A chance to do it better: Methadone maintenance treatment in the age of Covid-19

Highlights

• Changes to methadone maintenance treatment in the U.S. from Covid-19 have liberalized the strict, regulatory approach to treatment.

• It is important that research capture the experiences of people in treatment to understand the effects of regulatory changes on their lives.

• Changes resulting from Covid-19 represent an opportunity to improve the way that treatment is administered.

• Potential improvements could include: increasing provision of take-home doses and the use of office-based treatment.

Abstract

Methadone maintenance treatment (MMT) in the United States, and particularly the clinic system of distribution, is often criticized as punitive, over-regulated, and misaligned to the needs of many patients. However, changes to the regulations that COVID-19 caused may have provided an opportunity for improving service. This commentary uses literature and my own experience to provide a brief description of how MMT programs responded to the threat of Covid-19 and how such responses fit into the larger context of attempts to reform treatment. It discusses, in particular, opportunities for liberalizing “take-home” doses and implementing office-based MMT.