Giving more patients at-home access to the opioid addiction treatment drug methadone during the COVID pandemic did not lead to more overdose deaths, a nationwide study shows.
The research, which covered the period from January 2019 to August 2021, found that the push to let more patients take home doses rather than visit a clinic daily did not increase harm among users.
"Treatment is an essential tool to stop the addiction and overdose crises, but it is vastly underused," said senior author Nora Volkow, director of the U.S. National Institute on Drug Abuse.
"This evidence adds significant weight to the argument that effective treatment for substance use disorders should be offered in an accessible and practical way that works for people who need it," Volkow said in an institute news release.
Despite the generally favorable outcome of the at-home methadone program, overdose deaths, with or without methadone treatment, increased during March 2020, the study found. The following months showed a clear split in outcomes: Overdose deaths that did not involve methadone continued to rise after the policy change, while overdoses involving methadone held steady.
In 2021, more than 107,000 people died of a drug overdose in 2021, with 75% of those deaths involving an opioid, according to data from the U.S. Centers for Disease Control and Prevention.
The rise in overdose deaths was largely blamed on the rise in accessibility and popularity of fentanyl, a highly potent, synthetic and lethal opioid. A key element of the federal government response to the opioid crisis is expanding access to medication to treat opioid use disorder. Even still, only 18% of opioid users receive medication as treatment, researchers said.
In the United States, methadone is only available at federally certified opioid treatment centers. They require patients to visit clinics in order to receive their medication, a process long criticized for adding unnecessary difficulty and access barriers.
When the pandemic made in-person visits risky, the Substance Abuse and Mental Health Services Administration allowed states to request exceptions to provide a 28-day supply of methadone for stable patients to take at home and 14-day supplies for those who were deemed less stable.
"The goal of health policy should be to promote health and reduce harm, and our goal in conducting studies like this is to ensure that those policies are based on the best available scientific evidence," said lead author Christopher Jones, acting director of the U.S. National Center for Injury Prevention and Control.
"Projects like this also underscore the important findings that can emerge when we collaborate across agencies under a common mission, as we continue to work together to address the overdose crisis," Jones said in the release.
The study was published July 13 in JAMA Psychiatry.
For information on substance abuse and mental health treatment in your area, visit the Substance Abuse and Mental Health Services Administration.
SOURCE: U.S. National Institute on Drug Abuse, news release, July 13, 2022