Brady Benjamin R, Meyerson Beth E, Davis Alissa, Carter Greg A, Najar Sara, Martinez Alexa, Mueller Caleb, Higbie Elias O, Ponte Holden Dal, Moneva Khino, Bentz Natalia C, Linde-Krieger Linnea B, Coffee Zhanette, Mahoney Arlene N, Frank David, Crosby Richard A
Western Michigan University, College of Health and Human Services, 1903W. Michigan Ave., Kalamazoo, MI 49001, USA; University of Arizona College of Medicine-Tucson, Harm Reduction Research Lab, 1501N Campbell Ave, Tucson, AZ 85724, USA; University of Arizona, Comprehensive Center for Pain and Addiction, 1501N Campbell Ave, Tucson, AZ 85724, USA.
University of Arizona College of Medicine-Tucson, Harm Reduction Research Lab, 1501N Campbell Ave, Tucson, AZ 85724, USA; University of Arizona, Comprehensive Center for Pain and Addiction, 1501N Campbell Ave, Tucson, AZ 85724, USA.
Int J Drug Policy. 2025 May;139:104799. doi: 10.1016/j.drugpo.2025.104799. Epub 2025 Apr 6.
Globally, access to opioid use disorder treatment remains insufficient. In the US, recent policy changes for opioid use disorder treatment present opportunities to improve patient access to evidence-based methadone treatment. To evaluate the adoption and sustained implementation of these changes, access to a national, representative sample of opioid treatment programs (OTPs, 'methadone clinics') is essential. This study reports the outcomes of a recruitment effort for a national sample of OTP administrators.
A stratified random sample of 1000 OTPs was drawn from the US Substance Abuse and Mental Health Services Administration's National Opioid Treatment Program Directory. Stratification was based on state-level OTP regulations and county-level opioid overdose rates. OTPs identified as tribal serving, located in jails or prisons, or requiring corporate approval for research participation were deemed ineligible and excluded from the sample. A team of trained researchers called OTP clinics seeking to speak with administrators and obtain their email addresses for study recruitment.
In the sample, 885 OTPs were eligible for study recruitment. We contacted a live person by phone at 73 % of OTPs and an administrator at 23 %. Of the administrators reached, 77 % agreed to receive study information and 22 % completed the survey. Total caller time was 276.5 hours at a cost of $5530.
Despite a rigorous sampling frame, and a costly and considerable effort, US OTP recruitment outcomes were suboptimal. Innovative strategies are needed to improve administrator recruitment. Recommendations include updating the SAMHSA directory to include administrator contact information (name, phone, email), using diverse outreach methods, and refining call scripts to improve engagement.
在全球范围内，阿片类药物使用障碍治疗的可及性仍然不足。在美国，近期阿片类药物使用障碍治疗的政策变化为改善患者获得循证美沙酮治疗的机会。为了评估这些变化的采用和持续实施情况，获取全国具有代表性的阿片类药物治疗项目（OTP，即“美沙酮诊所”）样本至关重要。本研究报告了针对全国OTP管理人员样本的招募工作结果。
从美国药物滥用和精神健康服务管理局的国家阿片类药物治疗项目目录中抽取了1000个OTP的分层随机样本。分层基于州级OTP法规和县级阿片类药物过量使用率。被确定为为部落服务、位于监狱或需要公司批准才能参与研究的OTP被视为不合格并被排除在样本之外。一组经过培训的研究人员致电OTP诊所，试图与管理人员交谈并获取他们的电子邮件地址以进行研究招募。
在样本中，885个OTP有资格参与研究招募。我们在73%的OTP通过电话联系到了真人，在23%的OTP联系到了管理人员。在联系到的管理人员中，77%同意接收研究信息，22%完成了调查。总通话时间为276.5小时，费用为5530美元。
尽管有严格的抽样框架，且付出了高昂且可观的努力，但美国OTP的招募结果并不理想。需要创新策略来改善管理人员的招募。建议包括更新药物滥用和精神健康服务管理局的目录以包含管理人员的联系信息（姓名、电话、电子邮件），使用多样化的外展方法，以及完善通话脚本来提高参与度。
