{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T17:06:16Z","timestamp":1783962376107,"version":"3.55.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"NATIONAL INSTITUTE OF DRUG ABUSE","doi-asserted-by":"crossref","award":["K12DA05060"],"award-info":[{"award-number":["K12DA05060"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007921","name":"university of pittsburgh","doi-asserted-by":"publisher","award":["UL1-TR-001857"],"award-info":[{"award-number":["UL1-TR-001857"]}],"id":[{"id":"10.13039\/100007921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Opioid treatment programs (OTPs), the only outpatient settings authorized to dispense methadone for opioid use disorder in the United States, often operate within compliance-focused frameworks that do not reflect the complex realities of substance use or the needs of many patients with the evolving opioid crisis. Given their unique infrastructure, OTPs are well-positioned to provide risk reduction services including naloxone, wound care supplies, and other safer use tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Describe the implementation and early outcomes of a pragmatic pilot program integrating safer use kit distribution within a large OTP in Western Pennsylvania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Our team worked with the OTP to develop a workflow for safer use kit distribution. Staff offered interested patients a menu of safer use kits from which they could select up to one of each kit type. Prepackaged kits included fentanyl\/xylazine test strips and safer injection, smoking, snorting, and wound care supplies. Kit distribution was tracked over a thirteen-month period. Postimplementation, we sampled patient-facing OTP staff on their perspectives of the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From November 2024 to November 2025, 643 kits were distributed during 266 encounters with 142 unique patients. High-demand items included test strips and safer smoking kits. Staff reported improved patient engagement, reduced stigma, and stronger therapeutic relationships after implementing on-site kits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Integrating safer use kits into OTPs is both feasible and impactful, demonstrating consistent patient uptake and positive staff perceptions. These findings suggest such models have the potential to support more inclusive, patient-centered care, though future research is needed to determine downstream effects on retention, safety, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342261463988","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T07:11:07Z","timestamp":1783667467000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reimagining Methadone Clinics: A Case For Integrating Risk Reduction to Address the Complex Realities of Opioid Use Disorder"],"prefix":"10.1177","author":[{"given":"Mariska","family":"Goswami","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Public Health, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8328-2734","authenticated-orcid":false,"given":"Austen","family":"Markus","sequence":"additional","affiliation":[{"name":"Center for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Shang","sequence":"additional","affiliation":[{"name":"Center for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Studnicki","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Public Health, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Ganung","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erinn","family":"Wiers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess","family":"Tambellini","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody B.","family":"Glance","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Liebschutz","sequence":"additional","affiliation":[{"name":"Center for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6420-5385","authenticated-orcid":false,"given":"Raagini","family":"Jawa","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Public Health, PA, USA"},{"name":"Center for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2020.1824046"},{"key":"e_1_3_3_3_2","first-page":"15","volume-title":"Methadone Treatment for Opioid Use Disorder: Improving Access Through Regulatory and Legal Change: Proceedings of a Workshop","author":"National Academies of Sciences, Engineering, and Medicine; Action Collaborative on Countering the U.S. Opioid Epidemic; Health and Medicine Division; Board on Health Care Services; Board on Health Sciences Policy","year":"2022","unstructured":"National Academies of Sciences, Engineering, and Medicine; Action Collaborative on Countering the U.S. Opioid Epidemic; Health and Medicine Division; Board on Health Care Services; Board on Health Sciences Policy. Chapter 3, the history of methadone and barriers to access for different populations. In: Stroud C, Posey Norris SM, Bain L, eds. Methadone Treatment for Opioid Use Disorder: Improving Access Through Regulatory and Legal Change: Proceedings of a Workshop. National Academies Press (US); 2022:15."},{"key":"e_1_3_3_4_2","unstructured":"Methadone treatment: recent revision to regulation covering facilities treating individuals for a primary diagnosis other than opioid use disorder. Legislative Analysis and Public Policy Association. Accessed August 25 2025. https:\/\/legislativeanalysis.org\/methadone-treatment-recent-revision-to-regulation-covering-facilities-treating-individuals-for-a-primary-diagnosis-other-than-opioid-use-disorder\/"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.19914"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-022-00316-3"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108399"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108844"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2020.07"},{"key":"e_1_3_3_10_2","unstructured":"Department of Health and Human Services; Office of the Secretary. Medications for the Treatment of Opioid Use Disorder. Accessed August 21 2025. https:\/\/www.federalregister.gov\/documents\/2024\/02\/02\/2024-01693\/medications-for-the-treatment-of-opioid-use-disorder"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-023-00897-5"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00594-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-025-00535-4"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00628-2"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221138335"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2024.209616"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/08964289.2021.1922347"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2025.209703"}],"container-title":["Substance Use &amp; Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342261463988","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342261463988","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342261463988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T16:18:02Z","timestamp":1783959482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342261463988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":17,"alternative-id":["10.1177\/29767342261463988"],"URL":"https:\/\/doi.org\/10.1177\/29767342261463988","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"article-number":"29767342261463988"}}