Optimal Policies to Improve Methadone Maintenance Adherence Long-Term (OPTIMMAL)

The COVID-19 pandemic triggered relaxed regulations on methadone administration. The clinical outcomes of this altered clinical practice, however, remain to be systematically evaluated. A case-control, quasi-experimental design is proposed to evaluate this impact. A total of 1,200 OUD patients in methadone treatment will be recruited from 10 CTN sites with OTP practice and EHR systems. The cohort will be divided into two study groups (n=600 each) based upon their methadone treatment periods: prior and post COVID pandemic. The focused outcome assessments between the two periods are: (1) Retention rate, abstinence situation, and associations with other covariates; (2) Opioid overdose, fatality, and AE rates; (3) Acceptability and sustainability of reformed OTP. The analysis will be conducted upon EHRs and responses from interviews to both health care providers and study participants.