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Improving methadone access for rural communities in the USA: lessons learned from COVID-19 adaptations and international models of care.
Lister, Jamey J; Lister, Holly H.
  • Lister JJ; School of Social Work, Rutgers, The State University of New Jersey, 120 Albany Street, Tower One - Suite 200, New Brunswick, NJ 08901, USA jlister@ssw.rutgers.edu.
  • Lister HH; Behavioral Research and Training Institute, Rutgers University Behavioral Health Care, 151 Centennial Avenue, Piscataway, NJ 08854, USA holly.lister@rutgers.edu.
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.
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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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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