Background: Opioid-related overdoses are a major concern in the United States (US) stemming from the high rates of Opioid Use Disorder (OUD). The rates of US overdoses continue to exceed one-hundred thousand per year. Methadone, a medication used as a treatment for OUD, is effective in reducing cravings and withdrawal symptoms which improves the quality of life for OUD. This study analyzed the distribution of methadone to Opioid Treatment Programs (OTP) across the US including the District of Columbia and Puerto Rico. Methods: The weight of methadone (in grams) was gathered from the Drug Enforcement Administrations Automated Reports and Consolidated Ordering System (ARCOS) database and population data from the US Census Bureau. The number of OTPs per state from the ARCOS Database was obtained. GraphPad Prism Version10.2.3 was used to make figures and perform data analysis. A paired t-test compared distribution in 2019 to 2023. Datawrapper was used to create heat maps. Results: Analyzing the population-adjusted percent change by state from 2019 to 2023 showed 32 states had a positive percent change (61.5%), 19 states had a negative one (36.5%), and one state had no change (1.9%). The percent change between 2019 and 2023 (+6.2%) was statistically significant (p=0.047). When looking at the number of OTPs (population-adjusted), there was a twenty-fold state-level difference in 2023. Discussion: Although there was a modest increase overall, there were pronounced state-level differences in methadone distribution across the nation. An emphasis on establishing policies to make a positive change widespread over the nation is crucial. New policies are urgently needed to increase the availability of OUD treatments more widely by initiating more OTPs and a more treatment retention focused program to reverse the escalation in overdose deaths.

The authors have declared no competing interest.

This study did not receive any funding

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Source data was used from openly available human data located at... DEA Diversion Control Division: ARCOS Census.gov

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All data produced in the present study are available upon reasonable request to the authors