Study finds take-home methadone at hospital discharge can be a critical turning point in opioid recovery

Nearly half of patients who received take-home methadone successfully connected to treatment, showing how even a short supply of medication can bridge the gap between crisis and care

University of Colorado Anschutz Medical Campus

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For patients recovering from opioid use disorder, particularly from drugs like fentanyl or heroin, the days immediately following a hospital stay are among the most dangerous. A new multi-state study led by researchers at CU Anschutz found that nearly half of patients discharged with take-home methadone successfully connected to follow-up treatment within 72 hours. That window can be the difference between relapse and recovery or even life and death.

The study was published today in JAMA.

“This is a moment where a life can tip one way or the other,” said Susan Calcaterra, MD, MPH, MS, the study’s lead author and an associate professor at The University of Colorado Anschutz School of Medicine. “And we now have a practical, economical, and proven way to help people stay on the path to recovery.”

The study examined 519 hospital visits across Connecticut, Maryland and Colorado, focusing on patients discharged with take-home methadone for opioid use disorder treatment. This strategy became more accessible following a 2023 update to the Drug Enforcement Administration’s “72-hour rule,” which allows practitioners working outside of an opioid treatment program (OTP), also known as a methadone clinic, to dispense (but not prescribe) up to three days of narcotics to manage acute withdrawal while formal treatment is arranged.

Researchers found that 44% of patients who received take-home methadone successfully connected to an OTP within 72 hours. The likelihood of successful follow-up increased if patients were already enrolled in an OTP, discharged to a structured care setting like a rehab facility or received higher methadone doses. Conversely, patients who used stimulants such as methamphetamine or cocaine alongside opioids were less likely to engage in follow-up care.

“The take-home methadone doses serve as a critical bridge when treatment isn’t immediately available, especially when a patient is discharged from the hospital on a weekend or a holiday when OTPs are closed or have limited hours, leading to a delay in medication treatment access,” said Calcaterra.

Calcaterra emphasized that untreated opioid withdrawal can cause a person to return to unprescribed opioid use, increasing their risk of overdose and death.

“Providing take-home methadone doses ensures the patient has sufficient time to connect to the OTP after hospital discharge before experiencing opioid withdrawal. Whereas before, patients had to connect to the OTP in less than 24 hours from the time of their last methadone dose to avoid uncomfortable opioid withdrawal symptoms, a challenge for people who are weak and deconditioned following a hospitalization,” said Calcaterra.

Hospitals that had strong partnerships with OTPs and post-acute care facilities saw better outcomes. Shared electronic health records, coordinated discharge plans and formal agreements between hospitals and treatment providers all contributed to higher follow-up rates.

“What made the biggest difference in linkage from the hospital to the OTP was the combination of the medication and the support system built around it. . When hospitals, clinics and caregivers work together, patients are far less likely to fall through the cracks,” said Calcaterra.

As overdose deaths continue to rise nationwide the findings offer a realistic, evidence-based solution that hospitals can adopt immediately.

“This isn’t a major overhaul, it’s a simple low-cost intervention that can keep someone alive during a critical few days,” said Calcaterra. “In a crisis, something as small as a few take-home meathdone doses can give people the time they need to get connected to life-saving treatment and stay in recovery.”

The study was a collaboration between University of Colorado Anschutz; Yale School of Medicine; Yale School of Public Health; UCHealth; Skaggs School of Pharmacy and Pharmaceutical Sciences; Johns Hopkins School of Medicine; Johns Hopkins Bloomberg School of Public Health; The Johns Hopkins Hospital; and Johns Hopkins Bayview Medical Center.

This research was conducted by Susan Calcaterra, MD, MPH, MS; Melissa B. Weimer, DO, MCR; Eric Grimm, MS; Yevgeniya Scherbak, PharmD; Rawan Abdel Galil, MBBS; Olivia Berger, PharmD; Lindsay A. Bowman, PharmD; Suzanne A. Nesbit, PharmD; Alexandra Barany, PharmD, MBA; and Megan Buresh, MD.

 

About the University of Colorado Anschutz

The University of Colorado Anschutz is a world-class academic medical campus at the forefront of transformative science, medicine, education and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado – which see more than two million adult and pediatric patient visits yearly. Innovative, interconnected and highly collaborative, CU Anschutz delivers life-changing treatments, patient care and professional training and conducts world-renowned research fueled by $910 million in annual research funding, including $757 million in sponsored awards and $153 million in philanthropic gifts. 

 

 

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Journal

JAMA Network Open

9600 BAUD

Faxes? Really? AI system speeds up new patient process

University of Pennsylvania School of Medicine

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PHILADELPHIA— An emerging artificial intelligence-powered system developed at Penn Medicine has tripled the speed of fax processing and cut a full week off the new patient intake process—freeing up thousands of staff hours. The system, called coordn8, was created by the Penn Medicine Center for Health Care Transformation and Innovation (CHTI) and is detailed in a new paper published this week in NEJM Catalyst. 

