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. 2022 Feb:133:108552.
doi: 10.1016/j.jsat.2021.108552. Epub 2021 Jun 24.

Changes in methadone take-home dosing before and after COVID-19

Ofer Amram  1 , Solmaz Amiri  2 , Emily L Thorn  3 , Robert Lutz  4 , Paul J Joudrey  5
Affiliations

Changes in methadone take-home dosing before and after COVID-19

Ofer Amram et al. J Subst Abuse Treat. 2022 Feb.

Abstract

Introduction: In response to the COVID-19 pandemic, a federal exemption allowed stable and less stable patients greater take-home doses of methadone. We assessed the adoption of increased take-home medication during COVID-19 and whether increased take-home doses is associated with clients' characteristics.

Methodology: We completed a pre-post study of adults receiving methadone for OUD from an OTP in Spokane, Washington. Our outcome was the change in the number of take-home methadone doses three months before and three months after the March 2020 take-home medication exemption. Clients' characteristics included age, gender, ethnicity, education level, homelessness, spatial access to the clinic, and methamphetamine use.

Results: The study included 194 clients in treatment for a median of three years. All study participants experienced an average increase in take-home medication of 41.4 in the three-month period after the COVID-19 exemption. In the final adjusted models, clients who reported using methamphetamine in the last 30 days experienced a significantly larger increase in take-home dosage (55.6 days) compare to clients who did not use methamphetamine (p ≤0.001). Most of the clients who reported using methamphetamine were also likely to be homeless. All other variables were not associated with a change in take-home doses.

Conclusion: These results suggest that the Spokane OTP quickly expanded take-home medication dosing in response to the COVID-19 exemption and broadly expanded take-home dosing among established clients. Clients with concurrent methamphetamine use were allowed fewer take-home doses prior to COVID-19, but after the exemption the clinic provided them the same number of take-home doses as clients who had not used methamphetamine.

Keywords: Access to care; COVID-19; Methadone.

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Conflict of interest statement

No conflict to declare.

References

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