Physician Clinical Support System for Methadone: Preliminary qualitative evaluation results

The Physician Clinical Support System for Methadone (PCSS-M) is a free, nationwide SAMHSA/CSAT-funded program that aims to increase the appropriate use and safety of methadone treatment for opioid addiction and/or pain. PCSS-M hosts a website with general information and clinical guidances available for download. The website also offers a portal through which providers seeking information and mentoring on methadone treatment can connect with experts in the field. Between September 2009 and February 2011, a total of 392 individuals registered into the PCSS-M from 35 states and Canada. Available baseline data indicate that almost half (47%) of those registered are general internal medicine or family practice physicians; 47% are in private practice. Approximately three-quarters of mentor contacts to date related to treatment for opioid dependence. Inquiries focused primarily on medication management, patient assessment, and urine toxicology. Contact descriptions provided by mentors illustrate concern with regulations and requirements (e.g. “MD had questions about certification and practice in Texas”), general treatment guidelines (e.g. “Mentee wanted to know if ‘older' patients on methadone maintenance are routinely advised to lower their methadone doses”), as well as specific problem areas (e.g. “He is being pressured by the nursing home he works in to convert patients from hydrocodone four times per day to pain meds [methadone] which can be dosed twice per day, apparently to save on personnel costs”). Although data are preliminary, findings to date suggest that PCSS-M is an accessible and useful resource for health professionals seeking mentorship in methadone treatment.