COVID-19-related policy changes for methadone take-home dosing: A multistate survey of opioid treatment program leadership. Levander, X. A., Pytell, J. D., Stoller, K. B., Korthuis, P. T., & Chander, G. Subst Abus, 43(1):633–639, 2022. Edition: 20211019
COVID-19-related policy changes for methadone take-home dosing: A multistate survey of opioid treatment program leadership [link]Paper  doi  abstract   bibtex   
Background: In the United States, methadone for treatment of opioid use disorder is dispensed via highly-regulated accredited opioid treatment programs (OTP). During the COVID-19 pandemic, federal regulations were loosened, allowing for greater use of take-home methadone doses. We sought to understand how OTP leaders responded to these policy changes. Methods: We distributed a multistate electronic survey from September to November 2020 of OTP leadership to members of the American Association for the Treatment of Opioid Dependence (AATOD) who self-identified as leaders of OTPs. We asked study participants about how their OTP(s) implemented COVID-19-related policy changes into their clinical practice focusing on provision of take-home methadone doses, factors used to determine patient stability, and potential concerns about increased take-home doses. We used Chi-square test to compare survey responses between characterizations of the OTPs. Results: Of 170 survey respondents (17% response rate), the majority represented leadership of for-profit OTPs (69%) and were in a Southern state (54%). Routine allowances and practices related to take-home methadone doses varied across OTPs during the COVID-19 pandemic: 80 (47%) reported 14 days for newly enrolled patients (within past 90 days), 89 (52%) reported 14 days for "less stable" patients, and 112 (66%) reported 28 days for "stable" patients. Conclusions: We found that not all eligible OTP leaders adopted the practice of routinely allowing newly enrolled, "less stable," and "stable" patients on methadone to have increased take-home doses up to the limit allowed by federal regulations during COVID-19. The pandemic provides an opportunity to critically re-evaluate long-established methadone and OTP regulations in preparation for future emergencies.
@article{levander_covid-19-related_2022,
	title = {{COVID}-19-related policy changes for methadone take-home dosing: {A} multistate survey of opioid treatment program leadership},
	volume = {43},
	issn = {1547-0164 (Electronic) 0889-7077 (Linking)},
	url = {https://www.ncbi.nlm.nih.gov/pubmed/34666636},
	doi = {10.1080/08897077.2021.1986768},
	abstract = {Background: In the United States, methadone for treatment of opioid use disorder is dispensed via highly-regulated accredited opioid treatment programs (OTP). During the COVID-19 pandemic, federal regulations were loosened, allowing for greater use of take-home methadone doses. We sought to understand how OTP leaders responded to these policy changes. Methods: We distributed a multistate electronic survey from September to November 2020 of OTP leadership to members of the American Association for the Treatment of Opioid Dependence (AATOD) who self-identified as leaders of OTPs. We asked study participants about how their OTP(s) implemented COVID-19-related policy changes into their clinical practice focusing on provision of take-home methadone doses, factors used to determine patient stability, and potential concerns about increased take-home doses. We used Chi-square test to compare survey responses between characterizations of the OTPs. Results: Of 170 survey respondents (17\% response rate), the majority represented leadership of for-profit OTPs (69\%) and were in a Southern state (54\%). Routine allowances and practices related to take-home methadone doses varied across OTPs during the COVID-19 pandemic: 80 (47\%) reported 14 days for newly enrolled patients (within past 90 days), 89 (52\%) reported 14 days for "less stable" patients, and 112 (66\%) reported 28 days for "stable" patients. Conclusions: We found that not all eligible OTP leaders adopted the practice of routinely allowing newly enrolled, "less stable," and "stable" patients on methadone to have increased take-home doses up to the limit allowed by federal regulations during COVID-19. The pandemic provides an opportunity to critically re-evaluate long-established methadone and OTP regulations in preparation for future emergencies.},
	number = {1},
	journal = {Subst Abus},
	author = {Levander, X. A. and Pytell, J. D. and Stoller, K. B. and Korthuis, P. T. and Chander, G.},
	year = {2022},
	note = {Edition: 20211019},
	keywords = {*Methadone, *Opioid-Related Disorders/drug therapy, *covid-19, *opioid treatment programs, *opioid-related disorders, *survey, Analgesics, Opioid/therapeutic use, Covid-19, Humans, Leadership, Methadone, Methadone/therapeutic use, Opiate Substitution Treatment, Pandemics, Policy, SARS-CoV-2, Surveys and Questionnaires, United States, opioid treatment programs, opioid-related disorders, survey},
	pages = {633--639},
}

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