ASAM: Make Methadone Treatment for OUD Accessible by Cutting Federal Red Tape, Allowing States to Personalize Treatment Models

MT is highly effective in treating people using high potency synthetic opioids like fentanyl. However, it’s largely restricted to federally regulated opioid treatment programs (OTPs), which 80% of US counties don’t have. Scarcity of OTPs, coupled with burdensome take-home medication policies and practices, contribute to underutilization. In 2021, fewer than 500,000 people received MT, despite an estimated 7.6 million people having OUD in 2019.  

The statement also notes that MT is the only area of medicine that has federal standards for medical practice, whereas all other areas are primarily state regulated. Reducing this federal bureaucracy would allow states to explore new models of treatment delivery that “would support fewer burdensome restrictions, reduced stigma, and increased access to MT.” 

“The severity of the ongoing opioid overdose crisis demands new, innovative approaches to methadone treatment delivery,” said Stephen M. Taylor, MD, MPH, DFAPA, DFASAM, president of ASAM. “Federal policymakers must reduce burdensome regulations that restrict patient access to methadone treatment for OUD. Without these barriers, states can explore more accessible models that allow addiction specialist physicians and their patients to pursue treatment options that are best for them, which may include methadone.” 

ASAM's statement offers different MT models that states could adopt if federal regulations on MT were reduced. In these models, the involvement of the federal government would not extend beyond regulating practitioners, pharmacies, and Medicare and Medicaid coverage: 

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