Related Experiment Video
Updated: Oct 8, 2026

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
Published on: April 23, 2019
Patient Travel Experiences for Methadone Dosing Visits
Elizabeth J Austin1, Varuna Ravi2, Alexander J Gojic1
1Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle.
Importance:
Patients often experience travel-related barriers to methadone dosing at opioid treatment programs (OTPs), but the nature of their experiences are not well understood.
Objective:
To characterize patient experiences with travel to OTPs for regular methadone dosing visits at a large multisite OTP in Washington state.
Design, Setting, And Participants:
This qualitative study utilized an embedded mixed-methods design. Our sample included patients currently receiving methadone treatment at 2 OTP sites in Washington state from November 2024 to February 2026 (including mobile units that operated as extension of the sites). Data were analyzed between February and July 2026.
Exposures:
Experiences of travel to OTPs for regular, in-person observed methadone dosing.
Main Outcomes And Measures:
Results of a survey administered to patients regarding the modality, time, and cost (eg, gas, childcare) of traveling to the OTP. A subsample of surveyed patients were interviewed about their experiences with and perspectives on traveling for dosing visits. Survey data were analyzed descriptively. Interviews were coded using rapid assessment process.
Results:
Our sample included 98 survey participants and 16 qualitative interview participants (median [IQR] age, 43.0 [38.8-50.3] years; 8 cisgender women [50.0%]). Among survey respondents, 54 (55.1%) drove themselves to the OTP, 21 (21.4%) were driven by another person, 12 (12.3%) took public transportation, and 6 (6.1%) took insurer-sponsored medical transportation; 18 (18.4%) reported a disabling condition and 16 (16.2%) needed an assistive device for walking. Participants spent a mean (range) 82.5 (10.0-330.0) minutes round trip and $15.80 ($0-$200.00) in travel-related costs for each visit. Qualitative interviews illuminated that, while distance was often a barrier, unpredictable OTP wait times or conflicts with work, medical, or family obligations also mattered considerably. Participants shared that dosing visits directly prohibited their ability to work, but missing visits put participants at risk for return to opioid use and treatment stagnation.
Conclusions And Relevance:
In this mixed-methods qualitative study, requiring regular visits for in-person observed methadone dosing presented significant structural barriers that affect patients' treatment experience, adherence, and lives. Increasing the flexibility and accessibility of methadone treatment-through policies and novel care practices that actively seek to minimize burden of travel to the OTP and destigmatize care-is essential to enhance care quality and equity.
Related Concept Videos
Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Therapeutic Drug Monitoring: Affecting Factors
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses
Drug Delivery: Miscellaneous Routes
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs through the...
Routes of Drug Administration: Overview
Enteral administration refers to drugs absorbed through the gastrointestinal tract. They can be swallowed (perorally), placed under the tongue (sublingually), or on the inner lining of the cheeks (buccally). Perorally administered drugs take time to be absorbed and have a slower onset of action. The rectal route is another form of enteral administration, which allows for...