Methadone has been used as a treatment for opioid use disorder (OUD) since the 1950s. Within this time, alterations have been made as to how this treatment is provided to help accessibility and effectiveness.[1]
Methadone treatment has been shown to prevent overdoses and deaths, improve withdrawal symptoms, and help maintain abstinence and recovery. However, requirements of methadone treatment include frequent drug tests, counseling, and daily dose administration, which many individuals find restrictive and burdensome.[1][2][3]
Within the next few months, new changes will be implemented for the first time in over 20 years. These changes are intended to improve access and reduce some of these restrictions.[3][4]
Dosages
Doctors will be given more flexibility in the doses they prescribe. Currently, new patients are given a standard dose of 30mg of methadone. However, for some people, this dose cannot be effective at managing withdrawal symptoms and cravings, particularly those who have been using fentanyl, a potent synthetic opioid.[5]
New regulations will allow doctors to use their discretion and best judgment to prescribe higher doses to new patients who may benefit from them.[4]
Take-home meds
Doctors will be allowed to prescribe take-home medications, after assessing the individual and ascertaining if this is safe and appropriate. This would mean that individuals do not need to attend the clinic every day and can self-administer at home, while also freeing up time for doctors to see more patients. [6]
During the coronavirus pandemic, the federal government relaxed regulations around methadone treatment, to help reduce the number of people attending clinics at one time and prevent contact. This allowed clinics to provide take-home meds to many individuals, improving access. Importantly, figures showed no increase in methadone abuse or overdoses at this time.[7][8]
Attendance
These changes will also help reduce the requirement for daily attendance at clinics for some individuals. Telehealth assessments can be used instead of in-person visits, helping people who cannot attend the clinic due to circumstances such as travel distances and work or family requirements.[4]
Requirements
Previous requirements to commence methadone treatment have since been altered. This includes providing proof that the individual has experienced one year of opioid addiction or that an individual under 18 years of age has had two unsuccessful attempts at withdrawal treatment.[6]
Additionally, requirements around accessing counseling services to commence treatment have been changed. This rule now depends on the individual’s needs and goals rather than being a blanket requirement.[4]
Reduce stigma
The language used in documentation has been altered to help reduce the stigma around methadone treatment. For example, words and phrases have been changed due to negative connotations, such as ‘detoxification’ and ‘drug abuse’. These changes can help improve patient-focused care and reduce stigma-related barriers to treatment. [3][6]
Additional information
These changes have been updated and agreed by the federal government and the Substance Abuse and Mental Health Services Administration (SAMHSA) and will become law in October 2024.[4]
However, although these changes have been made at a federal level, state laws can still apply and individual clinics may choose not to implement all of these changes.[3]
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