Expanding Methadone Access Through Community Pharmacies: A Qualitative Study Exploring Opioid Treatment Program Staff Perceptions of Pharmacy-Based Medication Units

BACKGROUND: In the United States, methadone for opioid use disorder is limited to opioid treatment programs. Increased methadone access is necessary, and community pharmacies may be a logical option for expansion. The objectives of this study were to explore opioid treatment program (OTP) staff members' perceptions of and anticipated barriers and facilitators to implementing pharmacy-based methadone dispensing via medication units. METHODS: Participants in this study were purposively sampled from OTP staff in North Carolina who completed a previous quantitative survey on the perceived acceptability, appropriateness, and feasibility of pharmacy-based methadone dispensing and agreed to be contacted for an interview. Thematic analysis was conducted to identify salient and main themes, and relationships among and between themes, as well as areas of divergence. RESULTS: OTP staff (n = 10) endorsed increased access and OTP-pharmacy collaboration as benefits of pharmacy-based methadone dispensing. OTP staff were concerned about community pharmacy stigma, the suitability of the pharmacy setting for methadone treatment, and loss of counseling and felt that lack of pharmacy interest would be a barrier to implementation. OTP staff identified 5 implementation facilitators, including OTP willingness and pharmacist capability to provide the service, telehealth, clear communication, and reimbursement. CONCLUSION: Results from this study demonstrate moderate interest from OTP staff towards pharmacy-based methadone dispensing. Researchers and other vested parties should consider conducting a pilot study to identify how best to implement medication units in the pharmacy setting.