Along with COVID came a whole host of associated social ills and issues. One of them was how to safely administer doses of methadone to those in medication-assisted treatment (MAT) programs for opioid addiction.

For many years, methadone has been delivered in single-day doses, meaning that a person in a MAT program had to arrive at the facility every day. In more recent years, those in treatment who showed reliability and stability have been allowed to take home multiple doses.

With COVID shutdowns across the country, many programs had to ease their restrictions. As noted by Pew Charitable Trusts, the federal government eased restrictions on delivery of methadone doses in 2020, since crowded waiting rooms were the opposite of COVID social distancing measures. The delivery of methadone and opioid treatment programs are strictly regulated by federal laws, so any change of procedure had to be authorized by the government. The eased restrictions permitted a supply for up to 28 days for “stable” patients and up to 14 days for “less stable” patients.

The guidelines for these programs are published by the Substance Abuse and Mental Health Services Administration and the Department of Health and Human Services.

A 2021 article on the Pew Charitable Trusts website also notes that when the pandemic is ended, it’s possible that the former restrictions might be re-implemented. They propose extending the current, more liberal administration of methadone. As we’re considering this point, should we also ask if it is possible to help those in MAT gradually withdraw from their methadone doses? Would “stable” patients be ready for a new phase in their recoveries?

One photo shows a long line of people standing close together while waiting for methadone at the counter of an opioid treatment program in Minneapolis last Friday. Another shows a crowded waiting room last Saturday at a similar clinic in Winston-Salem, N.C.

These images, collected by an advocacy group, show that many people are having to risk Covid-19 infection to get their addiction-treatment medication — weeks after the federal government relaxed rules that require people to show up at clinics every day to get methadone.

Aimed at reducing the spread of the novel coronavirus, the new rules allow people considered “stable” to take home up to a 28-day supply of methadone under a blanket exception, and people considered “less than stable” to take home up to a 14-day supply. But advocates for people recovering from addiction say compliance with the new guidelines has been inconsistent.