Who is Eligible for Take-Home Methadone? Breaking Down SAMHSA’s 6-Point Criteria
Since the start of the pandemic in 2020, take-home methadone flexibilities have been shown to enhance and encourage the use of opioid treatment programs, leading to increased engagement, improved patient satisfaction, and few incidents of misuse or medication diversion.
OTPs can exercise the take-home flexibility extension beyond the end of the COVID-19 public health emergency in 41 states. There is some nuance on an individual state level, and we encourage checking with the local State Opioid Treatment Authority for specific details and questions.
But how can OTPs determine who is a strong candidate for take-homes?
While SAMHSA provides guidelines for evaluating who is eligible for take-home methadone, the responsibility ultimately falls on OTPs to carefully consider the circumstances of each patient.
In this article, we’ll examine the current guidelines and the six-point criteria SAMHSA has created for evaluating a patient’s take-home eligibility.
6 Factors for Determining Take-Home Eligibility
When deciding whether or not to provide take-homes to a patient, SAMHSA has outlined six key criteria to consider.
To aid in your decision-making process, we’ve summarized those guidelines into a list of questions you can ask yourself when evaluating a patient:
Is the patient actively experiencing substance use disorder? Or do they have other physical or behavioral health conditions that may increase their risk of overdose or harm?
Does the patient consistently attend their clinic appointments for supervised medication administration?
Does the patient have serious behavioral problems that may put themselves or others in danger?
Does the patient have a recent history of medication diversion?
Does the patient and/or OTP have a solution for safely transporting and storing take-home doses?
Are there any other factors that you consider relevant to the patient's safety and the public's health?
Ultimately, SAMHSA instructs providers to consider “whether the therapeutic benefits of unsupervised doses outweigh the risks.”
Time in Treatment Standards for Take-Home Eligibility
Once an OTP determines a patient's eligibility for take-home doses, they must also decide on the appropriate quantity. While SAMHSA provides limits based on the duration of treatment, the actual number of doses distributed is at the discretion of the OTP:
After 0-14 days in treatment, a patient may receive up to 7 unsupervised take-home doses
After 15-30 days in treatment, a patient may receive up to 14 unsupervised take-home doses
After 31 days in treatment, a patient may receive up to 28 unsupervised take-home doses
How to Increase Take-Home Access While Minimizing Risk
When issuing take homes, OTPs must strike a difficult balance between providing the flexibility that makes it easier for patients to adhere to their programs and minimizing the risks that can come with those flexibilities.
In this context, a remote dosing solution like Sonara Health can be a powerful tool for increasing the OTP’s ability to safely and confidently issue take homes. This platform allows patients to record their remote doses for their care teams to review, reducing risk of diversion or misuse while improving program retention rates.
By empowering clinics with real-time insights to make informed treatment decisions, Sonara builds trust between OTP patients and their care teams while reducing treatment barriers like long travel times to daily clinic visits.
To learn more about Sonara Health’s remote dosing solution, please contact us here.
