Evidence map›Paper›PMID 38061636›Full record

ArticleJournal of substance use and addiction treatment2024

Loss, liberation, and agency: Patient experiences of methadone treatment at opioid treatment programs during the COVID-19 pandemic.

Teresa López-Castro, Andrea Jakubowski, Mariya Masyukova, Meghan Peterson, Amanda Pierz, Sruthi Kodali, Julia H Arnsten, Joanna L Starrels, Shadi Nahvi

Open access · greenAbstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Teresa López-CastroDepartment of Psychology, Colin Powell School of Civic and Global Leadership, The City College of New York, 160 Convent Avenue, New York, NY 10031, United States. Electronic address: tlopezcastro@ccny.cuny.edu.
Andrea JakubowskiDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States.
Mariya MasyukovaDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States; Project Renwal, Inc. 200 Varick Street, 9th Floor New York, NY 10014.
Meghan PetersonDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States; Department of Social Medicine, University of North Carolina - Chapel Hill School of Medicine, 321 S Columbia St, Chapel Hill, NC 27599, United States.
Amanda PierzDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States; The City University of New York Graduate School of Public Health and Health Policy, 55 W. 125(th) Street, New York, NY 10027, United States.
Sruthi KodaliDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States.
Julia H ArnstenDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States.
Joanna L StarrelsDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States.
Shadi NahviDepartment of Medicine, Albert Einstein College of Medicine, Montefiore Health System, 111 East 210th Street, Bronx, NY 10467, United States.
Albert Einstein College of Medicine · USCity College of New York · USUniversity of North Carolina at Chapel Hill · US

Funding

Integrated Care for Chronic Pain and Opioid Use Disorder: The IMPOWR Research Center at Montefiore/Einstein (IMPOWR-ME)RM1DA055437 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI ARNSTEN, JULIA H., GABBAY, VILMA · 2021 to 2025
$13.7M
Achieving smoking cessation milestones in opioid treatment patients: a randomized 2 x 2 factorial trial of directly observed and long-term vareniclineR01DA042813 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI NAHVI, SHADI · 2017 to 2022
$3.4M
Mentoring investigators to improve health outcomes among persons with opioid and tobacco use disorderK24DA051807 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Shadi Nahvi · 2022 to 2026
$972k
Mentoring Junior Investigators to Tackle the Opioid EpidemicK24DA046309 · NIDA · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI STARRELS, JOANNA L. · 2018 to 2023
$876k
NIDA NIH HHS K24 DA046309NIDA NIH HHS K24 DA051807NIDA NIH HHS L30 DA054668NIDA NIH HHS R01 DA042813NIDA NIH HHS RM1 DA055437
6 · The paper itself

Abstract

backgroundDespite its safety and effectiveness, methadone treatment for opioid use disorder (OUD) remains highly stigmatized, and stringent opioid treatment program (OTP) attendance requirements create barriers to retention for many patients. The COVID-19 pandemic prompted a shift in federal regulations governing methadone, including a blanket exemption permitting increased take-home doses of methadone. We studied the impact of these changes upon established patients' experiences of OTP care.

methodWe conducted semi-structured qualitative interviews with 18 OTP patients who met our criteria of having established OTP care (i.e., enrolled at the OTP for at least 12 weeks) and were administered methadone three to six days weekly prior to the March 2020 blanket exemption. Interviews centered on how COVID-19 had affected their experiences of receiving treatment at an OTP.

resultsWe identified three interconnected themes relevant to transformation of OTP care by the COVID-19 pandemic. Participants described mourning therapeutic OTP relationships and structure (1. loss), yet feeling more satisfaction with fewer in-person OTP visits (2. liberation), and appreciating more opportunities to self-direct their OUD care (3. agency). DISCUSSION: Structural changes made to OTP care early in the COVID-19 pandemic resulted in loss of community and structure. Increasing the availability of take-home methadone also improved patient experience and sense of agency. Our findings join a diverse body of converging evidence in support of policy changes allowing for more flexible dosing and individualized OTP care.

Indexed as

COVID-19Opioid-Related DisordersAnalgesics, OpioidHumansMethadoneOpiate Substitution TreatmentPandemicsPatient Outcome AssessmentAnalgesics, OpioidMethadoneCOVID-19Medications for opioid use disorderQualitative studyTake-home methadone

Identifiers

PMID38061636
PMCPMC10932891
OpenAlexW4389331083

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.