Improving methadone access for rural communities in the USA: lessons learned from COVID-19 adaptations and international models of care.
Rural Remote Health
; 21(4): 6770, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1716365
ABSTRACT
CONTEXT The COVID-19 pandemic led to several changes to methadone treatment protocols at federal opioid treatment programs in the USA. ISSUE Protocol changes were designed to reduce transmission of COVID-19 while allowing for continuity of care, but those changes also demonstrated that many policies surrounding opioid use disorder care in the USA cause unnecessary burdens to patients. In this commentary, we describe how current policies create and maintain fatal barriers to methadone treatment for people in rural communities who have opioid use disorder, and highlight how COVID-19 adaptations and more flexible methadone models in other countries can better allow for effective and accessible care. Reasons and ways to address these issues to create lasting solutions for rural communities are discussed. LESSONS LEARNED We focus on three lessons (1) methadone dispensing and take-home schedules during COVID-19, (2) telehealth services during COVID-19, and (3) international models in use prior to COVID-19. We then outline recommendations for each lesson to improve access to methadone treatment long term for rural communities in the USA. There is an urgent need to implement recommendations that maintain flexible approaches and address methadone treatment barriers in the rural USA. To achieve lasting health policy change and combat stigma about addiction and methadone treatment, there is a need for advocacy efforts that give voice to rural residents impacted by inequitable access to methadone treatment and rural-tailored educational initiatives that promote the evidence base for methadone. We hope opioid treatment program directors, regulatory authorities, and health policymakers consider our recommendations.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Rural Population
/
Delivery of Health Care
/
Opiate Substitution Treatment
/
COVID-19
/
Health Services Accessibility
/
Methadone
/
Opioid-Related Disorders
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Rural Remote Health
Journal subject:
Public Health
/
Health Services
Year:
2021
Document Type:
Article
Affiliation country:
Rrh6770
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