New Methadone Rules Are About To Take Effect: Here's how your treatment could change

Naomi Carr
Morgan Blair
Written by Naomi Carr on 16 April 2024
Medically reviewed by Morgan Blair on 17 April 2024

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.

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.

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.

New Methadone Rules Are About To Take Effect: Here's how your treatment could change

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.

New regulations will allow doctors to use their discretion and best judgment to prescribe higher doses to new patients who may benefit from them.

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.

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.

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.

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.

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.

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.

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.

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.

Resources:

  1. Geneva: World Health Organization. (2009). Chapter 6, Methadone Maintenance Treatment. In Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Retrieved from
  2. National Institutes of Health. (2018). Methadone and Buprenorphine Reduce Risk of Death After Opioid Overdose. NIH. Retrieved from
  3. Facher, L. (2024). Methadone Treatment Gets First Major Update in Over 20 Years. Stat News. Retrieved from
  4. Substance Abuse and Mental Health Services Administration. (2024). Expanding Access, Flexibility, and Empowerment for Patients. SAMHSA. Retrieved from
  5. Facher, L. (2023). Methadone Doses Haven’t Kept Up in the Age of Fentanyl. A New Rule Aims to Help. Stat News. Retrieved from
  6. Substance Abuse and Mental Health Services Administration. (2024). The 42 CFR Part 8 Final Rule Table of Changes. SAMHSA. Retrieved from
  7. Substance Abuse and Mental Health Services Administration. (Updated 2024). Methadone Take-Home Flexibilities Extension Guide. SAMHSA. Retrieved from
  8. Jones, C.M., Compton, W.M., Han, B., Baldwin, G., Volkow, N.D. (2022). Methadone-Involved Overdose Deaths in the US Before and After Federal Policy Changes Expanding Take-Home Methadone Doses From Opioid Treatment Programs. JAMA Psychiatry, 79(9), 932–934. Retrieved from



Activity History - Last updated: 17 April 2024, Published date:


Reviewer

Morgan Blair

MA, LPC

Morgan is a mental health counselor who works alongside individuals of all backgrounds struggling with eating disorders. Morgan is freelance mental health and creative writer who regularly contributes to publications including, Psychology Today.

Activity History - Medically Reviewed on 13 April 2024 and last checked on 17 April 2024

Medically reviewed by
Morgan Blair

MA, LPC

Morgan Blair

Reviewer

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