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...

Descripción completa

Detalles Bibliográficos
Publicado en:Drug & Alcohol Dependence Vol. 228
Autores principales: Madden, Erin Fanning, Christian, Bryson T., Lagisetty, Pooja A., Ray, Bradley R., Sulzer, Sandra H.
Formato: research Journal Article
Publicado: Elsevier B.V. Nov2021
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