Study Finds Video Observation Effective For Take-Home Methadone Dosing

A recent study published in the Journal of Substance Abuse Treatment has found evidence to support video observation as a method of methadone take-home dosing. Methadone is used to treat individuals with opioid use disorder (OUD). According to the study, OUD remains a major cause of morbidity and mortality in the United States. National data shows that rates of fatal and nonfatal overdoses increased dramatically during the first year of the COVID-19 epidemic, aggravating the OUD problem. For those with severe OUD, methadone may be the most often used treatment; for instance, a recent study of drug users indicated that nearly twice as many people reported receiving methadone treatment in the previous year as buprenorphine treatment. Historically, a patient and a clinician must interact face-to-face in order to monitor methadone dose. However, due to the nature of the COVID-19 pandemic, healthcare providers felt that the in-person observation method could increase the likelihood of patients catching respiratory diseases and so, the visits were switched to video form. 

A study was then conducted by an OTP agency in Washington State University to determine whether video observation was a viable alternative to in-person observation visits. Researchers ran a clinical trial program from April to August 2020 that included smartphone-based video surveillance of methadone take-home dosing. The COVID-19 symptom screener was completed by the participants, and then they were requested to videotape themselves taking their methadone doses at home. After two weeks, individuals who followed the guidelines continued to receive further take-home doses of methadone and participated in the whole pilot study. Of the 44 individuals who took part in the two-week trial program, 33 progressed to the subsequent stage. Subsequently, 20 of the 33 patients received higher take-home dosages. Researchers discovered that individuals who took part in the whole pilot study had more observed dosage days over a 60-day span than matched controls.

The study’s results indicated that video observation was an effective method in increasing rates of observed methadone dosing while lowering the risk of respiratory infection and removing obstacles related to in-person dosage observation.