A Crisis Within a Crisis: The Extended Closure of an Opioid Treatment Program After Hurricane Sandy

Abstract

Disruptions in opioid treatment programs (OTPs) are common after major disasters. Highly regulated OTPs confront challenges when responding to extended closures following disaster. Following Hurricane Sandy in 2012, an OTP located at the Manhattan Veteran Affairs Medical Center (VAMC) closed for 5 months. Semistructured interviews were conducted with clinicians and administrators who participated in the evacuation of the Manhattan VAMC, including the co-located OTP program. The Manhattan OTP preemptively dispensed emergency take-home methadone doses. Following closure, emergency guest-dosing arrangements were made for approximately 100 Veterans with Veterans Affairs (VA) and non-VA OTPs throughout New York City. Fortuitously, a retired VA OTP at another facility was reopened and accredited expeditiously. OTPs must improve contingencies for emergency response. However, disruptions in methadone delivery and threats to patient safety are likely to continue until agencies with oversight authority of OTPs describe specifications for emergency alternate care sites during long-term disaster recovery.