Covid-19-Related Policy Changes for Methadone Take-Home Dosing: A Multistate Survey of Opioid Treatment Program Leadership. Issue 1 (December 2022)

• Record Type: Journal Article
• Authors: Levander, Ximena A.; Pytell, Jarratt D.; Stoller, Kenneth B.; Korthuis, P. Todd; Chander, Geetanjali
• Is Part Of: Substance abuse. Volume 43:Issue 1(2022)
• Page Start: 633
• Page End: 639
• Publication Date: 2022-12
• Subjects: Methadone -- opioid-related disorders -- COVID-19 -- survey -- opioid treatment programs; Substance abuse -- Periodicals; Medical education -- Periodicals; Education, Medical -- periodicals; Substance Abuse -- periodicals; 362.29
• DOI: 10.1080/08897077.2021.1986768
• Languages: English
• ISSNs: 0889-7077

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.