ArticleJournal of substance abuse treatment2022
Treatment retention, return to use, and recovery support following COVID-19 relaxation of methadone take-home dosing in two rural opioid treatment programs: A mixed methods analysis.
Article in Journal of substance abuse treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
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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
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- The impact of relaxing restrictions on take-home doses during the COVID-19 pandemic on program effectiveness and client experiences in opioid agonist treatment: a mixed methods systematic review.Substance abuse treatment, prevention, and policy · 2023Pooled it
- Impact of COVID-19-related methadone regulatory flexibilities: views of state opioid treatment authorities and program staff.Addiction science & clinical practice · 2023Trial
- Medicaid payment policies for methadone maintenance treatment for opioid use disorder, 2020-2025.Health affairs scholar · 2026Article
- Narrative Review of Opioid Use Disorder Treatment Changes During the COVID-19 Pandemic and Their Impact on American Indian/Alaska Native Communities.Nursing open · 2026Review
- 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
- Developing and validating measures of take-home methadone with administrative data.Journal of substance use and addiction treatment · 2026Article
- Seventeen years of experience: a retrospective cohort analysis of methadone maintenance treatment program patterns in Georgia.Harm reduction journal · 2025Article
- Opioid Treatment Programs and Risks for COVID-19 Infections, Emergency Visits, and Hospitalizations.Journal of general internal medicine · 2025Article
- Article
- Does a take-home dose program result in better patient adherence to methadone? Evidence from Vietnam.Harm reduction journal · 2025Article
- Methadone-involved overdose deaths in urban and rural communities before and after the public health emergency flexibilities for methadone take-home doses.Drug and alcohol dependence reports · 2025Article
- State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID-19 onset.Addiction (Abingdon, England) · 2025Article
- Exploration of the multi-level barriers to scaling up methadone for HIV prevention among people who inject drugs in Kazakhstan.Journal of substance use and addiction treatment · 2025Article
- Exploring the Lived Experiences of Medication for Opioid use Disorder Treatment: A Qualitative Study among a Crowdsourced Convenience Sample.Community mental health journal · 2025Article
- Impact of guidance issued during COVID-19 to expand take-home doses of opioid agonist treatment (OAT) in Ireland: protocol for a population-based analysis of prescribing practices and patient outcomes 2018 to 2023.HRB open research · 2025Article
- Features of drug addiction treatment programs in Atlantic Canada that help (or not) with access and retention: A qualitative study.PloS one · 2025Article
- Patient and Prescriber characteristics associated with return to daily-dispense methadone: A multilevel cohort study.PLOS mental health · 2025Article
- "Tethered to this ball and chain": Women's perspectives on bodily agency within opioid treatment programs.The International journal on drug policy · 2024Article
- Methadone treatment utilization and overdose trends among Medicaid beneficiaries in New Jersey before and during the COVID-19 pandemic.Journal of substance use and addiction treatment · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesIn March 2020, the Substance Abuse and Mental Health Services Administration permitted Opioid Treatment Programs (OTPs) to relax restrictions on take-home methadone and promoted telehealth to minimize potential exposures to COVID-19. We assessed the effects of COVID-19-related changes on take-home methadone dosing in two OTPs serving five rural Oregon counties.
methodsWe used a mixed-methods convergent design. The OTPs extracted urine drug test (UDT) results, take-home methadone regimens, and treatment retention from the electronic health record (EHR) for patients (n = 377). A mixed-effects negative binomial regression model assessed patient-level differences in take-home doses before and after the COVID-19 policy changes and the associations with treatment discontinuation, and UDT positivity. Semi-structured qualitative interviews (n = 32) explored patient reactions to increased take-home dosing and reduced clinic visits to provide context for quantitative findings.
resultsThe number of take-home doses increased in the post-COVID-19 period for patients engaged in treatment for more than 180 days (median: 8 vs 13 take-home doses per month, p = 0.011). Take-homes did not increase for patients with fewer days of treatment. Each percentage point increase in take-home dosing above what would be expected without COVID-19 policy changes was negatively associated with the percent of UDT positive for opioids (B = -0.12, CI [-0.21, -0.04], p = 0.005) and the probability of treatment discontinuation (aOR = 0.97, CI [0.95, 0.99], p = 0.003). Qualitative analysis revealed three themes explaining how increased take-home dosing supported recovery: 1) value of feeling trusted with increased responsibility; 2) reduced travel time permitted increased employment and recreation; and 3) reduced exposure to individuals less stable in recovery and potential triggers.
conclusionsTake-home methadone dose relaxations were associated with increased methadone take-home doses, improved retention, and decreased UDT opioid positive results among clinically stable patients. Qualitative findings suggest that fewer take-home restrictions are feasible and desirable and do not pose safety or public health harms.
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