Project Grant R44DA061387

SECURE REMOTE DISPENSING OF LIQUID METHADONE WITH HOME MONITORING: ENVIRONMENTAL INTERACTIVE DEVICES SUPPORT SUSTAINABLE ECONOMIC AND EXPANSIVE CLINICAL TREATMENT OF OPIOID USE DISORDER TREATMENT - A 2017 PRESIDENT'S COUNCIL OF ECONOMIC ADVISERS REPORT FOUND THAT AFTER INCLUDING HEALTH CARE, CRIMINAL JUSTICE, LOST PRODUCTIVITY, AND THE VALUE OF A STATISTICAL LIFE, THE ESTIMATED ECONOMIC IMPACT OF PRESCRIPTION OPIOID USE DISORDER WAS GREATER THAN $1.02 TRILLION.1 METHADONE AND BUPRENORPHINE ARE THE MOST EFFECTIVE MEDICATIONS FOR OPIOID USE DISORDER (MOUD). HOWEVER, DESPITE LIQUID METHADONE DISPLAYING GREATER EFFECTIVENESS IN REDUCING OVERDOSE MORTALITY, IMPROVING TREATMENT RETENTION, AND BEING THE MOST DISPENSED MOUD IN ECONOMICALLY DISADVANTAGED NEIGHBORHOODS, IT REMAINS THE MOST STIGMATIZED AND INACCESSIBLE MOUD WHEN COMPARED TO BUPRENORPHINE/NALOXONE.6 UNMET NEEDS: CRITICAL BARRIERS IN DIGITAL HEALTH, GEOGRAPHY, INEFFECTIVE PRESCRIBING PRACTICES OF BUPRENORPHINE, AND OPIOID TREATMENT PROGRAM (OTP) TREATMENT CAPACITY IMPEDE ACCESS TO EFFECTIVE MOUD CARE, WHICH DIRECTLY INFLUENCING THE NATION'S ABILITY TO ADVANCE SCIENTIFIC KNOWLEDGE AND IMPROVE CLINICAL PRACTICE OUTCOMES IN OUD. SPECIFICALLY, 75% OF ASSESSED OTPS REPORTED CAPACITY CONCERNS, 96% OF PEOPLE HAD HIGHER RATES OF DEPENDENCE THAN THEIR PRESCRIBED MOUD, AND DAILY OTP VISITS FOR LIQUID METHADONE DISPENSING ARE COMPROMISED BY TRAVEL TIMES AND NEGATIVE PERCEPTIONS.5,13 EFFECTIVE MOUD TREATMENT MUST COMPREHENSIVELY ADDRESS THE INDIVIDUAL'S DRUG USE AND THEIR CONCURRENT MEDICAL, PSYCHOLOGICAL, SOCIAL, VOCATIONAL, AND LEGAL CHALLENGES.16 INNOVATIVE CARE SOLUTIONS: SANO HEALTHCARE'S COMPREHENSIVE EID TECHNOLOGY AND QUALITY OF CARE-UTILIZATION OF CARE (QOC-UOC) CODING SYSTEM IS CAPABLE OF IMPROVING CARE ACCESS, DELIVERY, AND OUTCOMES THROUGH A PATIENT-CENTERED SYSTEM DESIGNED TO (A) BE ACCESSIBLE ONLY BY OTP PERSONNEL AND COMMUNITY PHARMACIES FOR DOSING; (B) REMOTELY MEASURE MEDICATION ADHERENCE WHILE DISPENSING A DAILY DOSE OF LIQUID METHADONE; (C) IMPROVE TREATMENT CAPACITY, PRESCRIBING EFFICACY, AND TREATMENT RETENTION - WHILE REDUCING THE STIGMA OF LIQUID METHADONE; (D) ACCURATELY AND LONGITUDINALLY MEASURE HEALTH OUTCOMES AT GRANULAR LEVELS WITH NEGLIGIBLE PROVIDER BURDEN; (E) CREATE INTEGRATIVE VALUE-BASED CARE MODELS; AND (F) PROVIDE TELEHEALTH, VIDE0-DIRECTLY OBSERVED THERAPY, AND FUNCTION WITHOUT A SMARTPHONE, TABLET, OR PERSONAL COMPUTER.