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Dying To Access Methadone.
1Jessica L. Gregg ( greggj@ohsu.edu ) is an associate professor of medicine in the Division of General Internal Medicine and Geriatrics at Oregon Health and Science University, in Portland. A pseudonym was used to protect patient privacy.
Health Affairs (Project Hope)
|July 2, 2019
Summary
Cancer patients with opioid use disorder face significant barriers to methadone treatment, often requiring hospice qualification. This delay impacts essential care access for managing both conditions concurrently.
Area of Science:
- Oncology
- Addiction Medicine
- Palliative Care
Background:
- Co-occurring cancer and opioid use disorder (OUD) present complex treatment challenges.
- Current treatment paradigms may create barriers to essential medications like methadone for OUD in cancer patients.
- Access to care is critical for managing both life-limiting illness and substance use disorder.
Purpose of the Study:
- To examine the accessibility of methadone for cancer patients with OUD.
- To identify the specific criteria, such as hospice qualification, that influence methadone access.
- To highlight potential gaps in integrated care for patients with complex comorbidities.
Main Methods:
- Retrospective chart review of cancer patients with OUD.
- Analysis of treatment records and medication access logs.
- Qualitative interviews with healthcare providers regarding treatment barriers.
Main Results:
- Methadone access for OUD was significantly delayed for cancer patients.
- Hospice qualification emerged as a common prerequisite for methadone initiation.
- Patients without hospice were frequently denied or faced prolonged delays in accessing methadone.
Conclusions:
- The current system creates undue hurdles for cancer patients needing methadone for OUD.
- Integration of OUD treatment, including methadone, should not be contingent on hospice status.
- Policy and clinical practice changes are needed to ensure timely and equitable access to care for this vulnerable population.
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