Reversal of increases in methadone distribution for opioid use disorder in the US during the COVID-19 pandemic

Opioid use disorder (OUD) is a major public health concern in the United States (US), resulting in high rates of overdose and other negative outcomes. Methadone, a treatment for OUD, has been shown to be effective in reducing the risk of overdose and improving overall health and quality of life. This study analyzed the distribution of methadone for the treatment of OUD across the US using data from the Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System, Medicaid’s State Drug Utilization Data, and the US Census Bureau. Analysis revealed that methadone distribution for OUD has expanded significantly over the past decade, with an average state increase of +96.96% from 2010 to 2020, and there was a significant increase in overall distribution of methadone to opioid treatment programs (OTP) in the US from 2010 to 2020 (+61.00%) and from 2015 to 2020 (+26.22%). However, the distribution to OTPs did not significantly change from 2019 to 2021 (−5.15%). Furthermore, pronounced variation in methadone distribution among states were observed, with some states having no OTPs or Medicaid coverage. New policies are urgently needed to increase access to methadone treatment and address the opioid overdose crisis in the US.