As opioid overdose deaths continue to rise to record levels, most people with opioid use disorder still do not receive treatment, particularly evidence-based medications.
Despite decades of research demonstrating its effectiveness in treating opioid use disorder, methadone remains stigmatized and inaccessible. Federal law limits its availability to specific clinics – known as opioid treatment programs (OTPs) – rather than allowing it to be provided at a doctor’s office or pharmacy like other medications. Notably, when methadone is used to treat pain, such restrictions do not apply. Patients are required to go to OTPs daily to take the medication, which can present problems regarding employment, education, child care, transportation, etc. 80% of U.S. counties do not have a single OTP that can dispense methadone. These barriers, as well as the stigma around methadone stemming from the strict regulations that differentiate it from other medications, can often prevent people from seeking needed treatment.
During the COVID-19 pandemic, the federal government authorized flexibilities that allow patients to take home up to 14- or 28-day-supplies of methadone. Preliminary studies have shown that these larger take-home quantities have increased engagement with treatment, improved patient satisfaction, and resulted in very few incidents of misuse or diversion of the medication. Despite their successes, the COVID flexibilities are temporary and somewhat limited in scope. The federal requirements around methadone are outdated and rooted in stigma and need to be permanently changed.
The Modernizing Opioid Treatment Access Act would modernize methadone rules by empowering physicians board-certified in addiction medicine or addiction psychiatry to prescribe methadone and allowing pharmacies to dispense it, which would improve patients’ ability to access treatment. There are only about 2,100 OTPs nationwide, compared to over 60,000 pharmacies. The bill would also require the federal government to provide an annual report of the number of providers registered to prescribe methadone, number of patients prescribed methadone for opioid use disorder, and a list of states where physicians are registered to prescribe methadone.
Ask your members of Congress to cosponsor the Modernizing Opioid Treatment Access Act (S. 644/H.R. 1359) to reduce stigma and increase access to life-saving treatment for opioid addiction.