Nothing really changed: Arizona patient experience of methadone and buprenorphine access during COVID

Objective To understand patient experience of federal regulatory changes governing methadone and buprenorphine (MOUD) access in Arizona during the COVID-19 pandemic. Methods This community-based participatory and action research study involved one-hour, audio-recorded field interviews conducted with...

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Bibliographic Details
Published in:	PloS one Vol. 17; no. 10; p. e0274094
Main Authors:	Meyerson, Beth E, Bentele, Keith G, Russell, Danielle M, Brady, Benjamin R, Downer, Missy, Garcia, Roberto C, Garnett, Irene, Lutz, Rebecca, Mahoney, Arlene, Samorano, Savannah, Arredondo, Christina, Andres, Honey J, Coles, Haley, Granillo, Brenda
Format:	Journal Article
Language:	English
Published:	San Francisco Public Library of Science 25-10-2022 Public Library of Science (PLoS)
Subjects:	Arizona Buprenorphine Community involvement Community participation Consent Control COVID-19 Dosage Dosage and administration Drug abuse Drug addiction Drug dosages Drug overdose Drug use Epidemics Federal regulation Harm reduction Health care access Health risks Interviews Medicine and Health Sciences Methadone Methadone hydrochloride Minority & ethnic groups Multiculturalism & pluralism Narcotics Pandemics Patient safety Patients People and places Population Risk State regulations Substance abuse treatment Telemedicine Arizona United States > US
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Summary:	Objective To understand patient experience of federal regulatory changes governing methadone and buprenorphine (MOUD) access in Arizona during the COVID-19 pandemic. Methods This community-based participatory and action research study involved one-hour, audio-recorded field interviews conducted with 131 people who used methadone and/or buprenorphine to address opioid use disorder at some point during COVID (January 1, 2020- March 31, 2021) in Arizona. Transcribed data were analyzed using a priori codes focused on federally recommended flexibilities governing MOUD access. Data were quantitated to investigate associations with COVID risk and services access. Results Telehealth was reported by 71.0% of participants, but the majority were required to come to the clinic to attend video appointments with an offsite provider. Risk for severe COVID outcomes was reported by 40.5% of the sample. Thirty-eight percent of the sample and 39.7% of methadone patients were required to be at the clinic daily to get medication and 47.6% were at high risk for COVID severe outcomes. About half (54.2%) of methadone patients indicated that some form of multi-day take home dosing was offered at their clinic, and 45.8% were offered an extra day or two of multi-day doses; but no participants received the federally allowed 14- or 28-day methadone take-home doses for unstable and stable patients respectively. All participants expressed that daily clinic visits interrupted their work and home lives and desired more take-home dosing and home delivery options. Conclusions MOUD patients in Arizona were not offered many of the federally allowed flexibilities for access that were designed to reduce their need to be at the clinic. To understand the impact of these recommended treatment changes in Arizona, and other states where they were not well implemented, federal and state regulators must mandate these changes and support MOUD providers to implement them.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0274094