{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:51:54Z","timestamp":1787791914407,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DA1104470"],"award-info":[{"award-number":["R01DA1104470"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011404","name":"Indivior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011404","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Opioid agonist treatment (OAT) clients frequently bear costs associated with their treatment, including dosing fees. This study aimed to explore the financial and social impact of dosing fees upon clients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional survey of people who use opioids regularly (<jats:italic>N<\/jats:italic>\u00a0=\u00a0402) between December 2017 and March 2018, conducted in Australia. Dosing fees were calculated and expressed as percentage of income, by OAT type. Consequences and strategies for difficulties making payments were examined as proportions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of <jats:italic>N<\/jats:italic>\u00a0=\u00a0360 participants had ever been in OAT and <jats:italic>N<\/jats:italic>\u00a0=\u2009245 participants currently engaged in OAT reported data on dosing fees, of them 53% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0129) reported paying dosing fees. Compared to clients with high levels of dosing supervision, those with moderate or low levels of supervision were more likely to pay dosing fees. The median 28\u2010day dosing fee was AUD$110 (interquartile range AUD$80); median 28\u2010day income was AUD$1520 (interquartile range AUD$700). For those who paid dosing fees, the fee comprised &lt;10% of total monthly income for 70% of participants; however, 23% of participants paid fees comprising 10% to\u2009&lt;20%, and 7% of participants paid fees comprising 20% or more of monthly income. Among those that had ever been in OAT, 72% experienced difficulties in paying treatment costs; 36% left treatment earlier than intended and 25% had been excluded due to payment difficulties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Negative consequences of treatment costs to clients, particularly dosing fees, are evident. These costs impact treatment access and retention that may negatively impact clients' physical health, mental health and social wellbeing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13437","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T21:54:26Z","timestamp":1644270866000},"page":"841-850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Examining the cost and impact of dosing fees among clients in opioid agonist treatment: Results from a cross\u2010sectional survey of Australian treatment clients"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6646-1633","authenticated-orcid":false,"given":"Emma","family":"Zahra","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory","family":"Chen","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Dam","family":"Tran","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Thomas","family":"Santo","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-2218","authenticated-orcid":false,"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude","family":"Byrne","sequence":"additional","affiliation":[{"name":"Australian Injecting and Illicit Drug Users League  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Ali","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Faculty of Health and Medical Sciences University of Adelaide  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-7673","authenticated-orcid":false,"given":"Briony","family":"Larance","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"School of Psychology University of Wollongong  Wollongong Australia"},{"name":"Illawarra Health and Medical Research Institute University of Wollongong  Wollongong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32229-9"},{"key":"e_1_2_9_3_1","first-page":"CD002207","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","volume":"3","author":"Mattick RP","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_4_1","unstructured":"World Health Organization. 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