{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:26:09Z","timestamp":1774574769741,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Methadone treatment (MT) for opioid use disorder is only available in opioid treatment programs (OTPs) in the United States, with retention predictive of positive health outcomes. OTP discharge reason information is needed to develop interventions for facilitating MT retention. We sought to identify discharge reason frequencies and associations between discharge reasons and facility\/county\u2010level characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined annual OTP discharge reasons for all Florida OTPs from 2014 to 2017 (<jats:italic>n<\/jats:italic>\u2009=\u200944,774 discharges). We used multinomial logistic regression analysis to examine associations between patients\u2019 discharge reasons and (1) facility\u2010level characteristics (e.g., size, funding type) and (2) county\u2010level characteristics (e.g., race\/ethnicity, overdose rates).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lost contact was the most common discharge reason (29%). Only 11% of patients were discharged for treatment completion, with the proportion one\u2010third as low in privately versus publicly\u2010funded OTPs (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Privately<jats:bold>\u2010<\/jats:bold>funded OTPs had a patient share self\u2010terminating treatment against medical advice about 3.5 times higher than publicly\u2010funded OTPs. Inability to pay accounted for 7% of OTP discharges. Noncompliant discharges represented 6% and were more common in counties with larger proportions of Black residents (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Counties with higher drug overdose rates had significantly more discharges for noncompliance or self\u2010terminating against medical advice (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01 and <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Statewide differences in discharge reasons exist between publicly and privately\u2010funded OTPs, possibly reflecting differences in funding incentives and state oversight. State agencies should develop consistent approaches for collecting\/reporting discharge reasons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>Our study is the first to examine the relationship between OTP funding type and discharge reasons.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13326","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T06:54:10Z","timestamp":1661237650000},"page":"508-516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comprehensive analysis of discharge reasons from methadone outpatient treatment programs"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-6369","authenticated-orcid":false,"given":"Barbara","family":"Andraka\u2010Christou","sequence":"first","affiliation":[{"name":"School of Global Health Management &amp; Informatics University of Central Florida Orlando Florida USA"},{"name":"Department of Internal Medicine University of Central Florida Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-1428","authenticated-orcid":false,"given":"Rachel","family":"Totaram","sequence":"additional","affiliation":[{"name":"School of Global Health Management &amp; Informatics University of Central Florida Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3790-6925","authenticated-orcid":false,"given":"Thuy D.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Health Management &amp; Policy, School of Public Health University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.0976"},{"key":"e_1_2_7_3_1","volume-title":"FAQs: Provision of Methadone and Buprenorphine for the Treatment of Opioid Use Disorder in the COVID\u201019 Emergency","author":"Substance Abuse & Mental Health Services Administration","year":"2021"},{"key":"e_1_2_7_4_1","volume-title":"Trends in the Use of Methadone, Buprenorphine, and Extended\u2010Release Naltrexone at Substance Abuse Treatment Facilities: 2003\u20132015 (Update)","author":"Alderks CE","year":"2021"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/002204269702700205"},{"key":"e_1_2_7_6_1","unstructured":"National Institute on Drug Abuse. Principles of Drug Addiction Treatment: A Research\u2010Based Guide;2008."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1635969"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232086"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2012.03.002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2018.1504081"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.07.011"},{"key":"e_1_2_7_12_1","unstructured":"Substance Abuse & Mental Health Services Administration. Federal guidelines for opioid treatment programs.https:\/\/store.samhsa.gov\/sites\/default\/files\/d7\/priv\/pep15-fedguideotp.pdf"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","DOI":"10.1353\/book.99593","volume-title":"The Opioid Fix: America's Addiction Crisis & the Solution They Don't Want You to Have","author":"Andraka\u2010Christou B","year":"2020"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2010.09.007"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2009.10400539"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02287327"},{"key":"e_1_2_7_17_1","unstructured":"Centers for Medicare & Medicaid Services. Opioid Treatment Programs; 2022.https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/Opioid-Treatment-Program"},{"key":"e_1_2_7_18_1","unstructured":"McCance\u2010KatzEF.Report to Congress on the State Opioid Response Grants; 2020.\u00a0https:\/\/www.samhsa.gov\/sites\/default\/files\/grants\/pdf\/other\/samhsa-sor-report.pdf"},{"key":"e_1_2_7_19_1","unstructured":"Centers for Medicare & Medicaid Services. Opioid use disorder treatment services; 2022.https:\/\/www.medicare.gov\/coverage\/opioid-use-disorder-treatment-services"},{"key":"e_1_2_7_20_1","unstructured":"Office of the Assistant Secretary for Planning and Evaluation DoHaHS. State and local policy levers for increasing treatment and recovery capacity to address the opioid epidemic; 2017.https:\/\/aspe.hhs.gov\/sites\/default\/files\/migrated_legacy_files\/\/182801\/SLlevers.pdf"},{"key":"e_1_2_7_21_1","first-page":"85","article-title":"Socio\u2010ecological model as a framework for overcoming barriers and challenges in randomized control trials in minority and underserved communities","volume":"3","author":"Salihu HM","year":"2015","journal-title":"Int J MCH AIDS"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15862"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108146"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2018.09.001"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.5734"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1998.931516.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000090"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2016.12.010"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.3575"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(98)00097-0"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2011.05.001"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2011.587392"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000584"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.03.009"},{"key":"e_1_2_7_35_1","unstructured":"Substance Abuse & Mental Health Services Administration.\u00a0Opioid Treatment Program (OTP) Guidance;\u00a02020."},{"key":"e_1_2_7_36_1","doi-asserted-by":"crossref","unstructured":"HoffmanKA FootC LevanderXA et al.Treatment retention return to use and recovery support following COVID\u201019 relaxation of methadone take\u2010home dosing in two rural opioid treatment programs: a mixed methods analysis.J Subst Abuse Treat.2022:108801.doi:10.1016\/j.jsat.2022.108801","DOI":"10.1016\/j.jsat.2022.108801"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/0893-164X.11.4.279"}],"container-title":["The American Journal on Addictions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajad.13326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajad.13326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajad.13326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T05:54:24Z","timestamp":1692683664000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajad.13326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,22]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/ajad.13326"],"URL":"https:\/\/doi.org\/10.1111\/ajad.13326","archive":["Portico"],"relation":{},"ISSN":["1055-0496","1521-0391"],"issn-type":[{"value":"1055-0496","type":"print"},{"value":"1521-0391","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,22]]},"assertion":[{"value":"2022-04-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}