Analgesic methadone prescribing in community health centers among patients with chronic pain




methadone, primary care, chronic pain, community health centers


Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain.

Design: Observational; two cross-sectional periods.

Setting: Oregon and California CHCs.

Patients: Chronic pain patients with 1 visit in 2012-2013 or 2017-2018 (N = 158,239).

Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with 1 methadone prescription.

Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving 1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs 65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White).

Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.

Author Biographies

Steffani R. Bailey, PhD

Family Medicine, Oregon Health & Science University, Portland, Oregon

Jean P. O’Malley, MPH

OCHIN, Inc., Portland, Oregon

Daniel M. Hartung, PharmD, MPH

College of Pharmacy, Oregon State University, Corvallis, Oregon

Nathalie Huguet, PhD

Oregon Health & Science University, Portland, Oregon

Miguel Marino, PhD

Oregon Health & Science University, Portland, Oregon

John Muench, MD, MPH

Oregon Health & Science University, Portland, Oregon


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How to Cite

Bailey, S. R., J. P. O’Malley, D. M. Hartung, N. Huguet, M. Marino, and J. Muench. “Analgesic Methadone Prescribing in Community Health Centers Among Patients With Chronic Pain”. Journal of Opioid Management, vol. 19, no. 5, Nov. 2023, pp. 369-75, doi:10.5055/jom.0811.



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