Narrative Review of Opioid Use Disorder Treatment Changes During the COVID-19 Pandemic and Their Impact on American Indian/Alaska Native Communities.

This is a narrative review, not a controlled trial or meta-analysis, so it cannot show that any policy change caused better or worse patient outcomes. The 44 included studies were heterogeneous, including qualitative interviews, surveys, chart reviews and national data, and many did not report race or ethnicity. Only two of the 44 studies provided an AI/AN option, and both had less than 4% AI/AN participants, so the review learned very little about AI/AN communities. Telehealth, take-home methadone and waiver changes happened together during the pandemic, so the contribution of any single component cannot be separated. Some included studies used convenience samples or had low response rates, such as 13.8% and 17%.

Funding was from a pre-doctoral diversity fellowship at the Tan Chingfen Graduate School of Nursing and UMass Chan Medical School, with C. Bingham-Hendrick as PI. No conflicts of interest are stated in the supplied text.

Do not read this as evidence that pandemic opioid treatment flexibilities improved outcomes for American Indian/Alaska Native communities. Only two of the 44 studies offered an AI/AN option, and both had less than 4% AI/AN participants, so the review could not assess their experience.