Liberating methadone: Building a roadmap and community for change

解放美沙酮：建立变革路线图和社区

• 批准号: 10683560
• 负责人: Ayana Jordan
• 金额: $ 1万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683560
• 关键词: Acceleration; Advocate; Affect; Area; Australia; COVID-19; COVID-19 risk; Canada; Caring; Child Care; Chronic Disease; Clinical; Collaborations; Communities; Congresses; Country; County; Dose; Drug Controls; Drug user; Effectiveness; Engineering; Ensure; Epidemic; Equity; Ethnic Origin; Event; Evidence based treatment; Face; Fostering; Future; Geography; Health; Healthcare Systems; Home; Hybrids; Improve Access; Individual; Knowledge; Life; Life Experience; Liquid substance; Medicine; Methadone; Modeling; National Institute of Drug Abuse; New York City; Opioid agonist; Opioid replacement therapy; Overdose; Overdose reduction; Patients; Persons; Pharmaceutical Preparations; Pharmacy facility; Policies; Policy Maker; Race; Recommendation; Recording of previous events; Regulation; Research; Research Personnel; Research Priority; Rest; Science; Stigmatization; Structure; Supervision; Survivors; System; Time; Travel; United States National Academy of Sciences; Vision; Visit; Work; addiction; clinical practice; cohesion; community engaged research; community engagement; experience; federal policy; flexibility; health disparity; improved; innovation; medical schools; methadone treatment; minority communities; novel; opioid treatment program; opioid use; opioid use disorder; overdose death; overdose risk; patient engagement; person centered; policy recommendation; prevent; racial diversity; racial minority; segregation; sound; standard of care; substance use treatment; symposium; treatment center; virtual; working group

PROJECT SUMMARY/ABSTRACT As we continue to face the worst overdose epidemic in U.S history, urgent policy changes are needed to expand access to evidence-based treatment to prevent overdose deaths. Methadone maintenance treatment (MMT) is highly effective at treating opioid use disorder (OUD) and cuts overdose risk by over 50%. And yet, MMT remains vastly under-utilized in the U.S. Since the 1970s, MMT for OUD in the U.S. can only be accessed via daily dispensing of medication at highly structured Opioid Treatment Programs (OTPs). Rigid regulations governing OTPs have greatly limited their availability, and have made the treatment experience highly burdensome and stigmatizing for patients. For decades, this system has been described as a form of “liquid handcuffs,” which degrades existing patients and deters new patients from engaging in treatment. For the first time in 50 years, we are at a historic moment that could alter the course of MMT delivery in the U.S.: Federal policy changes to alleviate COVID-19 risks, including increased flexibility for take-home methadone doses, instigated discussions about needed MMT reforms, including expanding methadone dispensing to pharmacies. However, to guide such reforms and inform a more equitable and accessible OUD treatment system, there is a need to gather the scientific evidence, clinical expertise, and lived experience of people receiving MMT. To this end, the NYU Grossman School of Medicine aims to host a 1.5-day conference in July of 2023 in NYC titled “Liberating Methadone: Building a roadmap and community for change.” This conference will provide a unique and timely opportunity to bring together key partners - including researchers, clinicians, policy makers and people who use drugs - to discuss the past, present and future of MMT for OUD. This hybrid in-person/virtual conference will stimulate innovative research and build cohesion across multiple groups, setting the stage for more inclusive research collaborations and policy reforms that meet the needs of the people most affected by the overdose crisis. Through research presentations, panel discussions, and policy working groups, conference sessions will: (1) Discuss the first-hand experiences of patients in the current OTP system and the need for a more accessible, equitable and person-centered treatment system; (2) Create opportunities for innovative research and novel collaborations among diverse partners by reviewing the existing evidence and gaps in knowledge regarding the current U.S. MMT system and alternative methadone delivery models; and (3) Draft and disseminate research, practice and policy recommendations to advance reforms needed to expand MMT beyond the OTP system. The conference will support NIDA priority research areas for the application of science to advance policy, foster true community- engaged research by bringing together a wide array of stakeholders from diverse geographies, racial and ethnic backgrounds, and life experiences, and most importantly, promote innovation towards improving access to life-saving and humanizing treatment and care.

项目概要/摘要 随着我们继续面临美国历史上最严重的药物过量流行病，需要紧急改变政策 扩大获得循证治疗的机会，以防止美沙酮维持用药过量死亡。 治疗 (MMT) 对于治疗阿片类药物使用障碍 (OUD) 非常有效，并将过量风险降低 50% 以上。 然而，MMT 在美国仍未得到充分利用。自 20 世纪 70 年代以来，美国的 OUD 的 MMT 只能是 通过高度结构化的阿片类药物治疗计划 (OTP) 的每日配药来获取。 管理 OTP 的法规极大地限制了它们的可用性，并降低了治疗体验 几十年来，这个系统被描述为一种对患者来说非常沉重的负担和耻辱。 “液体手铐”会降低现有患者的身份并阻止新患者接受治疗。 50 年来第一次，我们正处于一个可能改变 MMT 交付进程的历史性时刻 美国：联邦政策变化以减轻 COVID-19 风险，包括增加带回家的灵活性 美沙酮剂量，引发了有关必要的 MMT 改革的讨论，包括扩大美沙酮的范围 然而，指导此类改革并提供更公平和更容易获得的 OUD。 治疗系统，需要收集科学证据、临床专业知识和生活经验 为此，纽约大学格罗斯曼医学院计划举办一次为期 1.5 天的会议。 2023 年 7 月在纽约举行，题为“解放美沙酮：构建变革路线图和社区”。 这次会议将为主要合作伙伴提供一个独特且及时的机会 - 包括 研究人员、群体、政策制定者和吸毒者 - 讨论毒品的过去、现在和未来 OUD 的 MMT。这种面对面/虚拟会议将刺激创新研究并建立凝聚力。 跨多个群体，为更具包容性的研究合作和政策改革奠定基础 通过研究报告、小组讨论，满足受药物过量危机影响最严重的人们的需求。 讨论和政策工作组会议将： (1) 讨论 现有 OTP 系统中的患者以及需要一个更容易获得、公平和以人为本的系统 治疗系统；（2）为不同领域之间的创新研究和新颖合作创造机会 通过审查有关当前美国 MMT 体系的现有证据和知识差距来与合作伙伴合作 和替代美沙酮给药模式；以及 (3) 起草和传播研究、实践和政策 会议将提出推进将 MMT 扩展到 OTP 体系之外所需的改革的建议。 支持 NIDA 优先研究领域的科学应用，以推进政策、培育真正的社区- 通过汇集来自不同地域、种族和群体的广泛利益相关者进行研究 种族背景和生活经历，最重要的是，促进创新以改善获取机会 挽救生命和人性化的治疗和护理。