title: Challenges to Opioid Treatment Programs After Hurricane Sandy: Patient and Provider Perspectives on Preparation, Impact, and Recovery.
abstract: Over 300,000 patients with an opioid use disorder (OUD) receive methadone maintenance therapy from opioid treatment programs (OTPs) in the United States. Large numbers of these attend OTPs located in New York and New Jersey, areas (largely but not exclusively coastal) impacted by Hurricane Sandy (Sandy) on October 29th, 2012. Disruption of methadone dispensing and other services can have severe consequences to patients (and treatment seekers) such as relapse, dropping out of treatment and resumption or increase in HIV/HCV injection risk behaviors. To facilitate OTP preparedness and response, we developed recommendations for OTPs for future emergencies. Using both qualitative and quantitative measures, we obtained data from OTP directors, staff, patients and out-of-treatment persons to learn how OTPs prepared for the impending hurricane, whether recovery efforts were successful, and what impact the hurricane has had. We observed a wide range of preparation and recovery efforts among participating programs. Director, staff, and patient perspectives on programs' responses and storm impact often differed. Triangulated data suggest that program responses were adequate for a majority of patients. For a sizeable minority of patients, program responses were very successful; for at least 20% of the clinics, program planning and responses were inadequate to meet the needs of patients. Among the recommendations made for sustaining continuity of care in future emergencies are: a focus on improving communication, procuring transportation, guest dosing, and take home provisions.
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Harlan
authors.initials: H
authors.lastname: Matusow
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Benoit
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Luther
authors.initials: L
authors.lastname: Elliott
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Eloise
authors.initials: E
authors.lastname: Dunlap
authors.affiliation: a National Development and Research Institutes , New York , New York , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002959:Civil Defense / Q000379:methods*; D055867:Cyclonic Storms; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009515:New Jersey; D009518:New York; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires
chemical_list: D008691:Methadone
keywords: Disaster preparedness; Hurricane Sandy; OTPs; buprenorphine; methadone; opioid treatment; treatment access