View in EDS HTML Full Text PDF Full Text

State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset.

Saved in:
Bibliographic Details
Title: State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset.
Authors: Bórquez, Ignacio, Williams, Arthur R., Hu, Mei‐Chen, Scott, Marc, Stewart, Maureen T., Harpel, Lexa, Aydinoglo, Nicole, Cerdá, Magdalena, Rotrosen, John, Nunes, Edward V., Krawczyk, Noa
Source: Addiction. Jun2025, Vol. 120 Issue 6, p1207-1222. 16p.
Subjects: Substance abuse, Methadone hydrochloride, Research funding, Health policy, Retrospective studies, Descriptive statistics, Longitudinal method, Opioid analgesics, Medical records, Acquisition of data, Housing, Comparative studies, COVID-19 pandemic, Sequence analysis, COVID-19
Geographic Terms: United States
Abstract: Background and aims: US regulatory changes allowed for additional methadone take‐home doses following COVID‐19 onset. How dispensing practices changed and which factors drove variation remains unexplored. We determined daily methadone dispensing trajectories over six months before and after regulatory changes due to COVID‐19 using state sequence analysis and explored correlates. Design: Retrospective chart review of electronic health records. Settings Nine opioid treatment programs (OTPs) across nine US states. Participants: Adults initiating treatment in 2019 (n = 328) vs. initiating 1 month after the COVID‐19 regulatory changes of March 2020 (n = 376). Measurements Type of daily methadone medication encounter (in‐clinic, weekend/holiday take‐home, take‐home, missed dose, discontinued) based on OTP clinic; cohort (pre vs. post‐COVID‐19); and patient substance use, clinical and sociodemographic characteristics. Findings Following COVID‐19 regulatory changes, allotted methadone take‐home doses increased from 3.5% to 13.8% of total person‐days in treatment within the first 6 months in care. Clinic site accounted for the greatest variation in methadone dispensing (6.2% and 9.5% of the variation of discrepancy between sequences pre‐ and post‐COVID‐19, respectively). People who co‐use methamphetamine had a greater increase in take‐homes than people who did not use methamphetamine (from 3.7% pre‐pandemic to 21.2% post‐pandemic vs. 3.5% to 12.5%) and higher discontinuation (average 3.6 vs. 4.7 months among people who did not use methamphetamine pre‐COVID‐19; average 3.3 vs. 4.6 months post‐COVID‐19). In the post‐COVID‐19 cohort, females had a higher proportion of missed doses (17.2% vs. 11.9%) than males. People experiencing houselessness had a higher proportion of missed doses (19% vs. 12.3%) and shorter stays (average 3.5 vs. 4.5 months) when compared with those with stable housing. Conclusion: Daily methadone dispensing trajectories in the US both before and following COVID‐19 regulatory changes appeared to depend more on the opioid treatment programs' practices than individual patient characteristics or response to treatment. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 184927596
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Bórquez%2C+Ignacio%22">Bórquez, Ignacio</searchLink><br /><searchLink fieldCode="AR" term="%22Williams%2C+Arthur+R%2E%22">Williams, Arthur R.</searchLink><br /><searchLink fieldCode="AR" term="%22Hu%2C+Mei‐Chen%22">Hu, Mei‐Chen</searchLink><br /><searchLink fieldCode="AR" term="%22Scott%2C+Marc%22">Scott, Marc</searchLink><br /><searchLink fieldCode="AR" term="%22Stewart%2C+Maureen+T%2E%22">Stewart, Maureen T.</searchLink><br /><searchLink fieldCode="AR" term="%22Harpel%2C+Lexa%22">Harpel, Lexa</searchLink><br /><searchLink fieldCode="AR" term="%22Aydinoglo%2C+Nicole%22">Aydinoglo, Nicole</searchLink><br /><searchLink fieldCode="AR" term="%22Cerdá%2C+Magdalena%22">Cerdá, Magdalena</searchLink><br /><searchLink fieldCode="AR" term="%22Rotrosen%2C+John%22">Rotrosen, John</searchLink><br /><searchLink fieldCode="AR" term="%22Nunes%2C+Edward+V%2E%22">Nunes, Edward V.</searchLink><br /><searchLink fieldCode="AR" term="%22Krawczyk%2C+Noa%22">Krawczyk, Noa</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Jun2025, Vol. 120 Issue 6, p1207-1222. 