As the leader in developing clinical guidelines and standards in addiction medicine, ASAM takes its responsibility very seriously. Many providers and programs are urgently working to mitigate risks related to COVID-19. From May through August 2020, the American College of Medical Toxicology (ACMT) recurring “3rd Friday Addiction Toxicology Case Conference” series is co-hosted by the American Society of Addiction Medicine (ASAM). The co-hosted series will be an interactive discussion of addiction toxicology cases and will feature ASAM and ACMT members, as well as guest experts. This series of sessions provides a comprehensive overview of COVID-19 resources and focuses on challenging cases to inform your practices during the pandemic.
This co-hosted series has been extended to July 2021 and has also been moved to the 1st Friday of every month.
Buprenorphine is a life-sustaining medication. Abrupt discontinuation can lead to withdrawal as well as return to pretreatment substance use, overdose, and overdose death. The anxiety and stress associated with the COVID-19 pandemic, and the societal response to it, is exacerbating symptoms of opioid use disorder for many people. In addition, ongoing changes to the drug supply has increased the need for treatment. Every effort should be made to ensure that patients currently taking buprenorphine have timely access to refills of this medication and that any new patients in need of treatment for opioid use disorder can initiate treatment in a timely manner.
This resource was developed by a Task Force appointed by ASAM’s Executive Council. To enable more rapid development and dissem-ination it was not developed through ASAM’s normal process for clinical guidance development that is overseen by the ASAM Quality Improvement Council.
These materials seek to provide guidance to ambulatory addiction treatment clinicians, including those working in primary care, and in addiction treatment programs as they strive to ensure that patients continue to have safe, appropriate access to buprenorphine1 during the COVID-19 pandemic.
This article analyzes the available evidence to address airborne, aerosol transmission of the SARS‐CoV‐2. We review and present three lines of evidence: case reports of transmission for asymptomatic individuals in association with studies that show that normal breathing and talking produce predominantly small droplets of the size that are subject to aerosol transport; limited empirical data that have recorded aerosolized SARS‐CoV‐2 particles that remain suspended in the air for hours and are subject to transport over distances including outside of rooms and intrabuilding, and the broader literature that further supports the importance of aerosol transmission of infectious diseases.
The weight of the available evidence warrants immediate attention to address the significance of aerosols and implications for public health protection.
SOURCE: Risk Analysis
EDITOR’S NOTE: the authors make recommendations at the end of this well-researched commentary, including: ‘If aerosols are confirmed as an important transmission pathway for SARS‐CoV‐2, further explore airborne concentrations and the role of dose to various parts of the respiratory tract in the progression and severity of the disease. This information may inform public policy and earlier treatment decisions.’
Which mask works best? To visualise droplets and aerosols, UNSW researchers used LED lighting system & a high-speed camera, filming people coughing and sneezing in different scenarios — using no mask, two different types of cloth masks, and a surgical mask.
We confirmed that even speaking generates substantial droplets. Coughing and sneezing (in that order) generate even more. A three-ply surgical mask was significantly better than a one-layered cloth mask at reducing droplet emissions caused by speaking, coughing and sneezing, followed by a double-layer cloth face covering. A single-layer cloth face covering also reduced the droplet spread caused by speaking, coughing and sneezing but was not as good as a two-layered cloth mask or surgical mask.
We do not know how this translates to infection risk, which will depend on how many asymptomatic or mildly symptomatic infected people are around. However, it shows a single layer is not as good a barrier as a double layer.
DASHBOARD: PA Dept of Health
DASHBOARD: Arizona ADHS