This academic paper provides a summary on state-level policy data relevant to opioid use disorder treament reported by government and non profit agencies that track healthcare regulations. The four areas this report focuses on are tele-health, privacy, licensing, and medication for opioid use disorder (MOUD) during the COVID-19 pandemic. 

This report displays which states continue to allow tele-health prescriptions for medications for opioid use disorder (MOUD) through an interactive map. Each state is assigned a color based on whether or not the state explicitly allows tele-health prescriptions. It provides a snapshot of current tele-health MOUD state policy 18 months into the pandemic. 

This academic paper describes the implementation of a novel telemedicine treatment program that provided buprenorphine to incarcerated individuals in detention centers located in rural Maryland. Results of this flexible and innovative program are promising. The challenges and successes that this program faced are discussed in detail. 

This academic paper conducted a review of existing literature describing new services and service modifications implemented by treatment and harm reduction programs serving people who use opioids, and also discusses implications for policy and practice. The authors set their literature review in the specific time frame of the COVID-19 pandemic, in order to analyze how the pandemic impacted these programs. 

This is a report from the National Council on Mental Wellbeing that aims to help harm reduction organizations, treatment providers, and other organizations that serve people who use drugs overcome challenges associated with implementing telehealth and technology-assisted services and leverage these advances to help improve the health and wellness of the individuals they serve. Successful initiatives are highlighted throughout the report. 

This is a report from the National Council for Behavioral Health that conducted an environmental scan consisting of a literature review and key informant interviews to better understand the impact of the coronavirus pandemic on harm reduction services and people who use drugs. It highlights how services have been disrupted and how programs have adapted.  

This is an academic paper that provides a review of public health messaging related to harm reduction, and calls for these services as being essential during the coronavirus pandemic. The reference list has 60 reports and papers related to the intersection of the opioid crisis and the pandemic. 

This is an academic paper that provides commentary an overview of operational changes for 82 syringe service programs SSP) across the United States as a result of the coronavirus pandemic. Most SSPs remained open (85%) but services were disrupted as some offered less services and others had moved to mobile outreach. 

This is an academic paper that provides commentary on the risk factors for substance use among youth that have been exacerbated by the coronavirus pandemic. Challenges to program adaptions for this population are highlighted and recommendations are made. 

This is an academic paper that provides commentary on the racial disparities in access to medications for opioid use disorder (MOUD), especially buprenorphine, and proposes short- and long-term solutions to address racial and socioeconomic disparities in access to MOUD following changes in regulations due to the coronavirus pandemic. 

This is an academic paper that presents promising findings from the HEROES program in Texas that reported an overall increase in patient engagement over time after rapidly enacted virtual care with telehealth for peer coaching, counseling, groups, and provider visits in response to the coronavirus pandemic. 

This is a policy brief from the Foundation for Opioid Response Efforts that provides best practices for delivering medications for opioid use disorder (MOUD) in correctional settings during the coronavirus pandemic and highlights modifications undertaken in these settings from three different states. 

This is a toolkit from the National Academy for State Health Policy (NASHP) that shares innovations, resources, and lessons learned from five state teams (Alabama, Illinois, South Dakota, Virginia, and Wisconsin) that are working to strengthen the capacity of their Federally Qualified Health Centers (FQHCs), such as community health centers, to deliver substance use disorder care. Program models are discussed that overcome the unique challenges of FQHCs. There is a special section on COVID-19.

This is an academic article that provides commentary on the possibilities of new models of care for opioid use disorder (OUD) as a result of changing regulations during the coronavirus pandemic. Framed in the cascade of care model, new models could identify, initiate, engage, and retain more people in OUD treatment with medications. 

This is an academic paper that highlights that, even though the majority of those who are incarcerated have substance use disorders, there is little opportunity for treatment while incarcerated. As a solution to addiction, mass incarceration has only led to a larger population at higher risk during the coronavirus pandemic. Recommendations are made for criminal justice reform.  

This is an academic paper that describes an adaptation of one of the only syringe service programs in Florida, the IDEA Exchange, to the coronavirus pandemic. The program location had to temporarily close but a telemedicine clinic, called TeleMOUD, was started to deliver buprenorphine to their clients, which was found to be a feasible, low-threshold access program. 

