State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset.
Background and aims: US regulatory changes allowed for additional methadone take‐home doses following COVID‐19 onset. How dispensing practices changed and which factors drove variation remains unexplored. We determined daily methadone dispensing trajectories over six months before and after regulato...
| Publicado en: | Addiction Vol. 120; no. 6; pp. 1207 - 1223 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2025
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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=184927596&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184927596 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Jun2025 vid: 120 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 184927596 183789116 184927596 184927596 10.1111/add.70008 184927596 ppf: 1207 ppct: 16 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset. aug: au: Bórquez, Ignacio Williams, Arthur R. Hu, Mei‐Chen Scott, Marc Stewart, Maureen T. Harpel, Lexa Aydinoglo, Nicole Cerdá, Magdalena Rotrosen, John Nunes, Edward V. Krawczyk, Noa affil: Center for Opioid Epidemiology and Policy (COEP), Department of Population Health, New York University Grossman School of Medicine, New York NY,, USA sug: subj: COVID-19 Pandemic United States Analgesics, Opioid Therapeutic Use Methadone Administration and Dosage Substance Use Disorders Drug Therapy Human Funding Source Male Female Adult United States Retrospective Design Record Review Sequence Analysis Housing Descriptive Statistics Comparative Studies Prospective Studies Health Policy COVID-19 Trends Adult: 19-44 years Male Female ab: Background and aims: US regulatory changes allowed for additional methadone take‐home doses following COVID‐19 onset. How dispensing practices changed and which factors drove variation remains unexplored. We determined daily methadone dispensing trajectories over six months before and after regulatory changes due to COVID‐19 using state sequence analysis and explored correlates. Design: Retrospective chart review of electronic health records. Settings Nine opioid treatment programs (OTPs) across nine US states. Participants: Adults initiating treatment in 2019 (n = 328) vs. initiating 1 month after the COVID‐19 regulatory changes of March 2020 (n = 376). Measurements Type of daily methadone medication encounter (in‐clinic, weekend/holiday take‐home, take‐home, missed dose, discontinued) based on OTP clinic; cohort (pre vs. post‐COVID‐19); and patient substance use, clinical and sociodemographic characteristics. Findings Following COVID‐19 regulatory changes, allotted methadone take‐home doses increased from 3.5% to 13.8% of total person‐days in treatment within the first 6 months in care. Clinic site accounted for the greatest variation in methadone dispensing (6.2% and 9.5% of the variation of discrepancy between sequences pre‐ and post‐COVID‐19, respectively). People who co‐use methamphetamine had a greater increase in take‐homes than people who did not use methamphetamine (from 3.7% pre‐pandemic to 21.2% post‐pandemic vs. 3.5% to 12.5%) and higher discontinuation (average 3.6 vs. 4.7 months among people who did not use methamphetamine pre‐COVID‐19; average 3.3 vs. 4.6 months post‐COVID‐19). In the post‐COVID‐19 cohort, females had a higher proportion of missed doses (17.2% vs. 11.9%) than males. People experiencing houselessness had a higher proportion of missed doses (19% vs. 12.3%) and shorter stays (average 3.5 vs. 4.5 months) when compared with those with stable housing. Conclusion: Daily methadone dispensing trajectories in the US both before and following COVID‐19 regulatory changes appeared to depend more on the opioid treatment programs' practices than individual patient characteristics or response to treatment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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