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. 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 still temporary and somewhat limited in scope. The federal requirements around methadone are outdated and rooted in stigma and need to be permanently changed.
The Opioid Treatment Access Act would modernize methadone requirements and improve access to the medication by allowing prescribers to prescribe up to 1-month take-home doses to be dispensed at a pharmacy and allowing patients to receive take-home methadone earlier in the course of their treatment. It would also require a study on the impact of the COVID flexibilities, permanently allow OTPs to operate mobile components without separate registrations, and encourage states to similarly reform their OTP regulations and break down barriers to care.