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Pharmacy-based methadone treatment for opioid use disorder (OUD) is favored by patients and providers. Key facilitators include support and clear regulations, while barriers like stigma and cost must be addressed to expand access.

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Area of Science:

  • Pharmacology
  • Public Health
  • Health Policy

Background:

  • Access to opioid use disorder (OUD) medications is crucial globally.
  • In the US, methadone for OUD is restricted to Opioid Treatment Programs (OTPs).
  • Current regulations allow limited pharmacy partnerships with OTPs for methadone via 'medication units'.

Purpose of the Study:

  • To identify advantages, disadvantages, barriers, and facilitators of pharmacy-based methadone treatment for OUD.
  • To explore perspectives on potential legislative and regulatory changes.
  • To assess the feasibility and impact of expanding methadone access through pharmacies.

Main Methods:

  • Qualitative study using semi-structured interviews.
  • Conducted from April to July 2024.
  • Thirty-one key informants interviewed, including patients, OTP and pharmacy leaders, payers, and policymakers.

Main Results:

  • Pharmacy-based methadone treatment received favorable views across all stakeholder groups.
  • Patients preferred pharmacy-based models over restrictive OTP practices.
  • Key facilitators identified: support for change, sustainable payment, and clear regulations.
  • Barriers identified: stigma, financial challenges, and regulatory ambiguity.

Conclusions:

  • Legislative and regulatory reforms could significantly improve access to methadone for OUD.
  • Pharmacy-based treatment offers a promising alternative to current OTP-centric models.
  • Addressing identified barriers is essential for successful implementation and expanded access.