This is an academic article that discusses why people who use drugs are at increased risk for exposure to COVID-19, due to structural and social challenges, and why this population is at increased risk for a more severe course of the virus, primarily due to comorbidities. 

This is an academic paper that reviews the relaxed regulations and laws around medications for opioid use disorder and discusses the possibilities of expanding low-threshold access, such as prescribing methadone in primary care and higher utilization of long-acting injectables. 

This is commentary from the New England Journal of Medicine that gives an overview of the evidence for initiating medications in the emergency department for opioid use disorder and highlights the importance of scaling this beneficial intervention given the increasing overdoses during the coronavirus pandemic. 

This is an academic paper that provides commentary on the fact that reduction in jail populations during coronavirus are likely to be disproportionately suffering from substance use disorders. Medicaid expansion, outreach and assistance with obtaining Medicaid coverage, and leveraging telemedicine are possible policy solutions. 

This is a collection of a wide range of COVID-19 resources from the Curated Library of Opioid Use for Decision-Makers (CLOUD) across the continuum of care: prevention, harm reduction, treatment, and recovery. 

This is a report from the Addiction Policy Forum that surveys over 1,000 people with substance use disorders and their families. More than a third reported service disruption of treatment or recovery support services, 14% were unable to receive needed services, and 20% reported that their/their family member's substance use has increased during the coronavirus pandemic. 

This is an academic paper that assess treatment utilization among those with substance use disorders during the coronavirus pandemic. Like other areas of the healthcare system, findings from this study show that service disruption and fear of contracting COVID-19 have decreased treatment utilization among this population. 

This is an article from NASHP that describes Louisiana's statewide response to ensure access to harm reduction services, which include syringe service programs, overdose prevention, and infectious disease testing. Funding allocation, the use of telemedicine, and addressing disparities is discussed. 

This is an academic paper that presents the findings of a survey among young adults during the coronavirus pandemic. Nearly half of participants reported a great degree of loneliness, almost 80% reported depressive symptoms, 61% reported anxiety symptoms, and 22% reported drug use (with 38% of these reporting severe drug use). 

This is a commentary from clinicians that have adapted their treatment of youth with substance use disorders during the coronavirus pandemic, including using telehealth to deliver care. Barriers of telehealth specific to youth and how these can be overcome are discussed. 

This is an academic paper that presents the results of a survey to those with substance use disorder, along with those in remission, and their families on the impact of COVID-19. Those with a history of using multiple substances reported greatest disruption in services, suggesting that polysubstance users may be at greater risk during the coronavirus pandemic. 

This is a report from NASHP that discusses how states are providing guidance to ensure access to harm reduction services and highlights programs that have successfully adapted to the coronavirus pandemic. 

This is an academic commentary that discusses the impact of coronavirus pandemic on residential recovery homes, with a focus on the disruption of the social aspects of this model that are critical to improving client wellness. Adaptions of recovery homes during COVID-19 are highlighted. 

This is an academic paper that provides an overview of digital recovery support services, types of these services, how they may work to help people sustain recovery during the coronavirus pandemic, and evidence of their effectiveness. 

The Homeless Health Care Los Angeles Center for Harm Reduction (HHCLA-HRC) provides harm reduction and treatment services to marginalized populations. They have adapted to COVID-19 with two innovative models, the "telephone booth" model and the "coordinated pharmacy" model, with preliminary results showing that they are maintaining patient enrollment and engagement of medications for opioid use disorder. 

This is an academic commentary article that gives an overview of the expansion of telemedicine to treat substance use disorder during the coronavirus pandemic as well as both opportunities and barriers to accessing care in this new environment.  

This is an academic paper that discusses the impact of the coronavirus pandemic on treatment of opioid use disorder among Indigenous people and how services tailored to this vulnerable population have adapted. 

This is an academic paper that uses a national database of drug screens to examine how the coronavirus pandemic has affected substance use. Using drug testing as a surveillance tool, findings show that positive test rates increased by 35% for non-prescribed fentanyl, 44% for heroin, and 10% for non-prescribed opioids.

This is an academic paper that describes interventions put in place in British Columbia, Canada to address unique problems exacerbated by the coronavirus pandemic, such as safe supply and relaxing medication treatment regulations. Protective measures for first responders responding to overdoses is also discussed. 

