Patient experiences of methadone treatment changes during the first wave of COVID-19: a national community-driven survey

Sarah Brothers; Adam Palayew; Caty Simon; Abby Coulter; Knina Strichartz; Nick Voyles; Louise Vincent

doi:10.1186/s12954-023-00756-3

Patient experiences of methadone treatment changes during the first wave of COVID-19: a national community-driven survey

Harm Reduct J. 2023 Mar 9;20(1):31. doi: 10.1186/s12954-023-00756-3.

Authors

Sarah Brothers¹, Adam Palayew², Caty Simon^{3

4

5}, Abby Coulter³, Knina Strichartz³, Nick Voyles³, Louise Vincent^{3

4}

Affiliations

¹ Department of Sociology, Pennsylvania State University, University Park, USA. sarah.brothers@psu.edu.
² Department of Epidemiology, University of Washington, Seattle, Washington, USA.
³ Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA.
⁴ NC Survivors Union, Greensboro, NC, USA.
⁵ Whose Corner Is It Anyway, Holyoke, MA, USA.

Abstract

Background: During COVID-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed Methadone Maintenance Treatment (MMT) programs to relax in-person MMT requirements to reduce COVID-19 exposure. This study examines patient-reported changes to in-person methadone clinic attendance requirements during COVID-19.

Methods: From June 7, 2020, to July 15, 2020, a convenience sample of methadone patients (N = 392) were recruited in collaboration with National Survivors Union (NSU) in 43 states and Washington D.C. through social media (Facebook, Reddit, Twitter, and Web site pop-ups). The community-driven research (CDR) online survey collected information on how patient take-home methadone dosing and in-person drug testing, counseling, and clinic visit frequency changed prior to COVID-19 (before March 2020) to during COVID-19 (June and July 2020).

Results: During the study time period, the percentage of respondents receiving at least 14 days of take-home doses increased from 22 to 53%, while the percentage receiving one or no take-home doses decreased from 22.4% before COVID-19 to 10.2% during COVID-19. In-person counseling attendance decreased from 82.9% to 19.4%. While only 3.3% of respondents accessed counseling through telehealth before COVID-19, this percentage increased to 61.7% during COVID-19. Many respondents (41.3%) reported visiting their clinics in person once a week or more during COVID-19.

Conclusions: During the first wave of COVID-19, methadone patients report decreased in-person clinic attendance and increased take-home doses and use of telehealth for counseling services. However, respondents reported considerable variations, and many were still required to make frequent in-person clinic visits, which put patients at risk of COVID-19 exposure. Relaxations of MMT in-person requirements during COVID-19 should be consistently implemented and made permanent, and patient experiences of these changes should be explored further.

Keywords: COVID-19; Community-driven research; Methadone; Opioid use disorder; United States.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid / therapeutic use
COVID-19*
Humans
Methadone / therapeutic use
Opiate Substitution Treatment
Opioid-Related Disorders* / drug therapy
Patient Outcome Assessment
Surveys and Questionnaires

Substances

Methadone
Analgesics, Opioid