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The 72-hour rule allows take-home methadone for opioid use disorder (OUD) patients. Factors like prior OTP enrollment and higher methadone doses improved linkage, while stimulant co-use hindered it.

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Area of Science:

  • Addiction Medicine
  • Public Health
  • Pharmacology

Background:

  • The US federal 72-hour rule permits hospitals to dispense take-home methadone for opioid use disorder (OUD) at discharge.
  • This rule facilitates continuity of care for patients transitioning from acute settings to opioid treatment programs (OTPs).

Purpose of the Study:

  • To analyze acute care encounters involving take-home methadone.
  • To identify factors associated with successful 72-hour hospital-to-OTP linkage for OUD patients.

Main Methods:

  • A cohort study analyzed 519 encounters for OUD patients receiving take-home methadone across four hospitals (Nov 2022-Apr 2024).
  • Multinomial logistic regression assessed variables linked to 72-hour hospital-to-OTP linkage completion.

Main Results:

  • 44.5% of patients completed the 72-hour hospital-to-OTP linkage.
  • Discharge to postacute care, prior OTP enrollment, and higher methadone doses were associated with successful linkage.
  • Co-use of opioids and stimulants was linked to lower linkage rates.

Conclusions:

  • Existing relationships between healthcare facilities and OTPs, coupled with take-home methadone, appear to support successful patient linkage.
  • Enhancing these collaborations and processes can improve OUD treatment engagement during care transitions.