Though faxing might seem like antiquated technology, in health care it remains a vital communications tool due to challenges with interoperability and HIPAA privacy requirements. For example, at the University of Pennsylvania Health System (UPHS), between 8,000 and 9,000 faxes are processed each day. Coordn8 automates the intake and filing of faxed documents into electronic health records and allows patients to digitally give their consent to release records instead of mailing forms. 

“Reducing processing time allows staff to focus on more patient-facing activities and results in higher job satisfaction,” said Jency Daniel, DNP, MSN, RN, a lead transformation strategist at CHTI. “On top of that, we designed this in a way so that team members can easily cover for each other. Vacations or sick days won’t slow the process down anymore.” 

Employees on Board with Efficiency 

During a nine-month pilot period in 2023, the CHTI team surveyed clinical staff using coordn8 and found that their satisfaction with the new patient intake process jumped from 35 to 60 percent in just two weeks. In addition, a survey of coordn8 users found the same improvement (35 to 60 percent) in their “effort score,” a measure of how staff felt about the effort required to successfully file incoming faxes into the electronic medical record. 

Fax processing time under coordn8 improved from an average of two minutes to just about 40 seconds. So, for every 100,000 faxes processed (a number reached every 11 to 12 days at Penn Medicine now), staff could save 2,300 hours of time that could be devoted to other critical tasks. 

Digital consent speeds up record gathering 

The time savings continued in a coordn8 process for getting patients’ consent to share past health information, such as test results and scans.   

At the start of every new patient intake process, many health care organizations require a signed release of information form, and this often means a snail-mailed piece of paper. On average, it took a week to process this at UPHS. Digitizing the consent (now called eDisclosure) reduced both the steps required from a patient and the time it took to get the actual form from UPHS to the patient and back again.  

By sending the eDisclosure via text message—thanks to Penn Medicine’s Way to Health platform—the coordn8 team decreased the time it took to get a patient signature by 85 percent. This allowed staff to get to work acquiring health information six days sooner than before, increasing staff satisfaction from 41 percent to 90 percent. Patients can still get a paper form, if they choose. 

Expansion 

While the NEJM Catalyst paper described the initial implementation in more than 150 fax lines across many different departments across UPHS, coordn8 is expanding its fax processing and eDisclosure form to span outpatient services throughout Penn Medicine.  

In just over a year and a half of use, coordn8 has reached an average of more than 3,000 faxes per day and saved a total of 8,500 staff hours in total. Such an expansion is likely attractive to other health systems, both large and small, looking to free up their staff. But applying it strategically will be important. 

“For other health systems looking to apply this, it’s essential to identify the departments with the highest need and the highest willingness to participate,” said Yevgeniy Gitelman, MD, head of Custom Software at CHTI and associate chief medical information officer at Penn Medicine. “If others in a health system can see their colleagues thriving, it will increase buy-in and help to better expand a service like this, increasing its impact.” 

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Journal

NEJM Catalyst

DOI

10.1056/CAT.25.0117 

Method of Research

Case study

Subject of Research

People

 

Rice engineers show lab grown diamond films can stop costly mineral buildup in pipes

Rice University

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image: 

Pulickel Ajayan and Xiang Zhang

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Credit: (Photo by Jeff Fitlow/Rice University)

HOUSTON – (Nov. 21, 2025) – In industrial pipes, mineral deposits build up the way limescale collects inside a kettle ⎯ only on a far larger and more expensive scale. Mineral scaling is a major issue in water and energy systems, where it slows flow, strains equipment and drives up costs.

A new study by Rice University engineers shows that lab-grown diamond coatings could resolve the issue, providing an alternative to chemical additives and mechanical cleaning, both of which offer only temporary relief and carry environmental or operational downsides.

“Because of these limitations, there is growing interest in materials that can naturally resist scale formation without constant intervention,” said Xiang Zhang, assistant research professor of materials science and nanoengineering and a first author on the study alongside Rice postdoctoral researcher Yifan Zhu. “Our work addresses this urgent need by identifying a coating material that can ‘stay clean’ on its own.”

Diamond is well-known for its hardness, chemical stability and ability to withstand high heat ⎯ qualities that already make it useful in demanding industrial settings. Earlier studies showed that diamond can fend off biological fouling and bacterial growth, but its potential to reduce mineral scaling had not been systematically examined.

The researchers grew diamond films through microwave plasma chemical vapor deposition, or MPCVD, a technique that uses gas to create a solid coating: Methane and hydrogen gases were fed into a chamber where microwave radiation energized the atoms into a hot plasma state. This broke apart the gas molecules, freeing up carbon atoms that settled onto a silicon wafer and linked into the tightly packed structure of diamond. By applying postgrowth treatments, the researchers could tailor the chemistry of the diamond’s surface as it formed.

Their goal was to test whether those subtle surface changes would affect how mineral scaling first takes hold. One version ⎯ the nitrogen-terminated diamond ⎯ stood out in terms of performance: It accumulated more than an order of magnitude less scale than diamond treated with oxygen, hydrogen or fluorine, and microscopy showed only scattered crystal clusters where other surfaces formed dense layers.

