HIV Specialist - March 2021 - 43

Peer support specialists can help patients
be more successful by accompanying them
along their path to recovery.21 They can help
ensure patients remain engaged in care
by assisting patients with transportation,
linking them to the recovery community, and
even assisting with audio/video communication for telemedicine visits. One example
of this is the way my practice partnered with
our local Recovery Community Organization,
THRIVE, Mental Health America of Indiana,
and the Indiana Rural Health Association to
equip peer support specialists with tablets to
literally bring MOUD access to people otherwise unable or too frightened to access help.

Final Thoughts

Telehealth can also be used to improve
patient outcomes by increasing their access
to ancillary services such as support groups,
behavioral health, vocational support, and
one-on-one peer support. Project ECHO uses
telehealth to move expert knowledge by empowering local providers with the resources
needed to care for their own patients.22

All of this assumes an infrastructure that
supports telehealth. Many of our patients
affected by adverse social determinants
of health do not have access to broadband,
Wi-Fi, or data plans. In our community, we
are equipping community partners and even
patients with data plan-equipped tablets to
reduce this barrier.
In America, our Constitution proclaims
that all people have the right to life, liberty,
and the pursuit of happiness. Yet we tolerate
a system that denies equal access to safety,
health, and opportunity. Under this system,
how much life someone has access to is
far too often based on his or her ZIP Code,
race, socioeconomic status, or what those
in power think of them. This predictable
outcome played out on a much larger scale
during the COVID-19 pandemic when the
disease, disability, and death disproportionately struck along the fault lines of race and
socioeconomic class.
The harms that arise from adverse health
and socioeconomic factors, childhood trauma, and isolation represent a real national

crisis. But as National Youth Poet Laureate
Amanda Gorman recently said so eloquently,
our nation is " not broken but simply unfinished. " We can all work together to reduce
harm to our neighbors by removing barriers
and increasing access to opportunity, healthcare, and social support. HIV

8.	 " HHS Expands Access to Treatment for Opioid Use
Disorder, " press release of US Department of Health and
Human Services, January 14, 2021, https://www.hhs.gov/
about/news/2021/01/14/hhs-expands-access-totreatment-for-opioid-use-disorder.
html?fbclid=IwAR1EJfLtFFnWnwFkFWfq24mqjCmrRLAoXDGvL_
XdD8AMja0RHRq9N34e32w.

16.	 Aaron D. Fox et al., " Illicit Buprenorphine Use, Interest in
and access to Buprenorphine Treatment among Syringe
Exchange Participants, " Journal of Substance Abuse
Treatment 48, no. 1 (January 2015), 112-16, https://doi.
org/10.1016/j.jsat.2014.07.015.

WILLIAM COOKE, MD, FAAFP,
FASAM, AAHIVS, is a fellow of the
American Academy of Family Medicine
and the American Society of Addiction
Medicine, specializing in family
medicine, addiction medicine, and HIV medicine. His
work has been covered by CBS, NBC, PBS, the BBC,
USA Today, the New York Times, NPR, and others. In
2019, Dr. Cooke was named National Physician of the
Year by the American Academy of Family Physicians
and joined the ranks of two US surgeons general and
a former secretary of the US Department of Health
and Human Services in receiving the Ryan White
Distinguished Leadership Award. He was also the
first physician to be awarded the Pillar of Excellence
by Addiction Policy Forum. Dr. Cooke lives in his
hometown of New Albany, Indiana, with his wife,
Melissa, and six children.

REFERENCES
1.	 Centers for Disease Control and Prevention, " Increase in
Fatal Drug Overdoses across the United States Driven by
Synthetic Opioids before and during the COVID-19
Pandemic, " December 17, 2020, https://emergency.cdc.gov/
han/2020/han00438.asp?ACSTrackingID=USCDC_511DM44961&ACSTrackingLabel=HAN%20438%20-%20
General%20
Public&deliveryName=USCDC_511-DM44961.
2.	 " Issue Brief: Reports of Increases in Opioid-and Other
Drug-Related Overdose and Other Concerns during COVID
Pandemic, " Advocacy Resource Center of the American
Medical Association, October 31, 2020, https://www.
ama-assn.org/system/files/2020-09/issue-briefincreases-in-opioid-related-overdose.pdf.
3.	 US Statistics, Minority HIV/AIS Fund, US Department of
Health & Human Services, https://www.hiv.gov/hiv-basics/
overview/data-and-trends/statistics.

