Investigating heterogeneous effects of an expanded methadone access policy with opioid treatment program retention: a Rhode Island population-based retrospective cohort study

Le résumé fourni par la source

Following federal regulatory changes during the COVID-19 pandemic, Rhode Island expanded methadone access for opioid treatment programs (OTPs) in March 2020. The policy, which permitted take-home dosing for patients, contrasted with longstanding restrictions on methadone. This study used patient-level OTP admission and discharge records to compare six-month retention before and after the policy change. We conducted a retrospective cohort study of 1248 patients newly admitted to OTPs between March 18 and June 30 of 2019 (pre-policy) and 2020 (post-policy). We used logistic regression to estimate associations with retention before and after the policy and used a machine learning approach, the heterogeneous treatment effect (HTE)-Scan, to explore heterogeneity in retention across subgroups. Overall, we found no change in retention following the policy, with an adjusted OR of 1.08 (95% CI, 0.80, 1.45) and adjusted RR of 1.03 (0.90-1.18). Using HTE-Scan, we identified two subgroups with significantly increased retention above the overall cohort: (1) patients with below high-school education and past-month arrest and (2) male, non-Hispanic white or Hispanic/Latino patients reporting heroin or fentanyl use with past-month arrest. We identified no subgroups with significantly decreased retention. Collectively, findings suggest that expanded methadone access may benefit vulnerable populations without harming overall retention.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.