SAFE GC Coalition: Methadone Dispensation in Rural Areas

According to the National Institute on Drug Abuse (NIDA), methadone treatment is hampered by the fact that many counties in the United States, particularly in rural areas, do not have facilities certified to dispense the medication. This presents a unique barrier for many patients with Opioid Use Disorder (OUD) because methadone must be administered daily under supervision for at least the first 3 months of treatment. Even with the relaxation of these requirements during COVID-19, methadone treatment still requires patients to travel frequently for medication administration.

Current federal regulations allow for methadone dispensation at satellite medication units such as Federally Qualified Health Centers (FQHCs) or pharmacies; however, state regulations frequently prevent adoption of this process. In 2019, Ohio allowed FQHCs to act as medication units for methadone dispensation, but pharmacies were not included in this policy, even though the wide availability of community pharmacies and licensed pharmacists could help expand access to methadone treatment.

To quantify the potential impact of increasing methadone dispensation sites, researchers conducted a modeling study estimating the proportion of patients with OUD in Ohio who would be able to reach a methadone dispensation site within 15 minutes’ drive time with and without inclusion of FQHCs and Walmart pharmacies. They also determined the effects specifically for urban, suburban, large rural, and small rural zip codes. The model showed that with current opioid treatment programs, only 64 percent of people with OUD could reach a methadone dispensation site within 15 minutes; this proportion increased to 96 percent with the addition of FQHCs and to 99 percent with the addition of both FQHCs and Walmart pharmacies. Availability of a treatment site within 15 minutes increased particularly in currently underserved rural zip codes. The most rural communities and for patients facing transportation barriers, utilization of additional clinical sites such as pharmacies may be needed to ensure access to methadone treatment.

While this was only a modeling study, the results suggest that increased adoption of medication unit policies at the state level could greatly expand access to methadone treatment in the United States, particularly in currently underserved rural areas.

The National Institute on Drug Abuse (NIDA) is a United States federal-government research institute whose mission is to "lead the Nation in bringing the power of science to bear on drug abuse and addiction”. For more information please visit www.drugabuse.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled. “Keeping Glen Cove SAFE,” in order to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.