This is an academic paper that presents a case study on providing an online recovery support service, SMART Recovery meetings, in Kansas, a predominantly rural state. The implementation of the adapted program and lessons learned are discussed. 

This is an academic paper that provides commentary on how virtual mutual help organization meetings, such as online 12-Step meetings, can provide some of the therapeutic benefits of in-person recovery support meetings in the context of the coronavirus pandemic.  

This is a report from de Beaumont and the Well Being Trust that provides recommendations that can be implemented to address mental health in both the immediate response and recovery phases of the coronavirus pandemic, with a special section on substance use disorders.

This is an academic paper that provides results on a national survey of emergency medical services (EMS) directors to understand how overdose events and naloxone administration practices have changed during the coronavirus pandemic. Findings were geographically mixed, where some regions saw an increase in overdoses and naloxone administration and some regions saw a decrease. 

This is an article from the CDC that discusses how people with substance use disorder are especially vulnerable to the coronavirus pandemic, with an emphasis on the likely outcome that economic disruptions will increase substance use. The article highlights what is being done so far and has links to helpful resources. 

This is an academic paper that shows that the coronavirus pandemic exacerbated the opioid crisis in San Francisco. Emergency departments saw approximately 2.5 patients per day with opioid overdose compared with 1.4 patients per day prior to this period, and 8, there were 1.47 deaths per day due to overdose compared with 0.95 deaths per day prior to this period

This is an academic paper that shows that the coronavirus pandemic exacerbated the opioid crisis in Indianapolis. Overdose calls for service increased 43%, calls for service with naloxone administration increased 61%, and deaths from drug overdoses increased by 47%

This is a report from the National Institute of Environmental Health Sciences tailored to employers and employees on the acceleration of the opioid crisis during the coronavirus pandemic. Strategies are presented for employers to navigate increased risks to their employees.  

This is a website from the Indian Health Service that discusses the challenges in addressing the opioid crisis during the coronavirus pandemic among Native Americans and Alaskan Natives. Includes many useful links to resources. 

This is a report from JBS International targeted towards people who use drugs that provides guidance on navigating the coronavirus pandemic and decreasing risk of overdose, including safe injection practices, access to naloxone, and treatment options. 

This is a brief report from the New York State Department of Health that provides guidelines to opioid overdose prevention programs operating in the state during the coronavirus pandemic. The document includes links to resources. 

This is an academic paper that uses a surveillance technique to study national changes in illicit drug use during the coronavirus pandemic using urinary drug screens. Findings show that illicit drug use has increased during the pandemic, including heroin, fentanyl, cocaine, and methamphetamine use. 

This is an academic paper that summarizes the regulatory changes to opioid use disorder treatment, highlights how communities have responded, and provides updated evidence on the exacerbation of the opioid crisis during the coronavirus pandemic. 

This is an academic paper that shows that nonfatal overdoses increased in an urban hospital in Virginia during the coronavirus pandemic. The large majority (80%) of those who experienced a nonfatal overdose identified as Black. 

This is an academic paper that provides results of a qualitative study that interviewed buprenorphine prescribers on how they have adapted to the coronavirus pandemic. Most providers were only doing telehealth visits. Noted positives included increased access to treatment and noted negatives included technological issues and less structure and accountability. 

This is an academic paper that discusses the role of telehealth in expanding access to medications for opioid use disorder in rural areas. The need for integrating telemedicine into primary care in rural areas is highlighted as well as how the coronavirus pandemic has loosened restrictions to providing these services.  

This is an academic paper that gives an interdisciplinary perspective on the intersection of the coronavirus pandemic, substance use disorders, comorbidities, and socioeconomic status. A comprehensive set of policy changes and interventions are suggested.  

This website provides webinars, journal articles, and reports to support a community's response to the opioid crisis during the coronavirus pandemic. The webinars feature a panel of experts in the field and include a recording and presentation slides. 

This is a website that offers states resources on best practices, innovative policies, and emerging issues related to opioid use disorder treatment, with a particular focus on telehealth, expanding harm reduction services, and serving marginalized populations during the coronavirus pandemic. 

