{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:02:24Z","timestamp":1791860544095,"version":"4.3.4"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020359","name":"College of Earth and Mineral Sciences, Pennsylvania State University","doi-asserted-by":"publisher","award":["This study is supported by the EMS Dean\u2019s Fund for Postdoc-Facilitated Collaboration at Penn State University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the anuscript."],"award-info":[{"award-number":["This study is supported by the EMS Dean\u2019s Fund for Postdoc-Facilitated Collaboration at Penn State University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the anuscript."]}],"id":[{"id":"10.13039\/100020359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The COVID-19 pandemic introduced imminent and lasting impacts on the opioid crisis in the U.S., including a significant increase in opioid overdose and deaths and in use of telehealth in treatment. What lessons can we learn from the treatment transition during the pandemic that could help tackle the opioid crisis when future pandemics strike? In this paper, we conducted a phone survey with opioid treatment facilities in Pennsylvania to examine the COVID-19\u2019s impacts on treatment facilities and individuals with opioid use disorder during the first year of the pandemic. We separated the lockdown period (Mid-March through Mid-May, 2020) from the reopening period that followed, and urban areas from rural areas, to explore temporal evolution and rural-urban variations in the COVID-19\u2019s impacts. We found rural-urban heterogeneity in facilities\u2019 adoption of telehealth in treatment and in challenges and risk factors faced by their clients during the lockdown period. During the reopening, telehealth was adopted by most facilities, and telehealth-related challenges became less salient; however, both rural and urban facilities reported higher relapse risks faced by their clients, citing factors more likely to be at clients\u2019 end and related to socioeconomic stressors and mental health. Our results highlight the vitality of addressing socioeconomic and mental health challenges faced by individuals with OUD, via government policies and community interventions, when future pandemics strike. The findings also indicate the importance of maintaining facilities\u2019 financial well-being to provide treatment services.<\/jats:p>","DOI":"10.1371\/journal.pone.0310386","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T17:28:08Z","timestamp":1726248488000},"page":"e0310386","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lessons for future pandemics: Temporal evolution and rural-urban variations in the impacts of the COVID-19 on opioid use treatment"],"prefix":"10.1371","volume":"19","author":[{"given":"Zhongyang","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Heess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7308-3028","authenticated-orcid":true,"given":"Zhen","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"pone.0310386.ref001","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1038\/s41562-021-01079-8","article-title":"A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)","volume":"5","author":"T Hale","year":"2021","journal-title":"Nat Hum Behav"},{"key":"pone.0310386.ref002","article-title":"Optimizing Medication Treatment of Opioid Use Disorder During COVID-19 (SARS-CoV-2)","author":"IE Leppla","year":"2020","journal-title":"J Addict Med"},{"key":"pone.0310386.ref003","article-title":"Collision of the COVID-19 and Addiction Epidemics","author":"ND Volkow","year":"2020","journal-title":"Ann Intern Med"},{"key":"pone.0310386.ref004","unstructured":"NCHS. Provisional Drug Overdose Death Counts. 2023 [cited 10 Jul 2023]. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm."},{"key":"pone.0310386.ref005","unstructured":"CDC. U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020\u2014But Are Still Up 15%. 2022. https:\/\/www.cdc.gov\/nchs\/pressroom\/nchs_press_releases\/2022\/202205.htm."},{"key":"pone.0310386.ref006","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1097\/ADM.0000000000000679","article-title":"Opioid Policy Changes During the COVID-19 Pandemic\u2014and Beyond","volume":"14","author":"CS Davis","year":"2020","journal-title":"J Addict Med"},{"key":"pone.0310386.ref007","doi-asserted-by":"crossref","first-page":"102901","DOI":"10.1016\/j.drugpo.2020.102901","article-title":"No \u201cback to normal\u201d after COVID-19 for our failed drug policies","volume":"83","author":"B Del Pozo","year":"2020","journal-title":"Int J Drug Policy"},{"key":"pone.0310386.ref008","article-title":"Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them","author":"AJ Frontz","year":"2020","journal-title":"Department of Health and Human Services"},{"key":"pone.0310386.ref009","doi-asserted-by":"crossref","first-page":"108449","DOI":"10.1016\/j.jsat.2021.108449","article-title":"Changes in methadone program practices and fatal methadone overdose rates in Connecticut during COVID-19","volume":"131","author":"S Brothers","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"pone.0310386.ref010","doi-asserted-by":"crossref","first-page":"108393","DOI":"10.1016\/j.jsat.2021.108393","article-title":"The new services that opioid treatment programs have adopted in response to COVID-19","volume":"130","author":"J Cantor","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"pone.0310386.ref011","doi-asserted-by":"crossref","first-page":"108276","DOI":"10.1016\/j.jsat.2021.108276","article-title":"Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19","volume":"123","author":"MC Figgatt","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"pone.0310386.ref012","doi-asserted-by":"crossref","first-page":"108552","DOI":"10.1016\/j.jsat.2021.108552","article-title":"Changes in methadone take-home dosing before and after COVID-19","volume":"133","author":"O Amram","year":"2022","journal-title":"J Subst Abuse Treat"},{"issue":"166","key":"pone.0310386.ref013","article-title":"2013 NCHS Urban-Rural Classification Scheme for Counties. National Center For Health Statistics","volume":"2","author":"DD Ingram","year":"2014","journal-title":"Vital Health Stat"},{"key":"pone.0310386.ref014","unstructured":"Hedegaard H, Mini\u00f1o AM, Warner M. Urban\u2013rural differences in drug overdose death rates, by sex, age, and type of drugs involved, 2017. NCHS Data Brief No. 345. Hyattsville, MD: National Center for Health Statistics. 2019."},{"key":"pone.0310386.ref015","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1017\/ice.2016.171","article-title":"Research Methods in Healthcare Epidemiology: Survey and Qualitative Research","volume":"37","author":"N Safdar","year":"2016","journal-title":"Infect Control Hosp Epidemiol"},{"key":"pone.0310386.ref016","volume-title":"Natural language processing with Python","author":"S Bird","year":"2009","edition":"1"},{"key":"pone.0310386.ref017","unstructured":"StataCorp. Stata Statistical Software: Release 17. 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