Methadone Dosing Visits Involve Substantial Travel Time and Costs in Washington Study

Regular travel for observed methadone dosing can complicate access to treatment for opioid use disorder. A qualitative study with an embedded mixed-methods design examined patient experiences at two opioid treatment program sites in Washington state, including their mobile units. Researchers surveyed 98 patients receiving methadone between November 2024 and February 2026 about travel modes, time, and costs, and interviewed a subsample of 16 patients.

Participants reported a mean round-trip travel time of 82.5 minutes, ranging from 10 to 330 minutes, and mean travel-related costs of $15.80 per visit, ranging from $0 to $200. Most respondents drove themselves (55.1%) or were driven by someone else (21.4%); 12.3% used public transportation and 6.1% used insurer-sponsored medical transportation. Eighteen respondents (18.4%) reported a disabling condition.

Interviews indicated that distance was only one component of the burden: unpredictable program wait times and conflicts with employment, medical appointments, and family responsibilities also mattered. Participants described visits as preventing them from working and missed visits as risking return to opioid use and stalled treatment progress.

The findings support attention to travel burden when organizing methadone services. However, this descriptive study at two sites does not establish causal effects on adherence or opioid use, or test whether more flexible care improves outcomes. Only the abstract was available for this report.