Imagine a doctor diagnoses you or someone in your family with a serious health condition. If left untreated, the condition increases her risk of death by six times and causes symptoms that worsen her physical and mental health. Fortunately, there are established, inexpensive medications that are guaranteed to reduce symptoms and reduce the risk of death by 50%.
Surely you and your family have ready access to this drug, right? If the diagnosis is opioid addiction and the life-saving drug is methadone, the answer is unfortunately no.
This is the situation that people with opioid use disorder (i.e., opioid addiction) who struggle with heroin, fentanyl, or prescription painkillers and who happen to live in many suburban and rural communities in Colorado face when seeking life-saving treatment. . Methadone, a drug he developed in the 1940s, is the most effective drug for opioid use disorder.
Patients who have struggled with opioid use for years say methadone makes them feel normal and gives them the stability they need to improve their lives. Despite a sharp rise in preventable overdose deaths, access to the drug remains limited by outdated regulations that prohibit methadone use outside of certain clinics.
Restrictive regulations on methadone date back to the “war on drugs” of the 1970s. People seeking treatment typically need to come to a federally qualified opioid treatment program (a “methadone clinic”) several times a week to be directly observed while taking methadone. If a patient forgets to take their medication due to family responsibilities, snow, or illness, there is little a patient can do except prepare for the inevitable and debilitating withdrawal symptoms.
Furthermore, these programs are geographically concentrated in urban areas. A 2020 study found that of Colorado’s 34 opioid treatment programs, only five are located outside the Front Range, requiring patients to drive hundreds of miles in a week to receive methadone treatment. A situation has arisen where this cannot happen. For many rural and suburban Coloradans, it is simply not practical to maintain a job or engage in treatment while caring for children and family members.
Fortunately, there is an opportunity to change the outdated laws governing methadone treatment currently before the U.S. Congress. The Opioid Treatment Access Modernization Act (M-OTAA) is bipartisan legislation that proposes to increase safe access to methadone treatment.
M-OTAA provides greater flexibility for opioid treatment programs, as well as allowing addiction treatment professionals to prescribe methadone and patients to pick it up at local pharmacies, as is the case with most drugs. This bill has been approved by all major addiction medicine societies, including the American Society of Addiction Medicine, and specifically treats patients who may have limited access to methadone because of where they live. It empowers addiction medicine experts.
Colorado Sen. John Hickenlooper, who serves on the Health, Education, Labor and Pensions Committee, is sponsoring the bill. Now is the time for our fellow representatives to support this important legislation.
Despite widespread support for this bill from addiction health professionals across the country and more than 20 years of evidence showing methadone is effective when administered outside of regulated clinics, this bill remains There are vocal critics of the bill. Some believe that the chemical nature of methadone and the intensive services provided in opioid treatment clinics are reasons why methadone use continues to be limited. There are also concerns about overprescribing and a repeat of the prescription opioid overdose crisis of the early 2000s.
Like many medications, methadone can be dangerous if used improperly, but highly trained addiction treatment professionals are well placed to prescribe methadone in a safe and personalized manner. . By eliminating outdated regulations, M-OTAA will help ensure all Coloradans have access to safe and comprehensive addiction treatment from physicians like us who are experts in treating opioid use disorder. .
As with other complex illnesses, people can pick up a prescription from an addiction treatment specialist in their regular doctor’s office and pick up methadone at their local pharmacy, increasing privacy and reducing stigma. Eliminating geographic disparities in access to high-quality, effective drugs. Treatment of Opioid Use Disorder.
By supporting M-OTAA, our elected representatives can help expand access to life-saving treatments for all Coloradans, no matter where they live. The status quo in methadone treatment is unsustainable as the overdose crisis continues to ravage communities across the state. We urge our elected officials to support M-OTAA and increase access to quality addiction treatment.
Paul Christine, MD, is a primary care and addiction medicine physician and researcher in Denver. His focus is on increasing access to high-quality, low-barrier substance use disorder treatment and health care for people who use drugs.
Dr. Christine Neave is a primary care and addiction treatment physician in Denver. She focuses on integrating addiction medicine into primary care and is exploring new ways to increase access to methadone, especially for vulnerable populations.
Jarratt Pytel, M.D., MHS, lives in Denver and is a physician and researcher in primary care and addiction medicine. His focus is on improving care for people who use drugs in primary care.
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