Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug 22;11(5):131.
doi: 10.3390/pharmacy11050131.

Methadone Treatment Gap in Tennessee and How Medication Units Could Bridge the Gap: A Review

Joanna Risby  1 , Erica Schlesinger  1 , Wesley Geminn  1 , Alina Cernasev  2
Affiliations
Review

Methadone Treatment Gap in Tennessee and How Medication Units Could Bridge the Gap: A Review

Joanna Risby et al. Pharmacy (Basel). .

Abstract

The opioid epidemic has been an ongoing public health concern in the United States (US) for the last few decades. The number of overdose deaths involving opioids, hereafter referred to as overdose deaths, has increased yearly since the mid-1990s. One treatment modality for opioid use disorder (OUD) is medication-assisted treatment (MAT). As of 2022, only three pharmacotherapy options have been approved by the Food and Drug Administration (FDA) for treating OUD: buprenorphine, methadone, and naltrexone. Unlike buprenorphine and naltrexone, methadone dispensing and administrating are restricted to opioid treatment programs (OTPs). To date, Tennessee has no medication units, and administration and dispensing of methadone is limited to licensed OTPs. This review details the research process used to develop a policy draft for medication units in Tennessee. This review is comprised of three parts: (1) a rapid review aimed at identifying obstacles and facilitators to OTP access in the US, (2) a descriptive analysis of Tennessee's geographic availability of OTPs, pharmacies, and federally qualified health centers (FQHCs), and (3) policy mapping of 21 US states' OTP regulations. In the rapid review, a total of 486 articles were imported into EndNote from PubMed and Embase. After removing 152 duplicates, 357 articles were screened based on their title and abstract. Thus, 34 articles underwent a full-text review to identify articles that addressed the accessibility of methadone treatment for OUD. A total of 18 articles were identified and analyzed. A descriptive analysis of Tennessee's availability of OTP showed that the state has 22 OTPs. All 22 OTPs were matched to a county and a region based on their address resulting in 15 counties (16%) and all three regions having at least one OTP. A total of 260 FQHCs and 2294 pharmacies are in Tennessee. Each facility was matched to a county based on its address resulting in 70 counties (74%) having at least one FQHC and 94 counties (99%) having at least one pharmacy. As of 31 December 2022, 17 states mentioned medication units in their state-level OTP regulations. Utilizing the regulations for the eleven states with medication units and federal guidelines, a policy draft was created for Tennessee's medication units.

Keywords: medication units; methadone; opioid treatment program; opioid use disorder.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Centers for Disease Control and Prevention Understanding the Opioid Overdose Epidemic|Opioids|CDC. [(accessed on 6 October 2022)];2022 Available online: https://www.cdc.gov/opioids/basics/epidemic.html.
    1. Centers for Disease Control and Prevention Data Overview|Opioids|CDC. [(accessed on 6 October 2022)];2022 Available online: https://www.cdc.gov/opioids/data/index.html.
    1. Congressional Budget Office The Opioid Crisis and Federal Policy Responses. [(accessed on 6 October 2022)];2022 Available online: https://www.cbo.gov/publication/58221.
    1. Department of Human and Health Services, Adminstration for Strategic Preparedness and Response Declarations of a Public Health Emergency. [(accessed on 6 October 2022)]; Available online: https://aspr.hhs.gov/legal/PHE/Pages/default.aspx.
    1. American Medical Association AMA Overdose Epidemic Report. 2022. [(accessed on 6 October 2022)]. Available online: https://www.ama-assn.org/system/files/ama-overdose-epidemic-report.pdf.