Sens. Ed Markey (D-Mass.) and Rand Paul (R-Ky.) have introduced a bill that would codify the rules loosened during the pandemic, which allowed flexibility on take-home doses, telehealth, and treatment vans. It would also allow pharmacies to dispense methadone for opioid use treatment.

The article states that “Within the addiction treatment world, methadone patients are treated differently from patients who use other opioid addiction treatments, such as buprenorphine or Suboxone. Generally, buprenorphine is considered safer than methadone, with less risk of overdose…” However, this raises several questions. First, will opening up the use of methadone for addiction treatment be implemented to the detriment of other pathways to recovery?

Second, not everyone agrees that buprenorphine is totally safe. See, for examples these posts: More children poisoned by buprenorphine and The Emerging Buprenorphine Epidemic in the United States.

Now officials at the Substance Abuse and Mental Health Services Administration are considering permanent changes to federal methadone rules. A National Academy of Medicine workshop on methadone regulations on March 3 and 4 may signal an inflection point.

Any changes to federal rules, however, could face significant resistance from methadone clinics — many of them for-profit — whose financial models are built on daily patient encounters, counseling, and regular drug tests. “There are some entities who have a financial interest in keeping things the way that they are,” Ryan said. “Change costs money.”