ArticleHarm reduction journal2021
"It's like 'liquid handcuffs": The effects of take-home dosing policies on Methadone Maintenance Treatment (MMT) patients' lives.
Article in Harm reduction journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
109 citing papers in PubMed, 1 synthesis or guideline pooled it, 172 citations in OpenAlex.
- Examining inequities in access to opioid agonist treatment (OAT) take-home doses (THD): A Canadian OAT guideline synthesis and systematic review.The International journal on drug policy · 2024Pooled it
- Opioid consumption frequency and its associations with potential life problems during opioid agonist treatment in individuals with prescription-type opioid use disorder: exploratory results from the OPTIMA Study.Harm reduction journal · 2025Trial
- Mobile but still tied down: Challenges to scaling mobile methadone through a regulatory thicket.The International journal on drug policy · 2026Article
- Medicaid payment policies for methadone maintenance treatment for opioid use disorder, 2020-2025.Health affairs scholar · 2026Article
- "It's so much easier for them to just come to us": a qualitative study examining the implementation of mobile methadone treatment serving a residential SUD treatment program.Addiction science & clinical practice · 2026Article
- Self-reported cannabis use to manage opioid withdrawal symptoms and reductions in opioid use among people who use unregulated opioids: a cross-sectional analysis.Journal of cannabis research · 2026Article
- "Safer supply is the thing that changes everything": the role of prescribed safer supply in rebuilding trust following experiences of medical abandonment.BMC public health · 2026Article
- Navigating complexity: understanding the experiences, motivations and challenges of conducting research with perinatal individuals who use opioids and other substances.BMC pregnancy and childbirth · 2026Article
- Exploring multi-level barriers and human-centered solutions to expand methadone for HIV prevention among people who inject drugs in Kyrgyzstan.Journal of substance use and addiction treatment · 2026Article
- Envisioning a Humane and Accessible US Methadone Treatment System: Generating Policy and Practice Recommendations From the Liberate Methadone Movement.Substance use & addiction journal · 2026Article
- Barriers and facilitators to methadone dispensing for opioid use disorder in community pharmacies: A scoping review.Drug and alcohol dependence reports · 2026Review
- "With this you're not chained down to something": contrasting experiences of opioid agonist treatment and safer supply program participation among people receiving prescribed safer supply.Harm reduction journal · 2026Article
- 'It wasn't to get high; it was just to get by': experiences of patients who use fentanyl during methadone treatment and opportunities for improving care in Vermont and New Hampshire.Harm reduction journal · 2026Article
- Acceptability of and Implementation Supports for Video Directly Observed Treatment to Enhance Methadone Dosing Flexibility in a Multisite Opioid Treatment Program: Qualitative Rapid Needs Assessment Study.JMIR formative research · 2026Article
- De-implementation of inequitable methadone policy and treatment: lessons learned from COVID-19 to support a more just methadone treatment system in the United States.Frontiers in public health · 2026Review
- The Socioeconomic Impact of Long-Acting Injectable Buprenorphine.ClinicoEconomics and outcomes research : CEOR · 2026Article
- Article
- U.S. states opting out of expanded methadone take-home policies and associated mortality.Journal of substance use and addiction treatment · 2025Article
- Multilevel determinants of medication preferences for opioid use disorder among criminal-legal-involved populations: Insights from a scoping review.Drug and alcohol dependence reports · 2025Review
- Comparative effectiveness of urine drug testing schedules alongside opioid agonist treatment: Emulation of a population-based target trial in British Columbia, Canada.Addiction (Abingdon, England) · 2025Article
49 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMethadone Maintenance Treatment (MMT) is widely recognized as one of the most effective ways of reducing risk of overdose, arrest, and transmission of blood-borne viruses like HIV and HCV among people that use opioids. Yet, MMT's use of restrictive take-home dose policies that force most patients to attend their clinic on a daily, or near-daily, basis may be unpopular with many patients and lead to low rates of treatment uptake and retention. In response, this article examines how clinics' take-home dosing policies have affected patients' experiences of treatment and lives in general.
methodsThis article is based on semi-structured, qualitative interviews with a variety of stakeholders in MMT. Interviews explored: reasons for engaging with, or not engaging with MMT; how MMT is conceptualized by patients and treatment providers (e.g., as harm reduction or route to abstinence and/or recovery); experiences with MMT; perception of barriers to MMT (e.g., organizational/regulatory, social) and how MMT might be improved to support peoples' substance use treatment needs and goals.
resultsNearly all of the patients with past or present MMT use were highly critical of the limited access to take-home doses and consequent need for daily or near daily clinic attendance. Participants described how the use of restrictive take-home dose policies negatively impacted their ability to meet day-to-day responsibilities and also cited the need for daily attendance as a reason for quitting or avoiding OAT. Responses also demonstrate how such policies contribute to an environment of cruelty and stigma within many clinics that exposes this already-stigmatized population to additional trauma.
conclusionsTake-home dose policies in MMT are not working for a substantial number of patients and are reasonably seen by participants as degrading and dehumanizing. Revision of MMT regulations and policies regarding take home doses are essential to improve patient satisfaction and the quality and effectiveness of MMT as a key evidence-based treatment and harm reduction strategy.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.