Legislation would allow pharmacies to distribute methadone and increase the volume a patient can take home at a time, expanding access to treatment
WASHINGTON, DC – Today, U.S. Congressman Donald Norcross (D-NJ-01) announced the imminent introduction of the Opioid Treatment Access Act, innovative legislation that would increase access to and modernize the process of obtaining methadone to treat opioid use disorder (OUD). The bill will lower obstacles to treatment by making opioid treatment programs more accessible, allowing patients easier access to evidence-based treatment, and empowering them to spend more time living their lives and less time waiting in line at opioid treatment programs (often referred to as methadone clinics).
“People struggling with opioid addiction shouldn’t be stigmatized. They shouldn’t be forced to wait in lines every morning for treatment. They deserve dignity. They should be able to get their medicine from their pharmacist, just like everyone else does. If you can get the drug at a pharmacy, you should be able to get medicine to treat the drug misuse disorder at a pharmacy,” said Congressman Norcross, a member of the Bipartisan Addiction and Mental Health Task Force and the Education and Labor Committee’s Health, Education, Labor, and Pensions Subcommittee. “People lost hope during the 2008 financial crisis when jobs dried up. Tragically, some of my union brothers and sisters turned to opioids to numb the pain of losing their livelihoods, their ability to provide for their families, and their sense of self. We owe it to every person who has lost a loved one to addiction and every person struggling with opioid use disorder to improve access and modernize opioid treatment.”
“When he was alive, my brother endured such unfair stigma around his disease. This legislation provides greater flexibility in where and how a patient receives care when it is clinically appropriate. This should improve outcomes and reduce the stigma that is often associated with methadone treatment,” said Laura Walker-Talbot, a Woodbury resident and ambassador for Shatterproof, a national nonprofit organization dedicated to ending the addiction crisis in the United States.
“The treatment of opioid use disorder with methadone has a long history and robust scientific evidence supporting its effectiveness, but U.S. federal law limits its availability to heavily regulated and commonly inaccessible opioid treatment programs – a structure that has implications for access to, and quality of, care. The Opioid Treatment Access Act represents a thoughtful expansion of access to a life-saving, effective medication for many Americans with opioid use disorder,” said William F. Haning, MD, DLFAPA, DFASAM, president of the American Society of Addiction Medicine.
“Current federal restrictions on treatment medications for opioid use disorder, like methadone, often prohibit patients from accessing needed treatment. In order for our lifesaving, clinically proven medication treatments to work, patients need better access to them. That is why I am encouraged by the Opioid Treatment Access Act, which would allow patients to access methadone at a local pharmacy, rather than having to travel long distances, stand in line, and wait for this medication that patients must take every day to thrive,” said Kaitlan Baston, MD, MSc, DFASAM, division head of addiction medicine of Cooper University Health Care.
"With fatal overdoses surpassing 100,000 in the last 12 months, it’s time to tear down the barriers to life-saving medication-assisted treatment once and for all. I applaud Congressman Norcross for introducing this bill that will absolutely save lives,” said former U.S. Rep. Patrick J. Kennedy, founder of The Kennedy Forum.
“NAMA Recovery’s majority-patient Board of Directors acknowledges the critical and important role opioid treatment programs must play during the induction and stabilization of methadone treatment for opioid use disorder, but it is time access to treatment reflects the realities of patients’ daily lives. The Opioid Treatment Access Act ensures access to comprehensive OTP services based on patient needs and pushes federal rulemaking beyond arbitrary time-in-treatment requirements to be more evidence-based. This legislation has the potential to save and restore many lives when opioid overdose deaths continue to spike to historically unprecedented levels,” said Zachary Talbott, president of the National Alliance for Medication Assisted Recovery.
“This bill is one more example of how necessary innovation during the pandemic has shown a more effective path for treatment of opioid use disorder. Increasing access to care by eliminating the often daily trips to an opioid treatment center and the stigma that can accompany them, as well as making methadone more accessible through pharmacies and mobile units, provide great steps forward toward recovery,” said Debra L. Wentz, PhD, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies.
The increase in opioid overdose deaths in recent years got worse during the pandemic, with over 93,000 lives lost in 2020 alone. Methadone, a medication approved by the Food and Drug Administration, is among the most effective ways to treat opioid use disorder. Historically, patients have needed to line up every morning at methadone clinics to receive daily methadone doses from opioid treatment programs. The process is often time-consuming, stigmatizing, and logistically difficult, especially for patients in rural communities where travel over a long distance to the nearest opioid treatment program may be necessary. These obstacles to treatment can make it difficult for patients to maintain employment.
During the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) became allowing patients to take home larger quantities of methadone at a time, which preliminary studies have shown to increase engagement with treatment with few incidents of misuse. Though SAMHSA’s exemptions were recently extended by another year, these changes are not permanent and even with the SAMHSA exemption patients must go through opioid treatment programs to receive methadone.
Opioid Treatment Access Act is supported by the American Society of Addiction Medicine (ASAM), Shatterproof, the Kennedy Forum, NAMA Recovery, the National Council of Mental Wellbeing, and the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA).
Companion legislation is being led in the Senate by Senator Ed Markey (D-MA).
The Opioid Treatment Access Act improves access to and modernizes the process of receiving treatment for opioid use disorder by:
- Allowing certain prescribers to prescribe up to 1-month take-home doses to be dispensed at a pharmacy so that patients can receive methadone for OUD at more accessible locations and allowing states to permit aspects of that care to be conducted via telehealth
- Shortening the timeline for take-home methadone
- Directing SAMHSA to conduct a full study on the impact of the COVID-19 methadone exemptions
- Codifying regulations that allow OTPs to operate mobile medication components without separate registration
- Emphasizing that states should align their regulation of OTPs in a way that is consistent with the intent of this legislation and breaks-down barriers to care