From COVID-19 Crisis to Opportunity in Innovative Integrated Care in SUD Treatment Settings: Clinicians' Experiences and Perspectives on Transitioning to Virtual Care

Objective: The COVID-19 global pandemic has disrupted treatment service delivery for clients with substance use disorder (SUD). While virtual care might be the only available option and provide greater accessibility, the experiences and attitudes held by Alcohol and Other Drug (AOD) workers and clinicians may pose critical barriers or enablers to the success of such approaches.AimThis study investigates how, and to what extent COVID-19 affects the delivery of SUD treatment, and clinicians' perspectives on virtual care delivery, using modern digital health in response to COVID-19 and in the post-pandemic world.Methods: Semi-structured interviews with clinicians working in SUD treatment settings in Australia were conducted from September to October 2021. We used purposive sampling. In addition, standard qualitative analysis techniques, comprising both deductive and inductive approaches, have been used to identify and characterize themes.Results: Eighteen AOD practicians were recruited. The research team identified the following four themes: (1) COVID-19 led to significant changes in practice and innovations in SUD treatment and future service planning; (2) digital health provided a great opportunity for some of the clients; (3) digital health technology might not be appropriate for SUD clients' needs and resources; and (4) AOD clinicians struggled to establish a therapeutic alliance due to limited virtual intimacy through digital health.Conclusion: COVID-19 catalyzed and accelerated digital transformation in the SUD treatment setting. Furthermore, this may continue as an ongoing practice in SUD treatment systems in the post-COVID world, as the pandemic is likely to have an enduring impact on how we access care systems. Clinicians in this study reflected on substance dependency's challenging and evolving nature, and the indicators of the successful treatment outcome (such as client engagement through limited virtual intimacy), and how this can be achieved in an online environment. Research should explore how we enhance and leverage the current shift towards more consumer-focused, inclusive virtual SUD treatment service design and delivery, tailored to each client's circumstance.