On March 6, 2023, Senators Edward J. Markey (D-Mass.) and Rand Paul (R-Ky.) and Representatives Donald Norcross (NJ-01) and Don Bacon (NE-02) introduced the Modernizing Opioid Treatment Access Act (MOTAA) with the aim of enhancing patients’ access to medication for opioid use disorder (MOUD). The bill would permit physicians to prescribe methadone for opioid use disorder (OUD) without many of the safety precautions and supportive services opioid treatment programs (OTPs) provide. Responding to this issue, the American Association for the Treatment of Opioid Dependence (AATOD), an organization that collaborates with federal and state agencies on opioid treatment policy across the United States, released a comprehensive position statement and fact sheet addressing the MOTAA.
In its position statement, AATOD specifically cautioned against the bill’s emphasis on increasing medication access without addressing the need for comprehensive treatment. AATOD stressed that the OTP structure is fundamental in ensuring the safety of methadone for treating OUD, and any suggestion that methadone can be considered safe and effective for OUD treatment outside of an OTP setting lacks evidence-based support. Notably, AATOD cited studies revealing that a significant portion of methadone-related deaths can be attributed to physicians prescribing methadone (for pain) in private practices. Conversely, supervised methadone dosing has resulted in substantial reductions in methadone overdose-related deaths; however, pharmacy-filled prescriptions lack the rigorous processes involved in supervised dosing.
Rather than eliminate existing laws that establish a secure framework for methadone use in OUD treatment, AATOD proposes the permanent integration of provisions from the SUPPORT Act to ensure Medicare and Medicaid coverage for OTP services. Additionally, AATOD suggests allowing OTPs to admit patients using telehealth, expanding access to all three approved medications for OUD treatment in jails and prisons, and allocating funding for pilot programs that enable OTPs to develop innovative partnerships with hospitals and Federally Qualified Health Centers in rural areas.
Read AATOD’s position statement here.