SynthesisSubstance abuse treatment, prevention, and policy2023
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.
Synthesis in Substance abuse treatment, prevention, and policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses 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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 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
- 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
- Medications for opioid use disorder, recovery supports, and overdose risk -- a database linkage study of a rural cohort of people who inject drugs and use opioids.BMC public health · 2026Article
- Integrating Methadone Into Primary Care: Lessons From Ukraine.Annals of internal medicine · 2026Article
- Factors influencing family physicians' willingness to prescribe opioid agonist therapy using virtual modalities: a qualitative analysis.Frontiers in medicine · 2026Article
- Involving adult inpatients, family, partners and/or carers in measuring and monitoring patient safety in acute care hospitals: Protocol for an umbrella review.HRB open research · 2026Article
- Opioid Treatment Programs and Risks for COVID-19 Infections, Emergency Visits, and Hospitalizations.Journal of general internal medicine · 2025Article
- Modeling the impact of changing drug markets and structural determinants on HCV and/or HIV transmission among people who inject drugs in the United States: A rural and urban comparison.The International journal on drug policy · 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
- Evaluating the Efficiency and Productivity of Opioid Substitution Treatment Units in Greece: A DEA-Malmquist Analysis.Healthcare (Basel, Switzerland) · 2025Article
- City-level drug policies in Portugal: the COVID-19 pandemic as an analyzer of harm reduction responsiveness in Porto and Lisbon.Harm reduction journal · 2025Article
- Article
- 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
- Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- "Tethered to this ball and chain": Women's perspectives on bodily agency within opioid treatment programs.The International journal on drug policy · 2024Article
- Optimizing methadone dose adjustment in patients with opioid use disorder.Frontiers in psychiatry · 2023Article
- Methadone Take-Home Policies and Associated Mortality: Permitting versus Non-Permitting States.Substance use : research and treatmentArticle
- Trend in Prescription Medication Utilization for Opioid Use Disorder and Alcohol Use Disorder From 2015 to 2021: A Population-wide Study in a Canadian Province.Journal of addiction medicineObservational
- How Has the COVID-19 Pandemic Impacted Addiction Services? A Study of the Different Periods of the Pandemic and Patient Treatment Follow-up Over 1 Year.Substance use : research and treatmentArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe COVID-19 pandemic led to an unprecedented relaxation of restrictions on take-home doses in opioid agonist treatment (OAT). We conducted a mixed methods systematic review to explore the impact of these changes on program effectiveness and client experiences in OAT.
methodsThe protocol for this review was registered in PROSPERO (CRD42022352310). From Aug.-Nov. 2022, we searched Medline, Embase, CINAHL, PsycInfo, Web of Science, Cochrane Register of Controlled Trials, and the grey literature. We included studies reporting quantitative measures of retention in treatment, illicit substance use, overdose, client health, quality of life, or treatment satisfaction or using qualitative methods to examine client experiences with take-home doses during the pandemic. We critically appraised studies using the Mixed Methods Appraisal Tool. We synthesized quantitative data using vote-counting by direction of effect and presented the results in harvest plots. Qualitative data were analyzed using thematic synthesis. We used a convergent segregated approach to integrate quantitative and qualitative findings.
resultsForty studies were included. Most were from North America (23/40) or the United Kingdom (9/40). The quantitative synthesis was limited by potential for confounding, but suggested an association between take-home doses and increased retention in treatment. There was no evidence of an association between take-home doses and illicit substance use or overdose. Qualitative findings indicated that take-home doses reduced clients' exposure to unregulated substances and stigma and minimized work/treatment conflicts. Though some clients reported challenges with managing their medication, the dominant narrative was one of appreciation, reduced anxiety, and a renewed sense of agency and identity. The integrated analysis suggested reduced treatment burden as an explanation for improved retention and revealed variation in individual relationships between take-home doses and illicit substance use. We identified a critical gap in quantitative measures of patient-important outcomes.
conclusionThe relaxation of restrictions on take-home doses was associated with improved client experience and retention in OAT. We found no evidence of an association with illicit substance use or overdose, despite the expansion of take-home doses to previously ineligible groups. Including patient-important outcome measures in policy, program development, and treatment planning is essential to ensuring that decisions around take-home doses accurately reflect their value to clients.
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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.