Molecular simulations helped explain the behavior. Nitrogen encourages a tightly bound layer of water molecules to form on the diamond, creating a barrier that makes it difficult for mineral ions to attach and begin building scale.

The researchers applied the same chemistry to boron-doped diamond electrodes used in electrochemical systems. Those electrodes collected roughly one-seventh as much scale without losing performance.

Combined microscopy, chemical analysis and adhesion measurements captured not only how much scale formed but also how strongly it stuck. “Such a comprehensive study was previously limited by the cost and availability of high quality diamond films as well as reliable surface treatment methods, which technology has only recently made possible,” Zhang said.

“These findings identify vapor-grown, cost-effective, polycrystalline diamond films as a powerful, long-lasting anti-scaling material with broad potential across water desalination, energy systems and other industries where mineral buildup is a problem,” said Pulickel Ajayan, the Benjamin M. and Mary Greenwood Anderson Professor of Engineering and professor of materials science and nanoengineering.

Jun Lou, the Karl F. Hasselmann Professor of Materials Science and Nanoengineering, said “the scalable and versatile deposition process of the coating also makes it very attractive for various industry sectors.”

Ajayan, Lou and Zhang are corresponding authors on the study.

The research was supported by the National Science Foundation (1449500, 1539999), the Welch Foundation (C-2248), the Brazilian agency São Paulo Research Foundation (2023/08122-0), São Paulo State University, National Council for Scientific and Technological Development-Brazil (304957/2023-2) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil. The content in this press release is solely the responsibility of the authors and does not necessarily represent the official views of funding organizations and institutions.

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This news release can be found online at news.rice.edu.

Follow Rice News and Media Relations via Twitter @RiceUNews.

Peer-reviewed paper:

Nitrogen-Terminated Diamond Films for Anti-Scaling Coatings | ACS Nano | DOI: 10.1021/acsnano.5c13554

Authors: Xiang Zhang, Yifan Zhu, Eliezer Oliveira, Tymofii Pieshkov, Qing Ai, Tianshu Zhai, Michelle Chen, Yunrui Yan, Tianyou Xie, Robert Vajtai, Jun Lou and Pulickel Ajayan

https://doi.org/10.1021/acsnano.5c13554

Access associated media files:

https://rice.box.com/s/sqaex8o0y99ohgbu61ox43t06dtekzx6 (Photos by Jeff Fitlow/Rice University)

Xiang Zhang with the microwave plasma chemical vapor deposition setup.

Credit

(Photo by Jeff Fitlow/Rice University)

Journal

ACS Nano

DOI

10.1021/acsnano.5c13554 

Article Title

Nitrogen-Terminated Diamond Films for Anti-Scaling Coatings

Article Publication Date

24-Nov-2025

 

Sustainable pastoralism is an asset, not a threat, in stemming biodiversity loss

American Institute of Biological Sciences

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A new analysis (https://doi.org/10.1093/biosci/biaf158) published in the journal BioScience challenges conventional conservation approaches by demonstrating that traditional livestock grazing on rangelands represents a crucial but often overlooked strategy for protecting global biodiversity.

Dr. David D. Briske of Texas A&M University and colleagues argue that rangelands harbor far more biodiversity than is recognized in international conservation frameworks. "Sixty-seven percent of biodiversity hotspots and 38% of key biodiversity areas globally include rangelands, but international conventions seldom recognize this vast biodiversity repository," the authors write.

Rangelands cover 54% of Earth's land surface and support the livelihoods of approximately 500 million people. Despite these landscapes vast extent, only 12% of rangelands receive formal protection, leaving countless resident species unprotected.

The authors describe four key synergies between pastoralism and biodiversity conservation: working lands conservation that complements existing protected areas, the continuation of vital disturbance regimes through grazing and fire, connectivity through traditional migration corridors, and community-led governance systems that use local knowledge to maintain biodiversity and ecological function. Notably, the authors emphasize that "rangelands represent approximately 50% of Earth's remaining ecologically intact ecosystems."

Briske and colleagues call for a fundamental shift in conservation thinking. "We contend that the promotion of sustainable pastoralism on rangelands represents a critical mitigation strategy to support achievement of these goals," referring to targets established by the Kunming–Montreal Global Biodiversity Framework, which aims to halt species extinctions by 2050.

The authors recommend five broad strategies to take advantage of rangelands' conservation potential, including reshaping conservation narratives to view pastoralists as assets rather than threats to biodiversity, recognizing grazing and fire as natural ecological processes, and supporting secure land tenure and community-led governance for pastoral communities.

With 2026 designated as the International Year of Rangelands and Pastoralists by the United Nations General Assembly, the authors argue that there is no better time to recognize the value of rangelands and pastoralists and to capitalize on  "critical opportunities to mitigate biodiversity loss through integration with existing protected areas to create a vast network for biodiversity conservation."

 

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Journal

BioScience

DOI

10.1093/biosci/biaf158 

Article Title

Pastoralism Can Mitigate Biodiversity Loss on Global Rangelands

Article Publication Date

18-Nov-2025