Treatment provider perceptions of take-home methadone regulation before and during COVID-19.
Background: The loosening of U.S. methadone regulations during the COVID-19 pandemic expanded calls for methadone reform. This study examines professional perceptions of methadone take-home dose regulation before and during the COVID-19 pandemic to understand responses to varied methadone distributi...
| Publicado en: | Drug & Alcohol Dependence Vol. 228 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Nov2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153478073&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153478073 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03768716 3S6 jtl: Drug & Alcohol Dependence issn: 03768716 maglogo: N pubinfo: dt: Nov2021 vid: 228 pid: 1004 pub: Elsevier B.V. artinfo: ui: 153478073 153478073 NLM34600251 153478073 10.1016/j.drugalcdep.2021.109100 NLM34600251 153478073 ppct: 1 formats: tig: atl: Treatment provider perceptions of take-home methadone regulation before and during COVID-19. aug: au: Madden, Erin Fanning Christian, Bryson T. Lagisetty, Pooja A. Ray, Bradley R. Sulzer, Sandra H. affil: Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, 3939 Woodward Ave., Detroit, MI 48201, USA sug: ab: Background: The loosening of U.S. methadone regulations during the COVID-19 pandemic expanded calls for methadone reform. This study examines professional perceptions of methadone take-home dose regulation before and during the COVID-19 pandemic to understand responses to varied methadone distribution policies.Methods: Fifty-nine substance use disorder treatment professionals were interviewed between 2017 and 2020 in-person or over video call. An inductive iterative coding process was used to analyze the data. Constructivist grounded theory guided the collection and analysis of in-depth interviews.Results: Treatment professionals expressed mixed views toward methadone take-home regulations. Participants justified regulation using several arguments: 1) patient care benefitting from supervision, 2) attributing improved patient safety to take-home regulation, 3) fearing liability for methadone-related harms, and 4) relying on buprenorphine as an "escape hatch" for patients who cannot manage MMT policies. Other professionals suggested partial deregulation, while others strongly opposed pre-pandemic take-home regulation, explaining such regulations impede medication access and hinder patient-centered care. Some professionals supported the COVID-19 policy changes and saw these as a test run for broader deregulation, while others framed the changes as temporary and cautiously applied deregulation to their services, at times revoking looser rules for patients they perceived as nonadherent.Conclusion: Treatment professionals working in a range of modalities, including opioid treatment programs, expressed hesitation toward expanded take-home methadone access. While some participants also supported forms of deregulation, post-pandemic efforts to extend looser methadone distribution policies will have to address apprehensive professionals if such policy changes are to be meaningfully adopted in community services. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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