9.	 " Announcement of Practice Guidelines for the
Administration of Buprenorphine for treating Opioid Use
Disorder, " notice from the US Department of Health and
Human Services, January 12, 2021, https://www.hhs.gov/
sites/default/files/mat-physician-practice-guidelines.pdf.
10.	 Denise Paone et al., " Buprenorphine Infrequently Found in
Fatal Overdose in New York City, " Drug and Alcohol
Dependence 155 (October 1, 2015), 298-301, https://doi.
org/10.1016/j.drugalcdep.2015.08.007.

4.	 Centers for Disease Control and Prevention. HIV
Surveillance Report, 2018 (Updated); vol.31, http://www.
cdc.gov/hiv/library/reports/hiv-surveillance.html.
Published May 2020. Accessed 1/15/2021.

11.	 Hilary Smith Connery, " Medication-Assisted Treatment of
Opioid Use Disorder: Review of the Evidence and Future
Directions, Harvard Review of Psychiatry 23, no. 2 (March/
April 2015), 63-75, https://doi.org/10.1097/
HRP.0000000000000075.

5.	 Daniel Wolfe, M. Patrizia Carrieri, and Donald Shepard,
" Treatment and Care for Injecting Drug Users with HIV
Infection: A Review of Barriers and Ways Forward, Lancet
376, no. 9738 (July 31, 2010), 355-66), https://doi.
org/10.1016/S0140-6736(10)60832-X.

12.	 Marc R. Larochelle et al., " Medication for Opioid Use
Disorder after Nonfatal Opioid Overdose and Association
With Mortality: A Cohort Study, " Annals of Internal
Medicine 169 (2018), 137-45, https://doi.org/10.7326/
M17-3107.

6.	 Vivian F. Go et al., " Client and Provider Perspectives on
Antiretroviral Treatment Uptake and Adherence among
People Who Inject Drugs in Indonesia, Ukraine and
Vietnam: HPTN 074, " AIDS and Behavior 23, no. 4 (April
2019), 1084-93, https://doi.org/10.1007/
s10461-018-2307-y.

13.	 See this notification sent March 31, 2020: https://www.
deadiversion.usdoj.gov/GDP/(DEA-DC-022)
(DEA068)%20DEA%20SAMHSA%20buprenorphine%20
telemedicine%20%20(Final)%20+Esign.pdf

7.	 Frederick L. Altice et al., " HIV Treatment Outcomes among
HIV-Infected, Opioid-Dependent Patients Receiving
Buprenorphine/Naloxone Treatment within HIV Clinical
Care Settings: Results from a Multisite Study, " Journal of
Acquired Immune Deficiency Syndromes 56, suppl. 1
(March 2011), S22-32, https://doi.org/10.1097/
QAI.0b013e318209751e.

14.	 " Caring for Patients during the COVID-19 Pandemic:
ASAM COVID-19 Task Force Recommendations, " https://
www.asam.org/docs/default-source/covid-19/
obot-guidance.
pdf ?sfvrsn=8c6e53c2_4#search=%22telemedicine%22.

17.	 " Caring for Patients during the COVID-19 Pandemic:
ASAM COVID-19 Task Force Recommendations. "
" Consensus Statement: Appropriate Use of Drug Testing in
Clinical Addiction Medicine, " adopted by the ASAM Board
of Directors April 5, 2017, https://www.asam.org/docs/
default-source/quality-science/the-asam-appropriateuse-of-drug-testing-in-clinical-addiction-medicine-fulldocument.pdf?Status=Temp&sfvrsn=700a7bc2_2.
18.	 " Consensus Statement: Appropriate Use of Drug Testing in
Clinical Addiction Medicine, " adopted by the ASAM Board
of Directors April 5, 2017, https://www.asam.org/docs/
default-source/quality-science/the-asam-appropriateuse-of-drug-testing-in-clinical-addiction-medicine-fulldocument.pdf?Status=Temp&sfvrsn=700a7bc2_2.
19.	 " Consensus Statement: Appropriate Use of Drug Testing in
Clinical Addiction Medicine " .
20.	 National Practice Guideline, 2020 Focused Update,
American Society of Addiction Medicine, https://www.
asam.org/Quality-Science/
quality/2020-national-practice-guideline.
21.	 " Peers Supporting Recovery from Substance Use
Disorders, " Substance Abuse and Mental Health Services,
https://www.samhsa.gov/sites/default/files/programs_
campaigns/brss_tacs/peers-supporting-recoverysubstance-use-disorders-2017.pdf.Project ECHO,
University of New Mexico, https://hsc.unm.edu/echo/
about-us/.
22.	 Project ECHO, University of New Mexico, https://hsc.unm.
edu/echo/about-us/.

