AUGUST 9, 2022
New research has found that increased access to the opioid use disorder (OUD) drug methadone at the start of the COVID-19 pandemic may have been behind a reduction in methadone-related overdose deaths over a more than two-year period.
Due to efforts to limit the spread of COVID-19, methadone access was expanded to permit more OUD patients to take doses at home. In the United States, methadone treatment for OUD usually has required individuals to obtain doses daily in person through
New research has found that increased access to the opioid use disorder (OUD) drug methadone at the start of the COVID-19 pandemic may have been behind a reduction in methadone-related overdose deaths over a more than two-year period.
Due to efforts to limit the spread of COVID-19, methadone access was expanded to permit more OUD patients to take doses at home. In the United States, methadone treatment for OUD usually has required individuals to obtain doses daily in person through federally certified opioid treatment programs. In March 2020, the Substance Abuse and Mental Health Services Administration began allowing states to request exceptions to the rule, providing 28 days of take-home medication to stable patients and 14 days of medication for less stable patients.
The researchers reviewed data from January 2019 through August 2021, from the CDC National Vital Statistics System and determined monthly drug overdose deaths without methadone, monthly drug overdose deaths involving methadone and the percentage of overall overdose deaths involving methadone. They used interrupted time series analyses to determine if there was a shift in outcomes before and after the methadone take-home policy change.
The team found that overdose deaths not involving methadone rose on average by 78 more deaths each month before March 2020, increased by 1,078 deaths during March 2020, and then continued to increase by an average of 69 more deaths each month after March 2020. Methadone-involved overdose deaths showed a similar increase in March 2020 (94 deaths). However, the trend in number of deaths per month before and after this initial rise remained stable, and the percentage of overdose deaths involving methadone declined at similar rates before and after the take-home policy change, declining from 4.5% of overdose deaths in January 2019 to 3.2% in August 2021.
“These data indicate that broader access to treatment was not associated with harms,” the National Institutes of Health (NIH) wrote in a press statement. “While drug overdose deaths both with and without methadone increased in the month of March 2020, overdose deaths that did not involve methadone continued to increase in the months after the policy changes, while overdose deaths involving methadone held steady.”
“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 M. Jones, PharmD, DrPH, the acting director of the National Center for Injury Prevention and Control at the CDC.
This study was a collaboration between researchers at the National Institute on Drug Abuse (NIDA), which is part of the NIH, and the National Center for Injury Prevention and Control.
“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,” said NIDA Director and senior author Nora Volkow, MD.
The study was published in JAMA Psychiatry (2022 Jul 13:e221776).
Based on a press release from the National Institutes of Health.