This is an academic paper that provides commentary on the barriers and disparities of buprenorphine prescribing, the changes in buprenorphine delivery during the coronavirus pandemic, and how sustaining these changes long-term will lead to better outcomes for those with opioid use disorder. 

This is a report from several collaborating organizations (authors Johnson and Beletsky) that provides recommendations on how to scale up re-entry services for incarcerated individuals during the coronavirus pandemic, in the context of the general public's support of different re-entry interventions as a result of COVID-19. 

This is an academic paper that provides commentary on the temporary changes made to opioid use disorder treatment during the coronavirus pandemic, such as telemedicine, relaxed regulations around medications for opioid use disorder, and decarceration, and how sustain these changes will have positive long-term impacts on the opioid crisis. 

This is a report from the Opioid Response Network that discusses the importance of social determinants of health (SDOH) in the progression of opioid use disorder (OUD) and the role that SDOH are playing among those with OUD in the coronavirus pandemic. Recommendations are made targeting both individuals and organizations. 

This is an academic paper that focuses on the importance of naloxone distribution during the coronavirus pandemic. 

This is an academic paper that provides empirical evidence that opioid overdoses are increasing during the coronavirus pandemic in Kentucky, confirming anecdotal reports in news articles. 

This is an academic paper that gives an overview of the regulations that were relaxed to increase access and engagement in medications for opioid use disorder (MOUD) during the coronavirus pandemic, and the possibility for these new regulations to remain after the pandemic is over. 

This is an academic article that provides commentary on the unique opportunity of the coronavirus pandemic response to SUD that could reshape and update addiction treatment networks long-term, broken into seven pillars.

This is an academic paper that discusses how the coronavirus pandemic will disproportionately impact people who use drugs directly, through homelessness, cormorbidities, and incarceration, and indirectly, through closing down or restricting vital services. 

This is a report from the National Governors Association that describes strategies that governors are using to address the dual crises of the opioid epidemic and the coronavirus pandemic in the face of a restricted state budget.  

This is an academic paper that provides commentary on the impact of the coronavirus pandemic on syringe service programs (SEPs) in rural Appalachia. Although SEPs are closing nationally, this region has been disproportionately affected by closings and restricted services due to limited resources. Impacts on and responses of specific harm reduction organizations are highlighted. 

This is a report from ODMAP, an overdose surveillance organization, which found that 62% of participating counties experienced an increase in overdose submissions after March 19, 2020, there was an 18% increase in overdose submissions after stay-at-home mandates, and clusters of overdoses have moved from urban areas to suburban and rural areas. 

This is a brief report from the National Academy of Medicine that provides and expands upon key priorities to mitigate the worsening of the opioid crisis and other substance use disorders during the coronavirus pandemic. 

This is an academic article that highlights that, although access to syringe service programs is vital during the coronavirus pandemic, many of these organizations have had to close their doors. Leveraging these organizations to address the dual impact of the opioid crisis and the pandemic is discussed.  

This is an academic paper that describes the importance of using telemedicine to treat substance use disorders (SUD) during the COVID-19 pandemic. It discusses policy changes that have reduced barriers and provides recommendations on how to sustain implementation of telehealth into SUD treatment after the pandemic. 

This website is a collection of resources to inform the response to the opioid crisis in the context of the coronavirus pandemic. ORTAC directs and manages the website, OverdoseFreePA. 

This is an academic paper that highlights the potential exacerbation of the opioid crisis by the coronavirus pandemic and poses policy changes to mitigate this. 

This is an academic paper that discusses the increased risk of the coronavirus pandemic to those who are incarcerated, the majority of whom have a substance use disorder. Policy solutions are proposed. 

This is a regularly updated issue brief from the United Nations Office on Drugs and Crime that offers a preliminary assessment of the impact of the coronavirus pandemic on illicit drug markets, with the aim of alerting communities about how the drug supply and drug use could be affected in both the short- and long-term. 

This is an issue brief from the American Medical Association (AMA) that provides regularly updated literature (news articles and reports on the local, state, and federal levels) on the increase in opioid-related consequences due to the coronavirus pandemic. 

This is an academic paper that provides commentary on innovative strategies to increase physical distancing among those with substance use disorders beyond relaxing regulations for buprenrophine and methadone as part of the response to the Covid/coronavirus pandemic. 

