Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America.
North Carolina Survivor's Union, Greensboro, North Carolina, United States of America.
J Subst Abuse Treat. 2021 Apr;123:108276. doi: 10.1016/j.jsat.2021.108276. Epub 2021 Jan 8.
Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) has introduced many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing for the expansion of take-home methadone doses. We sought to describe changes to treatment experiences from the perspective of persons receiving methadone at outpatient treatment facilities for OUD.
We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina in June and July 2020. Surveys collected information on demographic characteristics, methadone treatment history, and experiences with take-home methadone doses in the context of COVID-19 (i.e., before and since March 2020).
Before COVID-19, the clinic-level percent of participants receiving any amount of days' supply of take-home doses at each clinic ranged from 56% to 82%, while it ranged from 78% to 100% since COVID-19. The clinic-level percent of participants receiving a take-homes days' supply of a week or longer (i.e., ≥6 days) since COVID-19 ranged from 11% to 56%. Among 87 participants who received take-homes since COVID-19, only four reported selling their take-home doses.
Our study found variation in experiences of take-home dosing by clinic and little diversion of take-home doses. While SAMSHA guidance should allow expanded access to take-home doses, adoption of these guidelines may vary at the clinic level. The adoption of these policies should be explored further, particularly in the context of benefits to patients seeking OUD treatment.
美沙酮维持治疗是治疗阿片类药物使用障碍（OUD）患者的救命治疗方法。冠状病毒大流行（COVID-19）引发了许多关于获得阿片类药物治疗的关注。2020 年 3 月，滥用药物和心理健康服务管理局（SAMHSA）发布了指导意见，允许扩大美沙酮的带回家剂量。我们试图从接受 OUD 门诊治疗的人员的角度描述治疗经验的变化。
我们在 2020 年 6 月至 7 月期间在北卡罗来纳州中部的三个诊所对 104 名接受美沙酮治疗的人进行了现场调查。调查收集了人口统计学特征、美沙酮治疗史以及在 COVID-19 背景下（即 2020 年 3 月之前和之后）带回家的美沙酮剂量的经验信息。
在 COVID-19 之前，每个诊所接受任何数量天的美沙酮带回家剂量的参与者比例在 56%至 82%之间，而自 COVID-19 以来，这一比例在 78%至 100%之间。自 COVID-19 以来，接受一周或更长时间（即≥6 天）的美沙酮带回家剂量供应的参与者比例在 11%至 56%之间。在 87 名自 COVID-19 以来接受美沙酮带回家的参与者中，只有 4 人报告出售了他们的美沙酮带回家剂量。
我们的研究发现，不同诊所的美沙酮带回家剂量的体验存在差异，而且美沙酮带回家剂量的滥用很少。虽然 SAMSHA 指南应该允许扩大美沙酮带回家的剂量，但这些指南的采用可能因诊所水平而异。应该进一步探讨这些政策的采用，特别是在寻求 OUD 治疗的患者受益的背景下。
