Structural Adaptations to Methadone Maintenance Treatment and Take-Home Dosing for Opioid Use Disorder in the Era of COVID-19

Societal disruption from the COVID-19 pandemic has accelerated the opioid overdose epidemic. Given the drastic increase in opioid overdose deaths during the pandemic, particularly within Black communities,1 it is important to reflect on the state of opioid addiction treatment in the United States. W...

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Bibliographic Details
Published in:American journal of public health (1971) 2022-04, Vol.112 (S2), p.S112-S116
Main Authors: Suen, Leslie W, Coe, William H, Wyatt, Janan P, Adams, Zoe M, Gandhi, Mona, Batchelor, Hannah M, Castellanos, Stacy, Joshi, Neena, Satterwhite, Shannon, Pérez-Rodríguez, Rafael, Rodríguez-Guerra, Esther, Albizu-Garcia, Carmen E, Knight, Kelly R, Jordan, Ayana
Format: Article
Language:English
Subjects:
Adaptation
Addictions
Coronaviruses
COVID-19
Crime
Drug abuse
Drug addiction
Drug dosages
Drug overdose
Drug policy
Drug use
Drugs
Epidemics
Health services
Homeless people
Housing
Humans
Infections
Maintenance
Management
Medicaid
Mental health
Mental health services
Methadone
Methadone - therapeutic use
Monetary incentives
Mortality rates
Narcotics
Opiate Substitution Treatment
Opiates
Opioid-Related Disorders - drug therapy
Opioids
Overdose
Pandemics
Patient safety
Policies
Public health
Quarantine
Racism
Regulation
Regulatory reform
Reimbursement
Scapegoating
Severe acute respiratory syndrome coronavirus 2
Social disorganization
State government
Substance abuse
Substance abuse treatment
Substance use
Substance use disorder
Telemedicine
Treatment programs
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Description
Summary:Societal disruption from the COVID-19 pandemic has accelerated the opioid overdose epidemic. Given the drastic increase in opioid overdose deaths during the pandemic, particularly within Black communities,1 it is important to reflect on the state of opioid addiction treatment in the United States. When COVID-19 was declared a public health emergency, more than 400 000 individuals were receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD) across the 50 states, the District of Columbia, and US territories including Puerto Rico.2 Individuals receiving MMT, a gold standard for OUD treatment, have lower rates of death and nonprescribed opioid use than those not receiving treatment and exhibit better treatment retention.3Despite these benefits, many structural barriers exist in accessing MMT, in large part because of decades of racist policies and political scapegoating (e.g., criminalizing those with substance use disorders and being "tough on crime" through harsh drug policies for political gain).4 Methadone dispensing is tightly regulated, and the medication can be dispensed only at opioid treatment programs (OTPs) overseen by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Enforcement Administration, and state governments. When used in the treatment of OUD, no other prescription medication is as tightly regulated as methadone.
ISSN:0090-0036
1541-0048
DOI:10.2105/AJPH.2021.306654