Research priorities for expanding access to methadone treatment for opioid use disorder in the United States: A National Institute on Drug Abuse Clinical Trials Network Task Force report

Abstract

In the US, methadone treatment can only be provided to patients with opioid use disorder (OUD) through federal and state-regulated opioid treatment programs (OTPs). There is a shortage of OTPs, and racial and geographic inequities exist in access to methadone treatment. The National Institute on Drug Abuse Clinical Trials Network convened the Methadone Access Research Task Force to develop a research agenda to expand and create more equitable access to methadone treatment for OUD. This research agenda included mechanisms that are available within and outside the current regulations. The task force identified 6 areas where research is needed: (1) access to methadone in general medical and other outpatient settings; (2) the impact of methadone treatment setting on patient outcomes; (3) impact of treatment structure on outcomes in patients receiving methadone; (4) comparative effectiveness of different medications to treat OUD; (5) optimal educational and support structure for provision of methadone by medical providers; and (6) benefits and harms of expanded methadone access. In addition to outlining these research priorities, the task force identified important cross-cutting issues, including the impact of patient characteristics, treatment, and treatment system characteristics such as methadone formulation and dose, concurrent behavioral treatment, frequency of dispensing, urine or oral fluid testing, and methods of measuring clinical outcomes. Together, the research priorities and cross-cutting issues represent a compelling research agenda to expand access to methadone in the US.

Keywords:

• Access
• methadone
• opioid use disorder

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Correction

Acknowledgements

The authors would like to thank the other task force participants: Quandra Blackeney, Laura Brandt, Cynthia Campbell, Jerry Cochran, Udi Ghitza, Petra Jacobs, David Liu, Lisa Marsch, Joseph Merill, Larissa Mooney, Carmen Rosa, Jeffrey Samet, Kurt Snyder, Betty Tai, and Xiaoming Wang for their assistance in developing the research agenda.

Disclosure statement

Dr Schwartz served as a consultant for Verily Life Sciences. He is Multiple PI of a NIDA cooperative grant that is receiving at no cost to the grant material support from Alkermes and Indivior.

Author contributions

CTN conceived of the Methadone Access Research Task Force and DF chaired the task force. All task force members, including all authors, contributed to the development of the research agenda. PJ drafted all initial commentary. All authors contributed to the writing of the manuscript.

Correction Statement

This article was originally published with errors, which have now been corrected in the online version. Please see Correction (http://dx.doi.org/10.1080/08897077.2021.1975344)

Additional information

Funding

Funding for this publication was provided by grant number 5K12DA033312 (PJJ) from the National Institute on Drug Abuse, a component of the National Institutes of Health, and grant 5UG1DA013034-20. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.