1. Revised service delivery of opioid agonist treatment in Norway in 2021, the second year of the pandemic: a national cross-sectional study of treatment provider experiences

In Norway, opioid agonist treatment (OAT) clinics had to adapt to more flexible approaches due to the pandemic. The main aim of this study was to explore treatment provider experiences during the second year of the pandemic.

Electronic questionnaires were distributed to OAT clinics in Norway in December 2021, with questions related to treatment provider experiences, changes in OAT service delivery and patient outcome during the past 12 months. The respondents were 23 managers/clinicians from publicly funded clinics, responsible for the treatment of 7789 (>90%) of around 8100 OAT patients.Most OAT clinics (21/23, 91%) still practiced some adjusted approaches as established in the beginning of the pandemic. The most common adaptions were provision of low-threshold access to OAT (14/23, 61%), extended intervals for take-home medications (12/23, 52%) and less urine tests (13/23, 57%). Telephone- (21/23, 91%) and video conferences (20/23, 87%) instead of face-to-face meetings were common. Few patients (<5) nationally had been hospitalised with COVID-19. Almost half of the clinics (10/23, 43%) had re-introduced pre-COVID OAT dispensing practices, and some respondents expressed concerns related to reports of increased diversion of OAT medications. Another clinical concern was isolation and mental health problems among OAT patients.

Although few OAT patients were hospitalized with COVID-19, measures such as social distancing might have had a negative impact on patients’ mental health as well as on aspects of clinical safety, including diversion. It remains open how clinical practice will be impacted in the longer term.