Untreated opioid use disorder is an important contributor to the current opioid epidemic. However, few implementation models exist to guide program managers to scale up medication-assisted treatment, an evidence-based treatment for opioid use disorder.
Shortly after becoming CEO of the APT Foundation, Lynn Madden, PhD, MPA, Postdoctoral Associate in Internal Medicine-AIDS at Yale, and her colleagues began developing and implementing an “open-access model,” whereby prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options.
Madden and colleagues, including Declan Barry, PhD, Associate Professor of Psychiatry, recently published a paper in Addiction which demonstrates the promise of this innovative approach.
In the nine years following the initial implementation of the open-access model at APT, patient census increased by 183 percent 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.
Madden, the paper's first author, and Barry, the senior author, noted that between fiscal year 2006 and fiscal year 2015 net operating margin at APT increased as state-block grant revenues declined.
The authors concluded that this low-barrier treatment model deserves further research investigation because it provides a promising approach to addressing the ongoing opioid epidemic in different countries.