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    Methadone exposures reported to poison control centers in the United States following the COVID-19-related loosening of federal methadone regulations.

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    Author
    Welsh, Christopher
    Doyon, Suzanne
    Hart, Katherine
    Date
    2022-01-20
    Journal
    International Journal on Drug Policy
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.drugpo.2022.103591
    Abstract
    Background: Methadone is a highly effective treatment for opioid use disorder. Its use in the United States is highly regulated at both the federal and state level. The regulations related to take-home doses were loosened because of the 2019 Novel Coronavirus public health emergency declaration. The aim was to assess the effect of loosened regulations on methadone-related exposures reported to poison control centers. Methods: Retrospective analysis of population-based intentional methadone exposures (in persons 18 years of age and older) reported to the American Association of Poison Control Centers’ National Poison Data System. A quasi-experimental design looking at one year before and after the March 16, 2020 loosening of methadone take-home regulations. Severity of exposure was assessed by: disposition (discharged from emergency department, admitted to non-critical care versus critical care units), medical treatments received, and medical outcomes (no effect, minor effect, moderate effect, major effect, death). One tail Student t-test and Chi Square were used; p significance was <0.05. Results: The number of adult intentional exposures involving methadone increased by 5.3% in the year following the change in federal regulations (p<0.05). There was no statistically significant difference in distribution of age, gender, whether exposures involved methadone-only or methadone plus other substances, therapies administered or hospitalizations. There was no difference in overall distribution of medical outcomes, including deaths. Conclusions: Although the number of exposures involving methadone increased post-regulation change, the severity of exposures remained unchanged. Various additional factors (Medicare and Medicaid expansion; increased number of opioid treatment programs) may have also contributed to this increase. As federal officials consider possible permanent changes to the methadone regulations, it is important to evaluate potential related risks and benefits. This study lends support to the consideration that loosening of methadone regulations does not necessarily lead to a substantial increase in severity of exposures.
    Rights/Terms
    Copyright © 2022 Elsevier B.V. All rights reserved.
    Keyword
    Agonist treatment
    Methadone
    Opioid treatment program
    Opioid use disorder
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17810
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.drugpo.2022.103591
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