Researchers at NYU Grossman School of Medicine are collaborating with the New York Office of Addiction Services and Supports, Weill Cornell Medicine, and the University of Connecticut to test an intervention to improve take-home methadone practices at opioid treatment programs (OTPs). The study, called Clinics Optimizing Methadone Take-Homes (COMET), is being supported by the National Institute on Drug Abuse.

Federal Substance Abuse and Mental Health Services Administration (SAMHSA) regulations governing take-home methadone changed after the onset of the COVID-19 public health emergency. These new regulations present an opportunity to provide care that is more patient-centered. The goal of COMET is to improve take-home medication decisions at OTPs under these new guidelines by addressing clinical decision-making practices, regulatory concerns, capacity for clinic practice change, and financial barriers. Our coaches are working with 27 OTPs throughout New York State to provide resources and support to clinics in their take-home medication decision-making.

The Study’s Public Health Impact

Methadone is a highly effective medication for treating opioid use disorder in OTPs. Regulatory changes made during the COVID-19 public health emergency allow more clinical discretion about take-home methadone. SAMHSA made these new regulatory guidelines permanent in February 2024. There is debate and confusion about how to interpret the new guidelines and put them into practice. The goal of the new guidelines is to promote best therapeutic benefits for patients. However, practitioners must also weigh the safety of increasing take-home medication under the new guidelines. Long-term studies are needed to understand best practices and outcomes.

The COMET project will not only impact New York’s large system of OTPs, which serve more than 38,000 individuals each year, but will also inform practices at treatment programs across the country that are governed by the same SAMHSA guidelines.

Resources for Participating Clinics

Participating clinics can utilize the following resources for additional information and guidelines:

• Take-Home Methadone Revised SAMHSA Guidelines Presentation: Recording
• Take-Home Methadone Revised SAMHSA Guidelines Presentation: Slides
• Patient Experience with Take-Home Methadone Recording
• Take-Home Medication Guide
• Shared Decision-Making Guide: English
• Shared Decision-Making Guide: Spanish
• Patient Information Card: English
• Patient Information Card: Spanish
• Take-Home Methadone Research Summary
• Identifying Goals and Priorities Template

Contact Us

The study’s principal investigators are Charles J. Neighbors, PhD, MBA, associate professor in NYU Langone’s Department of Population Health, and Yuhua Bao, professor of Population Health Sciences at Weill Cornell Medical College.

If you have questions about the study, please contact Dr. Neighbors at Charles.Neighbors@NYULangone.org.