15.	 Theodore J. Cicero, Hilary L. Surratt, and James Inciardi,
" Use and Misuse of Buprenorphine in the Management of
Opioid Addiction, Journal of Opioid Management 3, no.6
(2007), 302-8, https://doi.org/10.5055/jom.2007.0018.
WWW.AAHIVM.ORG   HIVSPECIALIST  MARCH 2021  

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https://www.hhs.gov/about/news/2021/01/14/hhs-expands-access-to-treatment-for-opioid-use-disorder.html?fbclid=IwAR1EJfLtFFnWnwFkFWfq24mqjCmrRLAoXDGvL_XdD8AMja0RHRq9N34e32w https://emergency.cdc.gov/han/2020/han00438.asp?ACSTrackingID=USCDC_511-DM44961&ACSTrackingLabel=HAN%20438%20-%20General%20Public&deliveryName=USCDC_511-DM44961 https://www.hhs.gov/about/news/2021/01/14/hhs-expands-access-to-treatment-for-opioid-use-disorder.html?fbclid=IwAR1EJfLtFFnWnwFkFWfq24mqjCmrRLAoXDGvL_XdD8AMja0RHRq9N34e32w https://doi.org/10.1016/j.jsat.2014.07.015 https://doi.org/10.1016/j.jsat.2014.07.015 https://emergency.cdc.gov/han/2020/han00438.asp?ACSTrackingID=USCDC_511-DM44961&ACSTrackingLabel=HAN%20438%20-%20General%20Public&deliveryName=USCDC_511-DM44961 https://www.asam.org/docs/default-source/quality-science/the-asam-appropriate-use-of-drug-testing-in-clinical-addiction-medicine-full-document.pdf?Status=Temp&sfvrsn=700a7bc2_2 https://www.asam.org/docs/default-source/quality-science/the-asam-appropriate-use-of-drug-testing-in-clinical-addiction-medicine-full-document.pdf?Status=Temp&sfvrsn=700a7bc2_2 https://www.hhs.gov/sites/default/files/mat-physician-practice-guidelines.pdf https://www.ama-assn.org/system/files/2020-09/issue-brief-increases-in-opioid-related-overdose.pdf https://www.hhs.gov/sites/default/files/mat-physician-practice-guidelines.pdf https://www.ama-assn.org/system/files/2020-09/issue-brief-increases-in-opioid-related-overdose.pdf https://doi.org/10.1016/j.drugalcdep.2015.08.007 https://doi.org/10.1016/j.drugalcdep.2015.08.007 https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.asam.org/docs/default-source/quality-science/the-asam-appropriate-use-of-drug-testing-in-clinical-addiction-medicine-full-document.pdf?Status=Temp&sfvrsn=700a7bc2_2 https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.asam.org/docs/default-source/quality-science/the-asam-appropriate-use-of-drug-testing-in-clinical-addiction-medicine-full-document.pdf?Status=Temp&sfvrsn=700a7bc2_2 https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html https://doi.org/10.1097/HRP.0000000000000075 https://doi.org/10.1097/HRP.0000000000000075 https://www.asam.org/Quality-Science/quality/2020-national-practice-guideline https://www.asam.org/Quality-Science/quality/2020-national-practice-guideline https://doi.org/10.1016/S0140-6736(10)60832-X https://doi.org/10.7326/M17-3107 https://doi.org/10.1016/S0140-6736(10)60832-X https://doi.org/10.7326/M17-3107 https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-022)(DEA068)%20DEA%20SAMHSA%20buprenorphine%20telemedicine%20%20(Final)%20+Esign.pdf https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-022)(DEA068)%20DEA%20SAMHSA%20buprenorphine%20telemedicine%20%20(Final)%20+Esign.pdf https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf https://doi.org/10.1007/s10461-018-2307-y https://hsc.unm.edu/echo/about-us/ https://doi.org/10.1007/s10461-018-2307-y https://hsc.unm.edu/echo/about-us/ https://www.asam.org/docs/default-source/covid-19/obot-guidance.pdf?sfvrsn=8c6e53c2_4#search=%22telemedicine%22 https://www.asam.org/docs/default-source/covid-19/obot-guidance.pdf?sfvrsn=8c6e53c2_4#search=%22telemedicine%22 https://hsc.unm.edu/echo/about-us/ https://hsc.unm.edu/echo/about-us/ https://doi.org/10.1097/QAI.0b013e318209751e https://doi.org/10.1097/QAI.0b013e318209751e https://www.doi.org/10.5055/jom.2007.0018 http://WWW.AAHIVM.ORG

HIV Specialist - March 2021

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