Recruiting opioid treatment program administrators for a national survey: Outcomes and lessons learned

Background: Globally, access to opioid use disorder treatment remains insufficient. In the US, recent policy changes for opioid use disorder treatment present opportunities to improve patient access to evidence-based methadone treatment. To evaluate the adoption and sustained implementation of these changes, access to a national, representative sample of opioid treatment programs (OTPs, ‘methadone clinics’) is essential. This study reports the outcomes of a recruitment effort for a national sample of OTP administrators. Methods: A stratified random sample of 1000 OTPs was drawn from the US Substance Abuse and Mental Health Services Administration's National Opioid Treatment Program Directory. Stratification was based on state-level OTP regulations and county-level opioid overdose rates. OTPs identified as tribal serving, located in jails or prisons, or requiring corporate approval for research participation were deemed ineligible and excluded from the sample. A team of trained researchers called OTP clinics seeking to speak with administrators and obtain their email addresses for study recruitment. Results: In the sample, 885 OTPs were eligible for study recruitment. We contacted a live person by phone at 73 % of OTPs and an administrator at 23 %. Of the administrators reached, 77 % agreed to receive study information and 22 % completed the survey. Total caller time was 276.5 hours at a cost of $5530. Conclusion: Despite a rigorous sampling frame, and a costly and considerable effort, US OTP recruitment outcomes were suboptimal. Innovative strategies are needed to improve administrator recruitment. Recommendations include updating the SAMHSA directory to include administrator contact information (name, phone, email), using diverse outreach methods, and refining call scripts to improve engagement.