Comments on methadone take‐home timing study

Last week we wrote about a study and accompanying commentary published in JAMA Internal Medicine that found methadone take‐homes can be given too early — namely, in the first four weeks of treatment (see https://onlinelibrary.wiley.com/doi/10.1002/adaw.35049 ). The study, “Timing of Initiation of Methadone Take‐Home Dosing,” by Belal Hossain, and the commentary on it, “Initiation of Take‐Home Medication Dosing and Methadone Maintenance Treatment Effectiveness” by Paul J. Joudrey, M.D., supported methadone take‐homes in general. Joudrey, who wrote the commentary, has been a particular advocate of “liberating methadone” from U.S. opioid treatment programs (OTPs), allowing physicians to prescribe and pharmacies to dispense it. The study itself was conducted in Canada, where there are no OTPs and methadone is dispensed by pharmacies, without the wraparound services of OTPs.