Research supports dispensing methadone at community pharmacies
A new study led by the UNC Eshelman School of Pharmacy could shape the future treatment of opioid use disorder.
As Congress considers legislation that could allow methadone, a treatment for opioid use disorder, to be dispensed through community pharmacies, researchers at the UNC Eshelman School of Pharmacy have completed one of the nation’s first comprehensive studies examining what it would take to make that vision a reality.
Funded by the NC Collaboratory through an investment by the North Carolina General Assembly, the multiyear project brought together researchers, pharmacists, addiction medicine providers and psychiatrists, opioid treatment program staff, policymakers and people with firsthand experience with treatment of opioid use disorder. The project aimed to examine how pharmacy-based methadone dispensing could improve access to care while addressing implementation challenges.
“This work comes at an important moment because policymakers are actively considering new models for methadone access at community pharmacies,” said Delesha Carpenter, pharmacy school professor and director of the Rural Research Alliance of Community Pharmacies.
Led by Carpenter, the pharmacy school’s research team includes research assistant professor Grace Marley, professor Carolyn Thorpe and research associate Caroline Shubel in the pharmaceutical outcomes and policy division and adjunct faculty member Bayla Ostrach.
The study examined two approaches to expanding access: North Carolina’s existing medication-unit model and Modernizing Opioid Treatment Access Act, the proposed Congressional legislation that would allow board-certified addiction medicine physicians and addiction psychiatrists to prescribe methadone for pharmacy dispensing.
Researchers collected survey and interview data from community pharmacists, physicians and those with direct experience with opioid use and its treatment. Working with North Carolina’s State Opioid Treatment Authority, the team helped update a state rule that now allows pharmacists to directly observe methadone dosing in approved medication units.
“It was incredibly rewarding to see this work move from research into real-world change,” said Marley, research assistant professor and practicing community pharmacist. “Being able to help advocate for a rule update in North Carolina that allows pharmacists to observe methadone dosing felt like an important step toward making evidence-based treatment more accessible for patients.”
Perhaps the strongest endorsement came from people with firsthand experience with opioid use disorder. Those participants said they would choose pharmacy-based methadone dispensing if it were available, describing how it could improve convenience and expand access — particularly for people living in rural communities.
“Hearing directly from North Carolina residents with a variety of experience with treatment was integral to understanding how methadone dispensing at pharmacies could work, and how it may be beneficial,” explained Ostrach, an applied medical anthropologist and community-based researcher in western North Carolina. “Having their input at every stage of conducting the study also ensured we asked the right questions and understood the answers.”
The project has already resulted in seven peer-reviewed publications. As debate over the proposed legislation continues, the study provides policymakers and healthcare leaders with data from every major stakeholder involved in methadone treatment.
“We are encouraged by the positive results from this study and hope to move this line of research forward by studying medication unit model implementation at community pharmacies in North Carolina as this could greatly improve access to methadone for patients with limited treatment options in rural communities,” said Carpenter.
