Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118750

Elizabeth B. Kirtland, PharmD, University of Maryland School of Pharmacy, 515 West Lombard Street, Baltimore, MD 21201, 410-706-7513, ekirtland@rx.umaryland.edu, Anthony C. Tommasello, PhD, Office of Substance Abuse Studies, Univeristy of Maryland School of Pharmacy, 515 West Lombard Street, 2nd Floor, Baltimore, MD 21201, Ernest Drucker, PhD, Epidemiology and Population Health, Montefiore Medical Center, 111 East 210 Street, Bronx, New York, NY 10467, and Eric Weintraub, MD, Drug Treatment Program, University of Maryland School of Medicine, 630 West Fayette Street, Baltimore, MD 21201.

Office-based methadone treatment with community pharmacy dispensing has been successfully implemented in countries including Britain, Canada, and Australia. This model has great potential to expand methadone services by allowing stable patients to receive treatment outside of the confines of methadone clinics. In the United States, however, the resources of primary care physicians and community pharmacists remain largely untapped for the purpose of offering methadone maintenance treatment. The Baltimore site of the Office Based Prescribing and Community Based Dispensing study, OBOT, is exploring the impact of this model on treatment retention and illicit drug use of twenty-five female methadone patients. Patient satisfaction with prescriber and pharmacist interactions and the economic viability of this patient care model are key elements in guiding the implementation of office and community based care. OBOT has demonstrated that this model does not pose insurmountable financial hurdles. The Baltimore Substance Abuse System, BSAS, allots $3500/year per patient for methadone maintenance treatment at the University of Maryland Methadone Clinic. This allotment provides for counseling, methadone therapy, and basic medical services. In OBOT, the $3500 is allocated evenly among the 3 aspects of patient care: medical, counseling, and pharmacy. This reimbursement for patient services remains adequate and sustainable with the existing funds from BSAS. OBOT has demonstrated an office based treatment and community based dispensing approach that satisfies the remunerative requirements of each of the three essential components of patient care in methadone maintenance treatment.

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