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

Background The United States (US) declared drug overdose a public health emergency in 2017. Despite this, two million people reported having an opioid use disorder (OUD) in 2018. However, following the beginning of COVID‐19 there was a 53% increase in overdose deaths, with American Indian/Alaska Native (AI/AN) individuals experiencing the highest rates of all racial groups. In response to the COVID‐19 pandemic and OUD treatment access challenges, OUD treatment policies were changed to improving access to care. Purpose This review examines how the state‐ and federal‐level policies impacted access to medications for opioid use disorder (MOUD) during the COVID‐19 pandemic. Due to the devastating impact of overdose and COVID‐19 on AI/AN communities, as a secondary aim, we examined the inclusion of these populations in the samples of the included studies. Methods We completed a narrative review using a data‐based convergent synthesis design. Results Forty‐four studies met the inclusion criteria. Most of the studies were quantitative descriptive studies ( n = 25). Only two studies offer AI/AN as a category for ethnicity and both had less that 4% of the sample that identified as an AI/AN individual. Conclusion and Implications Telehealth OUD treatment increased initiation and retention for patients taking buprenorphine. No increase in overdose rates was associated with allowing for additional take‐home doses of methadone. However, access to treatment, even telehealth, remains difficult for individuals due to a lack of OUD treatment providers and access to the internet. More needs to be done to address the opioid overdose crisis, especially among AI/AN communities. Research focused on cultural strategies to address this health disparity is desperately needed. We included nursing implications in response to this health disparity among AI/AN individuals.