The Elevance Health Public Policy Institute found no association between county-level uptake of take-home methadone — used to treat opioid use disorder — and differences in drug overdose rates and behavioral health- or OUD-related emergency department visits.
Published May 25 in the Journal of Addiction Medicine, researchers reviewed administrative medical claims spanning January 2016 through April 2024 from commercially insured members across 49 states and the District of Columbia. The study looked at the county level to limit selection bias and highlight geographical variation with take-home methadone access. The study did not account for the Medicaid and Medicare populations. The reviewed billing code for take-home doses also did not distinguish between patients in opioid treatment programs receiving up to 28 days’ supply of the drug versus those getting up to 14 days’ supply.
“The findings support continued implementation of flexible patient-centered methadone regulations, and also payer policies … and further exploration of strategies that reduce the barriers to evidence-based treatment,” Sarah Adkins, director of public policy with the Elevance Public Policy Institute, told Becker’s. “We were realizing that it’s a fairly lower risk approach to treating people, and that methadone really is the gold standard and should be expanded in a safe, effective way.”
Valentine Wanga, PhD, a senior researcher at Elevance, said the study found “no disruptions in treatment continuity,” either. Researchers reviewed continuity for members with continuous enrollment of at least six or 12 months.
The research also showed how, compared to counties without take-home uptake, urban populations, as well as those with higher comorbidity index scores, were more likely to have take-home access.
In March 2020, the Substance Abuse and Mental Health Services Administration relaxed restrictions for methadone treatment, including take-home doses. About four years later, SAMHSA codified some pandemic-era flexibilities as permanent. Of the 1,134 analyzed counties with at least one individual receiving methadone for OUD following the March 2020 policy, less than one-quarter had members with any claims for take-home methadone.
“We are excited about these findings because they do … underscore the fact that those SAMHSA regulations being made permanent is a good thing for members and patients,” Ms. Adkins said. “Payers can play an important role in ensuring access and availability for people with opioid use disorder through the use of take-home methadone.”
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