Longitudinal trends in service utilisation of Alcohol and Other Drugs Services (AODS) during COVID-19: A Scoping Review

Abstract

Background: COVID-19 has affected service delivery and utilization of AODS worldwide with a potential negative impact on service users and staff. Objectives: To understand the trends of service utilization of AODS, identify knowledge gaps, and provide directions for future research and planning. Methods: Medline, Embase, CINAHL, PubMed and PsycINFO were searched for original articles published in English since 2019, with quantitative analysis of service utilization of AODS. Of the 1546 initial search results, 938 were screened after de-duplication and 43 underwent full-text review. Data extracted from 30 studies informed this review. Results: Of the studies, 29 were from high-income countries and 15 focused on medication for opioid use disorders (MOUD). An initial reduction of service utilization followed by gradual improvement was seen in most treatment types, with most disruptions in residential programs, outreach services, home visits, group therapy and needle syringe programs and fewer disruptions in individual counselling and MOUD. Treatment initiations decreased, while treatment adherence improved during COVID-19. The use of telehealth and treatment-related policy changes were associated with improved service utilization. Telehealth was associated with catchment expansion and broadening of service-user profiles. An increased tendency to use the opioid long-acting injection was reported in Australia. Conclusions: The impact of COVID-19 on AODS changed over time and according to, the drug/treatment type and geographical remoteness. Main contributors to minimizing disruptions in service utilization included treatment-related policy changes, telehealth, and newer treatment modalities. Longitudinal studies beyond 2021 and studies on regional/rural AODS and AOD workforce are recommended.