Modernizing Opioid Treatment Access Act

The Modernizing Opioid Treatment Access Act is a proposed United States congressional bill introduced in the 118th United States Congress. Introduced in response to the national opioid epidemic, the legislation would expand access to methadone, an approved medication for treating opioid use disorder (OUD).[1]

Modernizing Opioid Treatment Access Act
Great Seal of the United States
Long titleTo expand the take-home prescribing of methadone through pharmacies.
Announced inthe 118th United States Congress
Number of co-sponsors5
Legislative history

The bill would give pharmacies the ability to provide methadone to patients with OUD, which can currently only be accessed at methadone clinics. Additionally, the bill would allow approved healthcare providers to prescribe take-home doses for OUD patients.[2][3]

Background

Federal law prohibit physicians from directly prescribing methadone for patients with opioid use disorder, and prevent pharmacies from dispensing the medication.

Classified as a schedule II substance, OUD patients are only permitted to access the medication at opioid treatment facilities (OTPs), known as methadone clinics.[4] Patients are generally required to visit clinics in-person to receive daily doses of methadone, and are usually prevented from receiving "take-home" doses.[5]  

Critics of these regulations note that while pharmacies are prohibited from dispensing methadone, they are permitted to dispense the same medication for pain.[6] However, opponents of relaxing regulations on methadone treatment for OUD argue that expanding access could lead to misuse of methadone.[7][8]

Rules were enacted during the COVID-19 pandemic to increase OUD patients' ability to receive take-home doses of methadone.[9][8] In 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) proposed to make expanded access permanent.[10]

Legislative history

On March 2, 2023, Senators Ed Markey (D-MA) and Rand Paul (R-KY) introduced the Senate version of the legislation, known as S.644.[11] Accompanying House legislation, known as H.R.1359, was introduced by Representatives Don Bacon (R-NE) and Donald Norcross (D-NJ).[12] As of July 25, 2023, the legislation has 24 co-sponsors in the House.[13] Representative David Trone, a Democrat from Maryland, has endorsed the legislation, arguing that current laws hinder patients' ability to receive medication.[14]

Support and opposition

The legislation is supported by the American Society of Addiction Medicine (ASAM), which represents addiction medicine professionals.[15] The legislation has received opposition from the American Association for the Treatment of Opioid Dependence (AAOTD), a trade group that represents the interests of methadone clinics.[16]

References
  1. Ovalle, David (2023-03-05). "Experts, lawmakers push for expanded access to methadone to save lives". Washington Post. Retrieved 2023-07-25.
  2. Larson, Chris (2023-03-07). "Lawmakers Push for More At-Home Methadone Prescriptions". Behavioral Health Business. Retrieved 2023-07-07.
  3. Thakrar, Ashish (2023-04-10). "Opinion: Why are we denying people with opioid addiction the most effective treatment?". Los Angeles Times. Retrieved 2023-07-07. The bipartisan Modernizing Opioid Treatment Access bill, introduced in the Senate and the House last month, would do just that, dramatically expanding access.
  4. Facher, Lev (2022-08-18). "Biden administration has simple way to cut overdose deaths, experts say: expand methadone access". STAT. Retrieved 2023-07-07.
  5. Radil, Amy (2020-04-13). "Seattle addiction clinic welcomes new methadone guidelines in wake of coronavirus". KUOW. Retrieved 2023-07-07.
  6. Ovalle, David (2023-03-05). "As drug deaths soar, experts urge expanded access to methadone". Washington Post. Retrieved 2023-07-06. They note that methadone can already be prescribed by physicians and dispensed by pharmacies for chronic pain. With a fentanyl crisis raging, they argue, board-certified specialists should be able to write prescriptions to treat addiction.
  7. Nordstrom, Benjamin (2023-05-16). "Good intentions alone won't solve the country's opioid crisis". The Hill. Retrieved 2023-07-07.
  8. Choi, Joseph (2023-07-12). "How the pandemic spurred a push to expand methadone access". The Hill. Retrieved 2023-07-26.
  9. "How COVID pandemic changed methadone treatment for addiction". AP News. 2021-08-12. Retrieved 2023-07-07.
  10. Mann, Brian (2022-12-17). "People addicted to opioids rarely get life-saving medications. That may change". NPR. Retrieved 2023-07-06. The rule-change proposed by the Biden administration would make those reforms permanent. It would also eliminate waiting periods for access to methadone and expand telehealth options even further.
  11. "S.644 – Modernizing Opioid Treatment Access Act". Congress.gov. Retrieved 2023-07-06.
  12. Fraser, Quanecia (2023-03-14). "'It will save lives': Rep. Don Bacon introduces bill to make opioid use disorder medication more accessible". KETV. Retrieved 2023-07-07.
  13. Redmond, Helen (2023-07-25). "Did ASAM Push to Limit Federal Methadone Reform Bill?". Filter. Retrieved 2023-07-29.
  14. McManus, Kevin (2023-03-14). "Two Bills To Deal With The Drug Problem Introduced This Week In Congress | WFMD-AM". WFMD. Retrieved 2023-07-07.
  15. Firth, Shannon (2023-05-18). "Addiction Doc Urges Lawmakers to Rethink Methadone Prescribing Restrictions". MedPageToday. Retrieved 2023-07-07.
  16. Redmond, Helen (2023-04-04). "Methadone Clinics Angry at Bad PR, But Not Afraid of SAMHSA". Filter. Retrieved 2023-07-07.
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