Study will use OTP to look at methadone reform

Abstract

A new study funded by the National Institute on Drug Abuse (NIDA) and headed by researchers interested in changing the way methadone for opioid use disorder is utilized will use Community Medical Services treatment staff and patients as research subjects. Community Medical Services operates more than 60 opioid treatment programs in 11 states, and is the first OTP, or methadone clinic, to be open around the clock in some areas, with head Nicholas Stavros incorporating novel ways to reach out to patients. The MPACT (Methadone Patient Access to Collaborative Treatment) study will develop and test a medical intervention using a $1 million NIDA grant. Researchers at the University of Arizona Health Sciences, under the direction of Beth Meyerson, Ph.D., will test a “patient‐empowered, trauma‐informed” treatment using methadone in Arizona. Meyerson is a professor, and director of the Harm Reduction Research Lab in the University of Arizona College of Medicine at Tucson. The study will take two years. “Improving methadone treatment is critical because one person dies from an opioid overdose every five minutes in this country,” said Meyerson, who is also director of policy for the University of Arizona Health Sciences Comprehensive Pain and Addiction Center. “Access to methadone has been found to reduce opioid overdoses by 80%, but it is currently being delivered in ways that can create suboptimal patient outcomes, where only 30% of patients complete treatment and over 30% experience significant treatment interruptions.” The protocol will be used to focus on how to make treatment more acceptable to patients and includes a staff‐focused intervention to reduce trauma related to actually working in the OTP. “Vicarious trauma has been found to impact both patient care and staff recognition of the need to adopt treatment and practice innovations,” Meyerson said, adding, “This study is the crucial first step in assessing MPACT's feasibility, acceptability and preliminary effects on patient and staff outcomes. Once our established milestones are reached from the pilot program, the second phase of funding will enable us to expand the study of MPACT among 30 clinics with 600 patients and 450 staff members across the U.S.” Kristen Rundell, M.D., professor and chair of the Department of Family and Community Medicine at the University of Arizona, where Meyerson's harm reduction lab is based, said the study “is a prime example of our department's emphasis of social justice through medicine.”