Clinical Edge

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Open-Access Model for Methadone Treatment Examined

Addiction; ePub 2018 Feb 17; Madden, Farnum, et al

An open-access model for rapid enrollment of people with opioid use disorder in methadone treatment appears to improve treatment access, treatment and capacity, and financial sustainability without evidence of deleterious effects on treatment outcomes, according to a recent study. Researchers evaluated individuals with opioid use disorder entering treatment between July 2006 and June 2015 in a methadone maintenance treatment center in Connecticut. 64% (n=2,594) of the sample were men, and 80% (n=3,133) were white. They found:

  • In the 9 years following the initial implementation of the open-access model, patient census increased by 183% from 1,431 to 4,051, and average wait-time days decreased from 21 to <1 (same day) without apparent deleterious effects on rates of retention, nonmedical opioid use, or mortality.
  • Between fiscal year (FY) 2006 and FY 2015, net operating margin rose from 2% to 10%, while state-block grant revenues declined 14% and the proportion of total revenue from state-block grant revenue decreased from 49% to 21%.


Madden LM, Farnum SO, Eggert KF, et al. An investigation of an open-access model for scaling up methadone maintenance treatment. [Published online ahead of print February 17, 2018]. Addiction. doi:10.1111/add.14198.