during the pandemic compared to 2019 rates.

  Slavova et al. [22] (U.S./Kentucky)


Kentucky State Ambulance Reporting System

71% increase in refusal of transport to a hospital following an overdose call to EMS. 50% increase in overdose calls involving death at the scene.

  Weiner et al. [23] (U.S./Massachusetts)


Massachusetts Ambulance Trip Information System

After the stay-at-home order, most calls other than substance use dropped, but substance related EMS calls increased substantially.

Provider and patient experiences (n = 3, 20%)

Provider experiences (n = 2)

  Caton et al. [24] (U.S./California)


338 clinicians from 57 primary care clinics in California

66% of clinics reported an easier time or an unchanged difference in retention and engagement of clients during the pandemic.

  Collins et al. [25] (U.S./Rhode Island)


14 Emergency room healthcare providers

Barriers persist in connecting patients to outpatient treatment, including capacity and infrastructure to use telehealth and, COVID-test requirements as a barrier to accessing treatment.

Patient experiences (n = 1)

  Krawczyk et al. [26] (International)


300 posts of Reddit users related to COVID-19 and opioid used

Concerns over less in-person access to OUD treatment facilities, COVID-19 testing treatment requirements and exposure to COVID were reported as an influence on motivation to seek treatment.

Patient outcomes (n = 5, 33%)

Overdose (n = 3)

  Khatri et al. [27] (U.S./Pennsylvania)


Philadelphia Dep Health Substance Use Dashboard and Medical Examiner’s Office Data

African Americans comprised 80% of overdose ED visits post-pandemic, compared to 63% pre-pandemic.

  Ochalek et al. [28] (U.S./Virginia)


Electronic medical record of Virginia Commonwealth University

During the pandemic, 2.5 patients were seen per day in the emergency department with opioid overdose, compared to 1.4 patients per day pre-pandemic.

  Rodda et al. [29] (U.S./California)


Electronic medical records and medical examiner records in San Francisco

Fatal overdoses significantly increased 60% in Non-Hispanic Black patients post-COVID restrictions, overdoses in Non-Hispanic White patients decreased.

Retention in treatment (n = 1)

  Tofighi et al. [30] (U.S./New York)


Bellevue Hospital (NYC) electronic medical record


  1. aEmergency Medical Services; bEmergency Department