This is a report from the Well Being Trust that predicts, across nine different scenarios, additional deaths of despair range from 27,644 (quick recovery) to 154,037 (slow recovery), with somewhere in the middle being around 68,000. 

This is an academic paper that provides commentary on an emerging treatment model for opioid use disorder (OUD), where medication treatment is delivered through telemedicine. Different telemedicine models for buprenorphine are discussed, as well as strengths and weaknesses of these models. This is especially relevant due to the recent Covid/coronavirus pandemic. 

This comprehensive website provides links to resources for the intersection of the opioid crisis and the coronavirus pandemic, makes available previously reported webinars on supporting addiction treatment during the pandemic, and lists several commentaries in academic journals written by experts in the field. 

This is a report from Unity Recovery that provides guidance on how this recovery community organization provides digital recovery support services to their clients, with a special emphasis on recovery coaching through telehealth. This technology is especially relevant in the context of the COVID-19/Coronavirus pandemic. 

This website from the Yale Program in Addiction Medicine provides documents for different stakeholders impacted by the coronavirus pandemic, including guidance for youths and adults engaged in treatment, clinicians, and hospitals. 

This website from KFF gives a breakdown of the epidemiology of the coronavirus epidemic in the United States on a state level, providing up-to-date numbers on cases, tests, hospitalizations, and deaths. 

This website from the Harm Reduction Coalition gives general information about the coronavirus, guidance for people who use drugs during the pandemic, and information on safer drug use during the COVID-19 outbreak. 

This is an editorial in an academic journal about the impact of the coronavirus pandemic on different aspects of the opioid use disorder treatment system, including opioid treatment providers, buprenorphine prescribing, bridge clinics, telemedicine, and delivery of harm reduction. 

This is a perspective academic paper by medical providers on the intersection of the opioid crisis and the coronavirus pandemic, with a focus on buprenorphine prescribing and sustainability of opioid research. 

This is a perspective academic article on the intersection of the opioid crisis and the coronavirus pandemic written by expert researchers, with a focus on treatment access for medications for opioid use disorder (MOUD). 

A perspective academic article by Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), about the intersection of the coronavirus pandemic and the opioid crisis. 

This is a policy brief from Carnevale Associates that discusses the short- and long-term need for substance use prevention and offers recommendations on how prevention professionals can safely continue work during the coronavirus pandemic. 

This is an academic paper that examines how the challenges presented by the coronavirus may further marginalize people who use drugs, especially in rural areas. The healthcare system, criminal justice system, housing, and overdose risks are discussed.

This is an academic paper that provides challenges for how primary care providers in rural areas will respond to the intersection of opioid use disorder and COVID-19, and recommendations are made to meet challenges presented by the coronavirus.

The Partnership for Drug-Free Kids hosts a web page listing many online addiction resources for families and individuals during the coronavirus pandemic.

Brattleboro Retreat in Vermont is taking a number of steps to meet the challenge of providing addiction treatment services during the coronavirus pandemic, including limiting admissions to in-state residents, setting up a care facility for those who test positive for the virus, and implementing telehealth for in-person meetings and counseling sessions.

This is a coronavirus toolkit from Shatterproof for addiction treatment providers. There are links to finding specific information on telehealth/telemedicine, state policies on opioid treatment providers (OTPs) operation during the pandemic, and insurance guidance. 

The Ohio Mental Health and Addiction Services Coronavirus Opioid Treatment Providers FAQ gives these organizations guidance on navigating state and federal regulations for methadone and buprenorphine during the Covid pandemic. 

The SAMHSA Coronavirus resource page provides information on assisting individuals, providers, communities, and states across the country in meeting the challenges of the Covid pandemic. These include a list of virtual recovery support services. 

The American Society of Addiction Medicine (ASAM) Coronavirus resource page provides information on the addiction treatment system during the Covid pandemic, including guidance to treatment providers, addiction treatment professionals, and accessing medications for opioid use disorder. 

NEXT Distro is a harm reduction organization that has created an online and mail-based opioid overdose response training platform that facilitates access to naloxone through the mail. In addition, this website has state-level information on harm reduction services and has been essential to naloxone distribution during the COVID-19 pandemic.