Prime Institution: New York University

During the COVID-19 public health emergency, regulations relaxed for take-home dosing of methadone, offering an opportunity to improve retention in care and address racial and ethnic disparities. This project aims to develop and evaluate an intervention in Opioid Treatment Programs to change clinical practice and address regulatory, legal liability, and financial concerns in New York. In Phase 1, investigators will assess data from state administrative databases and conduct qualitative interviews to inform the intervention approach. In Phase 2, investigators will evaluate an Opioid Treatment Program intervention employing take-home methadone using a stepped-wedge trial design across the state. The trial will test the effect of the intervention on take-home dosing, retention in care, and health care events, examining differential effects for Black/African American and Latinx clients. The study will inform the national debate about the benefits and harms of flexible take-home methadone dosing for patients with opioid use disorder.