16p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Methadone+hydrochloride%22">Methadone hydrochloride</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Health+policy%22">Health policy</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Opioid+analgesics%22">Opioid analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Housing%22">Housing</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19+pandemic%22">COVID-19 pandemic</searchLink><br /><searchLink fieldCode="DE" term="%22Sequence+analysis%22">Sequence analysis</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and aims: US regulatory changes allowed for additional methadone take‐home doses following COVID‐19 onset. How dispensing practices changed and which factors drove variation remains unexplored. We determined daily methadone dispensing trajectories over six months before and after regulatory changes due to COVID‐19 using state sequence analysis and explored correlates. Design: Retrospective chart review of electronic health records. Settings Nine opioid treatment programs (OTPs) across nine US states. Participants: Adults initiating treatment in 2019 (n = 328) vs. initiating 1 month after the COVID‐19 regulatory changes of March 2020 (n = 376). Measurements Type of daily methadone medication encounter (in‐clinic, weekend/holiday take‐home, take‐home, missed dose, discontinued) based on OTP clinic; cohort (pre vs. post‐COVID‐19); and patient substance use, clinical and sociodemographic characteristics. Findings Following COVID‐19 regulatory changes, allotted methadone take‐home doses increased from 3.5% to 13.8% of total person‐days in treatment within the first 6 months in care. Clinic site accounted for the greatest variation in methadone dispensing (6.2% and 9.5% of the variation of discrepancy between sequences pre‐ and post‐COVID‐19, respectively). People who co‐use methamphetamine had a greater increase in take‐homes than people who did not use methamphetamine (from 3.7% pre‐pandemic to 21.2% post‐pandemic vs. 3.5% to 12.5%) and higher discontinuation (average 3.6 vs. 4.7 months among people who did not use methamphetamine pre‐COVID‐19; average 3.3 vs. 4.6 months post‐COVID‐19). In the post‐COVID‐19 cohort, females had a higher proportion of missed doses (17.2% vs. 11.9%) than males. People experiencing houselessness had a higher proportion of missed doses (19% vs. 12.3%) and shorter stays (average 3.5 vs. 4.5 months) when compared with those with stable housing. Conclusion: Daily methadone dispensing trajectories in the US both before and following COVID‐19 regulatory changes appeared to depend more on the opioid treatment programs' practices than individual patient characteristics or response to treatment. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=184927596
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/add.70008
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 16
        StartPage: 1207
    Subjects:
      – SubjectFull: Substance abuse
        Type: general
      – SubjectFull: Methadone hydrochloride
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Health policy
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Opioid analgesics
        Type: general
      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Acquisition of data
        Type: general
      – SubjectFull: Housing
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: COVID-19 pandemic
        Type: general
      – SubjectFull: Sequence analysis
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: State sequence analysis of daily methadone dispensing trajectories among individuals at United States opioid treatment programs before and following COVID‐19 onset.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Bórquez, Ignacio
      – PersonEntity:
          Name:
            NameFull: Williams, Arthur R.
      – PersonEntity:
          Name:
            NameFull: Hu, Mei‐Chen
      – PersonEntity:
          Name:
            NameFull: Scott, Marc
      – PersonEntity:
          Name:
            NameFull: Stewart, Maureen T.
      – PersonEntity:
          Name:
            NameFull: Harpel, Lexa
      – PersonEntity:
          Name:
            NameFull: Aydinoglo, Nicole
      – PersonEntity:
          Name:
            NameFull: Cerdá, Magdalena
      – PersonEntity:
          Name:
            NameFull: Rotrosen, John
      – PersonEntity:
          Name:
            NameFull: Nunes, Edward V.
      – PersonEntity:
          Name:
            NameFull: Krawczyk, Noa
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 06
              Text: Jun2025
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 09652140
          Numbering:
            – Type: volume
              Value: 120
            – Type: issue
              Value: 6
          Titles:
            – TitleFull: Addiction
              Type: main
ResultId 1