Many Patients Still Not Benefiting From Changes Aimed at Easing Methadone Access

Although the federal government relaxed some rules around methadone access in April, many patients are still not benefiting from the changes, NPR reports.

Previously, most patients needed to go to an opioid treatment program (OTP) daily to receive treatment and mandatory counseling. Under changes made this spring by the Substance Abuse and Mental Health Services Administration (SAMHSA), patients must still get methadone at an OTP. But if they meet certain criteria, they can take home weeks’ worth of methadone and receive counseling via telehealth. In addition, providers have more flexibility in prescribing individual doses.

The new federal rules are voluntary, and some states continue to require daily check-ins at OTPs.

Mark Parrino, head of the American Association for the Treatment of Opioid Dependence, a trade group for OTPs, said his members are concerned about liability when patients are not closely supervised. He noted that patients can overdose on methadone, which is an opioid. Parrino said OTPs are waiting to see if Medicaid changes how it pays for methadone.

Dr. Yngvild Olsen, who directs substance abuse treatment for SAMHSA, said regulators first tried out the new rules during COVID and they did not lead to increased methadone-related deaths.

Many addiction specialists and advocates say the new federal rules don’t go far enough. The American Society of Addiction Medicine supports legislation sponsored by Massachusetts U.S. Senator Ed Markey, which would allow methadone to be prescribed by any board-certified addiction doctor and picked up at a regular pharmacy.