Methadone is a crucial tool in the opioid overdose crisis. During the COVID-19 pandemic, federal regulations allowed Opioid Treatment Programs greater flexibilities in providing take-home methadone, thereby reducing the frequency of office visits. These regulatory flexibilities were made permanent in April 2024.
As of 2021, 40 Medicaid programs covered methadone treatment for opioid use disorder. However, clinical data often exclude methadone maintenance therapy because of privacy regulations, and billing rules and practices may vary substantially by payer and program, presenting challenges for measuring take-home methadone at a population level.
Dr. Shashi Kapadia, assistant professor of medicine and population health sciences, and Dr. Yuhua Bao, professor of population health sciences, developed and validated measures of take-home methadone using national Medicaid data. Their study, published in the Journal of Substance Use and Addiction Treatment, used 2020 Medicaid data from four states for enrollees aged 18 to 64 receiving methadone services, encompassing 4,801 individuals.
The results indicate that the measure is valid, reproducible, and can be used in future studies using claims data. Following the permanent flexibilities established in 2024, it is important to track uptake of take-home methadone and its variation over time and across states and providers. Innovative and valid measures using population claims data such as the one developed by this team are critical for examining the practice, effectiveness, and safety associated with take-home methadone.
- Highlights