Johns Hopkins University researchers want new federal regulations regarding methadone doses to accommodate patients with opioid use disorder (OUD) in skilled nursing facilities and hospitals. 

Regulations should allow for the continued use of methadone for the disorder treatment in SNFs, according to recommendations published in JAMA Internal Medicine in late November. This would include cases in which methadone use was initiated during a hospitalization. Study authors also recommend the treatment be used until the patient can enroll in an opioid treatment program. 

The researchers explained that most patients with OUD need higher daily doses. Inadequate methadone doses can cause opioid withdrawal symptoms, they explained.

“The situation for patients who are transferred to skilled nursing facilities is even worse. The reason is that DEA regulations prohibit skilled nursing facilities from starting methadone treatment on their own or continuing methadone treatment initiated during a preceding hospitalization without enrollment in an opioid treatment program,” Jarratt D. Pytell, M.D., and colleagues wrote.