Interim Guidelines for Opioid Substitution Therapy during COVID-19 outbreak

Apr 6, 2020COVID, Guidelines, IPS Secretariat

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Summary: In view of the lock-down and other restrictions on movement and supplies, a potential suspension or glitches in maintaining the OST service is anticipated. In this context, it is essential to re-strategize the existing OST services to ensure the availability and access to services in the face of several structural (limited availability of human resources, restricted supply of medications) and attitudinal (fear and anxiety of healthcare workers) problems. These Interim Guidelines are issued by the IPS, keeping in view the different settings where OST is delivered in India. It is also recognized that settings operated under various Government programs may receive and follow the guidelines / instructions from their competent authorities. For example, OST facilities operating under NACO for injecting drug users dispensing plain buprenorphine have been instructed that “OST drugs may be distributed for at least seven days, based on the daily dosing and adherence level of IDUs, with issue of appropriate instructions”. This Interim Guidelines answers the challenges faced during COVID-19 outbreak for the OST services, including How to run the OST service in the context of outpatient department (OPD) restriction or full closure. How to carry on in-person medication dispensing (in view of the fact that buprenorphine and other controlled substances under Schedule X and NDPS Act are not permitted for prescription under the recently approved Telemedicine Practice Guidelines). How to maintain social distancing among patients and staff at the OST Clinic. How to maintain supply of BNX to patients on OST in the context of travel restrictions How to maintain supply of BNX to the Centre. How to manage the service with less-than-usual human resources.
Authors: Indian Psychiatric Society
Year of Publication: April-2020
Citation: n.a.

IJP Article Link

In view of the lock-down and other restrictions on movement and supplies, a potential suspension or glitches in maintaining the OST service is anticipated. In this context, it is essential to re-strategize the existing OST services to ensure the availability and access to services in the face of several structural (limited availability of human resources, restricted supply of medications) and attitudinal (fear and anxiety of healthcare workers) problems.

These Interim Guidelines are issued by the IPS, keeping in view the different settings where OST is delivered in India. It is also recognized that settings operated under various Government programs may receive and follow the guidelines / instructions from their competent authorities. For example, OST facilities operating under NACO for injecting drug users dispensing plain buprenorphine have been instructed that “OST drugs may be distributed for at least seven days, based on the daily dosing and adherence level of IDUs, with issue of appropriate instructions”.

This Interim Guidelines answers the challenges faced during COVID-19 outbreak for the OST services, including

  1. How to run the OST service in the context of outpatient department (OPD) restriction or full closure.
  2. How to carry on in-person medication dispensing (in view of the fact that buprenorphine and other controlled substances under Schedule X and NDPS Act are not permitted for prescription under the recently approved Telemedicine Practice Guidelines).
  3. How to maintain social distancing among patients and staff at the OST Clinic.
  4. How to maintain supply of BNX to patients on OST in the context of travel restrictions
  5. How to maintain supply of BNX to the Centre.
  6. How to manage the service with less-than-usual human resources.

The complete guideline can be downloaded in pdf format below.

 

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