Evidence-based treatment for opioid use disorders: A national study of methadone dose levels, 2011–2017

Thomas D'Aunno, Sunggeun (Ethan) Park, Harold A. Pollack

Research output: Contribution to journalArticle

Abstract

The nation's methadone maintenance treatment (MMT) programs play a central role in addressing the current opioid epidemic. Considerable evidence documents the treatment effectiveness of MMT and, in turn, the importance of adequate dosing to MMT's effectiveness. Yet, as recently as 2011, 41% of patients received doses below the level of 80 mg/day. Using survey data from a nationally representative sample of MMT programs in 2011 and 2017, we examine (1) the extent to which the nation's MMT programs are meeting evidence-based standards for methadone dose level and (2) characteristics of MMT programs that are associated with variation in performance. Our results show that 43% of MMT patients receive <80 mg/day in 2017, and 23% of methadone maintenance patients receive daily doses below 60 mg. Results from multivariate regression analysis of the 2017 survey data show that private for-profit and public organizations significantly under-dosed patients compared to private nonprofit providers. Under-dosing also was more common in programs that serve high proportions of African-American patients. These results are concerning because MMT remains the medication of choice for vulnerable patients with the most severe opioid use disorders, and for-profit providers treat a growing proportion of MMT patients.

Original languageEnglish (US)
Pages (from-to)18-22
Number of pages5
JournalJournal of Substance Abuse Treatment
Volume96
DOIs
StatePublished - Jan 1 2019

Fingerprint

Methadone
Opioid Analgesics
Therapeutics
African Americans
Multivariate Analysis
Regression Analysis
Organizations

Keywords

  • Methadone
  • Opioid-related disorders
  • Substance use treatment

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Evidence-based treatment for opioid use disorders : A national study of methadone dose levels, 2011–2017. / D'Aunno, Thomas; Park, Sunggeun (Ethan); Pollack, Harold A.

In: Journal of Substance Abuse Treatment, Vol. 96, 01.01.2019, p. 18-22.

Research output: Contribution to journalArticle

@article{909bbc2832c547bbaec0d529682d92d2,
title = "Evidence-based treatment for opioid use disorders: A national study of methadone dose levels, 2011–2017",
abstract = "The nation's methadone maintenance treatment (MMT) programs play a central role in addressing the current opioid epidemic. Considerable evidence documents the treatment effectiveness of MMT and, in turn, the importance of adequate dosing to MMT's effectiveness. Yet, as recently as 2011, 41{\%} of patients received doses below the level of 80 mg/day. Using survey data from a nationally representative sample of MMT programs in 2011 and 2017, we examine (1) the extent to which the nation's MMT programs are meeting evidence-based standards for methadone dose level and (2) characteristics of MMT programs that are associated with variation in performance. Our results show that 43{\%} of MMT patients receive <80 mg/day in 2017, and 23{\%} of methadone maintenance patients receive daily doses below 60 mg. Results from multivariate regression analysis of the 2017 survey data show that private for-profit and public organizations significantly under-dosed patients compared to private nonprofit providers. Under-dosing also was more common in programs that serve high proportions of African-American patients. These results are concerning because MMT remains the medication of choice for vulnerable patients with the most severe opioid use disorders, and for-profit providers treat a growing proportion of MMT patients.",
keywords = "Methadone, Opioid-related disorders, Substance use treatment",
author = "Thomas D'Aunno and Park, {Sunggeun (Ethan)} and Pollack, {Harold A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jsat.2018.10.006",
language = "English (US)",
volume = "96",
pages = "18--22",
journal = "Journal of Substance Abuse Treatment",
issn = "0740-5472",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Evidence-based treatment for opioid use disorders

T2 - A national study of methadone dose levels, 2011–2017

AU - D'Aunno, Thomas

AU - Park, Sunggeun (Ethan)

AU - Pollack, Harold A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The nation's methadone maintenance treatment (MMT) programs play a central role in addressing the current opioid epidemic. Considerable evidence documents the treatment effectiveness of MMT and, in turn, the importance of adequate dosing to MMT's effectiveness. Yet, as recently as 2011, 41% of patients received doses below the level of 80 mg/day. Using survey data from a nationally representative sample of MMT programs in 2011 and 2017, we examine (1) the extent to which the nation's MMT programs are meeting evidence-based standards for methadone dose level and (2) characteristics of MMT programs that are associated with variation in performance. Our results show that 43% of MMT patients receive <80 mg/day in 2017, and 23% of methadone maintenance patients receive daily doses below 60 mg. Results from multivariate regression analysis of the 2017 survey data show that private for-profit and public organizations significantly under-dosed patients compared to private nonprofit providers. Under-dosing also was more common in programs that serve high proportions of African-American patients. These results are concerning because MMT remains the medication of choice for vulnerable patients with the most severe opioid use disorders, and for-profit providers treat a growing proportion of MMT patients.

AB - The nation's methadone maintenance treatment (MMT) programs play a central role in addressing the current opioid epidemic. Considerable evidence documents the treatment effectiveness of MMT and, in turn, the importance of adequate dosing to MMT's effectiveness. Yet, as recently as 2011, 41% of patients received doses below the level of 80 mg/day. Using survey data from a nationally representative sample of MMT programs in 2011 and 2017, we examine (1) the extent to which the nation's MMT programs are meeting evidence-based standards for methadone dose level and (2) characteristics of MMT programs that are associated with variation in performance. Our results show that 43% of MMT patients receive <80 mg/day in 2017, and 23% of methadone maintenance patients receive daily doses below 60 mg. Results from multivariate regression analysis of the 2017 survey data show that private for-profit and public organizations significantly under-dosed patients compared to private nonprofit providers. Under-dosing also was more common in programs that serve high proportions of African-American patients. These results are concerning because MMT remains the medication of choice for vulnerable patients with the most severe opioid use disorders, and for-profit providers treat a growing proportion of MMT patients.

KW - Methadone

KW - Opioid-related disorders

KW - Substance use treatment

UR - http://www.scopus.com/inward/record.url?scp=85055052168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055052168&partnerID=8YFLogxK

U2 - 10.1016/j.jsat.2018.10.006

DO - 10.1016/j.jsat.2018.10.006

M3 - Article

C2 - 30466543

AN - SCOPUS:85055052168

VL - 96

SP - 18

EP - 22

JO - Journal of Substance Abuse Treatment

JF - Journal of Substance Abuse Treatment

SN - 0740-5472

ER -