An investigation of an open‐access model for scaling up methadone maintenance treatment

Madden, Lynn M.; Farnum, Scott O.; Eggert, Kathryn F.; Quanbeck, Andrew; Freeman, Robert; Ball, Samuel A.; Schottenfeld, Richard S.; Shi, Julia; Savage, Mary Ellen; Barry, Declan T.

doi:10.1111/add.14198

Cited by 49 publications

(43 citation statements)

References 52 publications

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“…This evidence-based implementation strategy improves treatment outcomes by reducing system-level inefficiencies that cause delays in treatment entry and increases retention by improving quality care. Programs adopting the NIATx framework team-up with expert consultants to develop strategies and implement changes geared toward reducing waiting times, increasing treatment retention and reducing attrition by tackling various organizational impediments (Campbell et al, 2009; Capoccia et al, 2007; Fitzgerald and McCarty, 2009; Hoffman et al, 2008; Madden, 2018; McCarty and Chandler, 2009; McCarty et al, 2009; McCarty et al, 2007). …”

Section: Discussionmentioning

confidence: 99%

Assessment of barrier severity and willingness to enter opioid agonist treatment among people who inject drugs in Ukraine

Zelenev

Shea

Mazhnaya

et al. 2018

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 99%

Assessment of barrier severity and willingness to enter opioid agonist treatment among people who inject drugs in Ukraine

Zelenev

Shea

Mazhnaya

et al. 2018

Drug and Alcohol Dependence

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“…For this population with high frequency of illicit drug use, urine screens may be insensitive to decreases in quantity and frequency of drug use. However, these changes can be meaningful in reducing important risks such as injection, overdose, and death, and are consistent with public health approaches (Madden et al, 2018;Wiessing et al, 2017). Such increases may also be important in the process of patients moving to higher levels of abstinence and achieving remission from substance use disorder (Carroll, 1998;McHugh, Hearon, & Otto, 2010).…”

Section: Discussionmentioning

confidence: 67%

A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use

Moore

Buono

Lloyd

et al. 2019

Journal of Substance Abuse Treatment

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Background: Relapse, drug use, and treatment dropout are common challenges facing patients receiving methadone. Though effective, multiple barriers to face-to-face counseling exist. The Recovery Line (RL), an automated, self-management system based on Cognitive Behavioral Therapy, is a phone-based adjunctive treatment that provides low cost, consistent delivery and immediate therapeutic availability 24 hours a day. Methods: The current study was a 12-week randomized clinical efficacy trial of treatment-asusual (TAU) only or RL+TAU for methadone treatment patients with continued illicit drug use (N=82). Previous small trial phases evaluated methods to increase participant engagement and use of the RL and were incorporated into the current RL version. Primary outcomes were days of selfreported illicit drug abstinence and urine screens negative for illicit drugs. Results: Days of self-reported illicit drug abstinence improved for patients in RL+TAU but not in TAU. Percent of urine screens negative for illicit drugs, coping skills efficacy, and retention in methadone treatment did not differ by condition. Patients in RL+TAU attended more substance use disorder treatment and self-help group sessions during treatment than those in TAU. RL system use was generally low and more system use was correlated with abstinence outcomes. Conclusions: Although the RL did not impact urine screen outcomes, it increases self-reported abstinence. Additional methods to increase patient engagement with automated, self-management systems for substance use disorder are needed.

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“…New Haven researchers working at Yale have championed buprenorphine treatment in out-patient medical practices and emergency departments [20,21]. Opioid treatment programs, most notably the APT Foundation in New Haven, have expanded evidence-based treatment for OUD by adopting open access models that eliminate waiting lists and shorten intake times to 90 min [22]. Methadone treatment has been expanded to incarcerated persons in six of the state's correctional facilities, beginning with the jails in New Haven in 2013 and in Bridgeport the following spring [23].…”

Section: Introductionmentioning

confidence: 99%

A Community Responds to the COVID-19 Pandemic: a Case Study in Protecting the Health and Human Rights of People Who Use Drugs

2020

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Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalition of people who use drugs, advocates, service providers, and academics to implement solutions to reduce these risks at a municipal and state level focusing on New Haven and the State of Connecticut. This coalition identified the communities at risk: active users needing access to harm reduction services, persons in treatment needing access to their medications, the homeless and marginally housed needing improved hygiene, people engaged in sex work, and the incarcerated needing release from custody. The section describing each of the risks demonstrates how the coalition acted preemptively at early stages of the pandemic, ahead of official initiatives, to develop ameliorative risk reduction solutions. Outcomes discussed include instances in which obstacles were overcome or still remain.

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An investigation of an open‐access model for scaling up methadone maintenance treatment

Abstract: An open-access model for rapid enrolment of people with opioid use disorder in methadone treatment appears to improve treatment access, capacity, and financial sustainability without evidence of deleterious effects on treatment outcomes.

Cited by 49 publications

References 52 publications

Assessment of barrier severity and willingness to enter opioid agonist treatment among people who inject drugs in Ukraine

Assessment of barrier severity and willingness to enter opioid agonist treatment among people who inject drugs in Ukraine

A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use

A Community Responds to the COVID-19 Pandemic: a Case Study in Protecting the Health and Human Rights of People Who Use Drugs

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