Timing of Initiation of Methadone Take-Home Dosing: Evidence Synthesis and Clinical Implications for Opioid Use Disorder Management

Highlights

  • Initiation of take-home methadone dosing within 5 to 24 weeks after OAT induction significantly reduces all-cause mortality and methadone discontinuation compared to no take-home dosing.
  • Any initiation of take-home dosing, even as early as within 4 weeks, is associated with better outcomes than daily witnessed ingestion without take-home privileges.
  • COVID-19 pandemic-related regulatory relaxations enhancing take-home dosing led to improved treatment retention and increased enrollment without adversely affecting survival.
  • Urine drug testing frequency and baseline polysubstance use impact treatment retention, but baseline anxiety does not significantly affect OAT retention, highlighting multifactorial determinants of treatment success.

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