Purpose 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. Methods 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). Results 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. Conclusions 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.

Social science has done well in providing empirical studies that depict how research is used in policymaking. Yet it performs less well in another contribution science can make-developing explanatory theoretical frameworks that predict and promote future research use. To address this theoretical void, onsite studies of policymakers have been called for. In this qualitative study, semistructured, face-to-face interviews were conducted with 123 legislators in 2 states, 32 legislators nominated by colleagues as exemplar research users, and 13 key informants. Policymakers' reports of 14 contributions that research makes to policymaking are compared to the predictions of four prominent theories of research utilization, which are representative of four categories of theories that examine the interface between researchers and policymakers-the politico-administrative decision-making model, a typology of research use; community dissonance theory; and policy agenda-setting/multiple-streams theory. The eight research contributions most frequently mentioned by policymakers cut across policymakers, political party, and states with varying degrees of partisan polarization. In some respects, policymakers' perceptions were well-aligned with theory, such as the contributions research makes to individual considerations (e.g., informing, explaining, and justifying one's positions), and to policy issue considerations (e.g., defining issues; designing legislation). Yet other contributions were seldom predicted by theory, such as the contributions research makes to policymakers' relationships (earning the trust of colleagues; educating others) and the policy process (asking important questions; enhancing debate, dialogue, collaboration, and compromise). Policymakers report that these contributions of research provide both policy and political benefits. Implications are drawn for advancing theory on research utilization.

Purpose: Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) introduces many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing 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. Methods: We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina. 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). Results: Before COVID-19, the clinic-level percent of participants receiving any amount of days supply of take-home doses at each clinic varied 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%. Of the 87 participants who received take-homes since COVID-19 began, only four reported selling their take-home doses. Conclusions: 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 treatment for OUD.

Common themes that have come up during COVID CLABSI case reviews and/or during the ICU central line prevalence day: ❖ Overdue transparent dressings ❖ Overdue cap changes ❖ Overdue and not labeled tubing ❖ Curos caps missing ❖ Daily CHG treatment not documented at least once every 24 hours New Considerations in COVID Care Line Selection: ❖ Consider a more permanent line (PICC) for patients with an expected longer length of stay ❖ Consult R-VAT team: Pager VEIN (8346) or PICC (7422)