National News

How the pandemic spurred a push to expand methadone access

BY JOSEPH CHOI  | 07/12/23 | 5:30 AM ET

A bipartisan push to expand methadone access across America is picking up momentum after restrictions on the medication were relaxed during the pandemic.

Methadone is one of the most effective treatments available for opioid use disorder (OUD), however experts have long feared that easy access could backfire since methadone carries its own potential for abuse and unintentional overdose.

But the pandemic provided an opportunity to see the real-world impact of dispensing restrictions being relaxed, as patients and clinicians experienced a more open system. 

Under current federal law, methadone can only be dispensed at licensed and accredited opioid treatment programs (OTPs), where patients take the medication under the supervision of a practitioner, with the potential of taking doses home after some time under stable treatment.

When the pandemic began in 2020, however, the Substance Abuse and Mental Health Services Administration (SAMHSA) swiftly issued guidance allowing states to relax OTP requirements and permit patients to take home doses of methadone sooner than usual. 

“That gave us several years of experience in at least a somewhat more open-access system,” said Wilson Compton, deputy director of the National Institute on Drug Abuse.

“So there’s been an opportunity to hear from patients, what they thought about it, to look at administrative data and even the overdose death data to see if there’s evidence of potential harms from the relaxation of access to methadone in the opioid treatment programs.”

2022 study that Compton was a part of found that methadone-involved overdose deaths remained stable after the onset of the pandemic despite the take-home policy change, while the rate of non-methadone opioid overdoses rose.