In a Congressional bipartisan show of support against opioid use disorder (OUD), Sens. Edward Markey of Massachusetts and Rand Paul of Kentucky introduced a bill Thursday to revise regulations on methadone in order to provide more treatment access to the drug.
The Opioid Treatment Access Act takes up legislation that was introduced in the House last December by Rep. Donald Norcross of New Jersey. Having now moved to the Senate, the bill calls for pharmacies to be given the power – for the first time – to dispense methadone, which along with other medication-assisted treatment (MAT) drugs like buprenorphine and naltrexone is provided to individuals suffering from OUD.
The Act further calls for the amount of in-treatment time for patients be shortened before they can begin methadone treatment in their homes. The bill also would codify a recent federal regulation allowing opioid treatment programs to add mobile clinics, as well as requiring the Substance Abuse and Mental Health Services Administration (SAMHSA) to study existing regulatory flexibilities on accessing OUD treatment.
“Opioid-related overdoses and deaths are the public health epidemic we aren’t talking about. It’s never been more important to modernize and expand how patients receive opioid treatment,” Markey, a Democrat, said in a statement regarding the Act. “By decentralizing opioid treatment, making permanent expanded access to take home methadone, and allowing access to this life-saving treatment at pharmacies, we can expand access, create opportunity, and set more people on a pathway to recovery.”
Federal steps toward increasing methadone access were taken last year when the U.S. Drug Enforcement Administration (DEA) issued a final rule that, among other measures, streamlined a registration process for providers to remotely dispense the MAT drug. More than 1,900 narcotic treatment programs nationwide were eligible to dispense methadone, according to the DEA.
The Act has been designed to improve methadone access by allowing patients to receive the medication from pharmacies, rather than having them make a potentially more burdensome daily commute to a clinic to be administered the MAT drug. Additionally, the bill would build on SAMHSA exemptions enacted since the onset of the pandemic that would provide for longer take-home supplies of methadone to patients.
Since the exemptions took effect in March 2020, various health care stakeholders have credited the flexibilities with helping to increase patient treatment engagement and improve patient satisfaction with care – with few incidents of medication misuse reported.
“As a physician, I know the value of the doctor-patient relationship,” Paul, a Republican, also commented in a statement regarding the bill. “This bipartisan legislation will return treatment decisions to health care providers, who know their patients best. Doing so will be another important step toward combating the opioid epidemic that has caused so much harm in Kentucky and our nation.”
More than 101,000 drug overdose deaths occurred over a 12-month period ending in June 2021 – according to the most recent provisional data tallied by the Centers for Disease Control and Prevention – with many of the deaths attributed to OUD.
The cost of OUD nationwide on a 12-month basis has been estimated to exceed $1 trillion. At current levels, an additional 1.2 million people throughout North America are expected to succumb to opioid overdoses by 2029.
