Related Experiment Video
Updated: Jun 9, 2025
Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
Published on: August 4, 2022
Clinician and Practice Characteristics Associated With Support of Office-based Methadone: Findings From a National
Minhee L Sung1, Anne C Black, Derek Blevins
1From the Pain Research, Informatics, Multimorbidities and Education Center of Innovation, VA Connecticut Healthcare System, West Haven, CT (MLS, ACB); Program in Addiction Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (MLS, DAF, EJE); Section of General Internal Medicine, Yale School of Medicine, New Haven, CT (MLS, ACB, DAF, EJE); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY (DB, FRL); Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY (DB, FRL); Consortium on Substance Use and Addiction, Social Science Research Institute, Pennsylvania State University, University Park, PA (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); VA Boston Healthcare System, Boston, MA (MAD); Department of Psychiatry, Boston University Medical Center, Boston, MA (MAD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO (HH); Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA (PJJ); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison, WI (TM); Department of Emergency Medicine, Yale School of Medicine, New Haven, CT & Yale School of Public Health, New Haven, CT (DAF); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE).
Background:
Alternative models for methadone delivery outside of federal and state-regulated opioid treatment programs may improve access. We determined factors associated with clinician support for continuing office-based methadone.
Methods:
We used data from the electronic Opioid Use Disorder Provider COVID-19 Survey conducted among X-waivered clinicians who were providing outpatient, longitudinal treatment of opioid use disorder (OUD) from July 2020 to August 2020. The outcome variable was selecting "The opportunity for patients to receive office-based methadone" when asked "Which pandemic-related policy changes or new policy changes would you like to be continued or started after the pandemic?" Using sequential multivariable logistic regression modeling, we estimated the association between clinician and practice characteristics and support for office-based methadone.
Results:
Of 1900 respondents, 728 met the inclusion criteria. Twenty-eight percent indicated support for office-based methadone. Clinician characteristics associated with support for office-based methadone were being Black or African American versus White (adjusted odds ratio [AOR] [95% confidence interval (CI)], 2.88 [1.19-6.98]), having provided medications for OUD (MOUD) for >15 years versus ≤15 years (AOR [95% CI], 1.66 [1.02-2.68]), treating 51 to 100 patients with MOUD monthly versus <25 patients (AOR [95% CI], 1.79 [1.04-3.09]), providing methadone (AOR [95% CI], 1.71 [1.03-2.85]) versus not providing MOUD previously, and working in an academic medical center versus other settings (AOR [95% CI], 1.88 [1.11-3.16]).
Conclusions:
A minority of surveyed X-waivered clinicians supported office-based methadone. Efforts to expand access to methadone via office-based settings should address implementation barriers.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:15Drug Abuse and Addiction: Pharmacological Phenomena
01:17Phase II Reactions: Methylation Reactions
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...