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State regulations governing opioid treatment programs (OTPs) vary widely in their restrictiveness, but how they affect geographic access to methadone maintenance treatment for opioid use disorder remains poorly understood. In this study of comprehensive data on methadone shipments to OTPs in 2019, we found that ZIP codes just across the border in states with low restrictiveness in OTP regulations had more than twice the OTP density and methadone shipments compared with nearby and otherwise similar ZIP codes in states with high restrictiveness. These findings suggest that restrictive state OTP regulations constrain geographic access to methadone maintenance treatment and that easing such restrictions is a viable strategy to expand access.
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http://dx.doi.org/10.1377/hlthaff.2025.00341 | DOI Listing |
J Exp Anal Behav
September 2025
Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, USA.
Polydrug abuse is the persistent self-administration of more than one reinforcing drug. The present study provided rhesus monkeys concurrent access to two drugs: 8% alcohol and solutions of either cocaine or methadone. The liquids were available under concurrent nonindependent fixed-ratio (FR) schedules across increasing and then decreasing ratio sizes.
View Article and Find Full Text PDFCochrane Database Syst Rev
September 2025
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
Background: Opioid use disorder (OUD) is commonly treated in specialized care settings with long-acting opioid agonists, also known as opioid agonist therapy, or OAT. Despite the rise in opioid use globally and evidence for a 50% reduction in mortality when OAT is employed, the proportion of people with OUD receiving OAT remains small. One initiative to improve the access and uptake of OAT could be to offer OAT in a primary care setting; primary care clinics are more numerous, might reduce the visibility and potential stigma of receiving treatment for OUD, and may facilitate the care of other medical conditions that are unrelated to OUD.
View Article and Find Full Text PDFBMJ Public Health
August 2025
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Introduction: Hepatitis C virus (HCV) infection is a substantial public health concern, particularly among individuals with opioid addiction. The methadone maintenance treatment (MMT) programmes serve as a harm reduction strategy to mitigate HIV disease spread, yet the risk of HCV infection remains high within these settings. Accurate risk prediction for HCV seroconversion is therefore crucial for improving patient outcomes.
View Article and Find Full Text PDFHealth Aff (Millwood)
September 2025
Anne Myrka, IPRO, Albany, New York.
The population of aging patients with substance use disorder (SUD) requiring care in nursing facilities is growing, yet these facilities are not sufficiently prepared to provide evidence-based treatment for such conditions, including opioid use disorder. Policy and practice innovations are needed to address barriers to access and care within these settings. This article provides an overview of the regulatory landscape and reviews existing efforts to improve the uptake of care for SUD in US nursing facilities, including educational and technical assistance programs; policy toolkits; state-based financial incentives; and collaborations among nursing facilities, community-based addiction services, and hospital systems.
View Article and Find Full Text PDFHealth Aff (Millwood)
September 2025
Pooja Lagisetty, University of Michigan, Ann Arbor, Michigan.
A central challenge in the opioid crisis in the US has been the underuse of lifesaving treatment and harm reduction programs. Conventional explanations focus on limited access to care when services are not convenient, affordable, or timely. However, these factors exist downstream from other fundamental causes of low utilization.
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