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Addiction Treatment Forum reports on substance use news of interest to opioid treatment programs and patients in medication-assisted treatment.

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Addiction Treatment Forum provides news for opioid treatment programs and their patients. OTPs offer comprehensive care, including the three federally approved medications for opioid use disorder: methadone, buprenorphine, and naltrexone.

What Really Matters is Retention in Treatment (JAMA Letters)

Barbara Goodheart, ELS
May 26, 2023

When evaluating a medication, researchers sometimes overlook a key factor: retention.  But how meaningful are other data, if patients drop out of treatment? A study recently published in JAMA Letters used U.S. prescription data to evaluate recent trends in buprenorphine initiation and retention. A team of researchers led by Kao-Ping Chua, MD, PhD, of the University of Michigan Medical School, conducted the study. Earlier studies had examined initiation and retention rates for buprenorphine through 2020, so the time was right for…

Continue Reading What Really Matters is Retention in Treatment (JAMA Letters)

SAMHSA and FDA reduce counseling recommendations for buprenorphine

Alison Knopf
May 24, 2023

Receiving buprenorphine should not be contingent upon receivingcounseling as well, according to a “Dear Colleague” letter issued May 9 bythe Food and Drug Administration (FDA) and the Substance Abuse andMental Health Services Administration (SAMHSA). In the letter, states that“an often-cited barrier to prescribing buprenorphine for the treatment of OUD[opioid use disorder] is the perception that…

Continue Reading SAMHSA and FDA reduce counseling recommendations for buprenorphine

The First 24 Hours

Barbara Goodheart, ELS
May 15, 2023

Part I: When OTP Patients Leave Lockup They’ve served their sentences, and now it’s time to leave.   Many look forward to a new start in life, but they may be woefully unprepared for the challenges they’ll face. When the lucky ones step outside, family will greet them, hug them, take them home for a…

Continue Reading The First 24 Hours

What’s happening with all the NPRMs and bills?

Alison Knopf
March 28, 2023

Quick summary from AT Forum Confused by all the bills and proposals? That puts you in good company with most of America, except for us nerds who do nothing else. Here’s a quick summary of what’s going on in the methadone (and sometimes, buprenorphine) world, and who’s for what. Regulatory Telemedicine and buprenorphine: The Drug…

Continue Reading What’s happening with all the NPRMs and bills?

NABH responds to “cartel” and “profits” comments against OTPs by lawmakers pushing office-based methadone bill

Alison Knopf
March 24, 2023

On March 24 the National Association for Behavioral Healthcare (NABH) wrote a blistering letter to the two leaders in charge of a bill which would move methadone treatment beyond opioid treatment programs (OTPs) to include office-based addiction medicine practitioners. The organization expressed its “deep disappointment” with the language used by the lawmakers in official press…

Continue Reading NABH responds to “cartel” and “profits” comments against OTPs by lawmakers pushing office-based methadone bill

Are OTPs cartels? Congressman Norcross says they are

Alison Knopf
March 21, 2023

The rhetoric against methadone has reached stunning levels. When Representative Donald Norcross (D-New Jersey) joined the other congressional sponsors of the Modernizing Opioid Treatment Access Act this month, his press statement referred to the opioid treatment program (OTP) model as a “cartel.” The proposed legislation would, like the OTAA proposed last year (see https://atforum.com/2022/11/otp-pressure-) make…

Continue Reading Are OTPs cartels? Congressman Norcross says they are

telehealth

DEA proposes permanent telemedicine flexibilities for buprenorphine and controlled substances

Alison Knopf
March 1, 2023

On February 24, Drug Enforcement Administration announced proposed permanent rules for the prescribing of controlled medications via telemedicine, expanding patient access to critical therapies beyond the scheduled end of the COVID-19 public health emergency. The public will be able to comment for 30 days on the proposed rules. The proposed rules – developed with the U.S.…

Continue Reading DEA proposes permanent telemedicine flexibilities for buprenorphine and controlled substances

Review: Hmmm… Methadone or Bupe for OUD? Or … LSD or THC?

Barbara Goodheart, ELS
February 20, 2023

As the tragic consequences of the opioid epidemic continue to mount, some experts are focusing on a creative new approach to treating opioid use disorder (OUD). At a planning meeting held in November 2019, experts met to consider strategies for evaluating medications that have not yet been used to treat OUD. Sponsoring the meeting was…

Continue Reading Review: Hmmm… Methadone or Bupe for OUD? Or … LSD or THC?

Update on Alabama

Alison Knopf
February 10, 2023

Our recent articles on two opioid treatment programs (OTPs) in Alabama — Shelby County Treatment Center and Chilton County Treatment Center – which reported police harassment of methadone patients, produced results. According to owner and director Susan Susan Staats-Combs, after she posted the articles all over town, the harassment abruptly stopped. Kudos to the power of the press.…

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Massive spending bill includes huge changes for SUD field: No more x-waiver, increases for treatment

Alison Knopf
December 23, 2022

Some people called it “something for everyone.” Others just said “at last.” The spending bill approved by Congress December 23 eliminates the x-waiver for prescribing buprenorphine for opioid use disorder, something that the field at large had been calling for for years. Who did not want this: OTPs, because it makes it much easier for…

Continue Reading Massive spending bill includes huge changes for SUD field: No more x-waiver, increases for treatment

SAMHSA proposal to update methadone regulations: Welcome news for OTPs and patients

Alison Knopf
December 19, 2022

On December 13, the U.S. Department of Health and Human Services (HHS), through its Substance Abuse and Mental Health Services Administration (SAMHSA), proposed to expand access to treatment for opioid use disorder (OUD). This is very good news for patients, providers, and other stakeholders. Here is the informational statement from SAMHSA. At the end of the article, find more comments from stakeholders.…

Continue Reading SAMHSA proposal to update methadone regulations: Welcome news for OTPs and patients

Lived Experience: A Refreshing New Voice

Barbara Goodheart, ELS
December 16, 2022

There’s a refreshing new voice in the addiction field—a voice that doesn’t always sing the establishment song, and is not afraid to question widely held beliefs. The new voice is Kirsten E. Smith, PhD, postdoctoral fellow in the Intramural Research Program at the National Institute on Drug Abuse (NIDA). Her latest publication, “Disease and Decision,”…

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AMERSA report OTP medical director discusses possibility of psychosis as a result of rapid methadone taper

Alison Knopf
December 7, 2022

At last month’s annual meeting of AMERSA, a standing-room-only workshop gave a close-up look at what can happen when an opioid treatment program (OTP) tapers a patient too quickly from methadone. The result, in the case discussed, was psychosis. “The only tapers I thought would happen were voluntary, very slow,” she said. The focus would…

Continue Reading AMERSA report OTP medical director discusses possibility of psychosis as a result of rapid methadone taper

methadone

First-of-a-kind OTP census shows vast majority of patients treated with methadone

Alison Knopf
December 5, 2022

Today an extraordinary project conducted by the National Association for State Alcohol and Drug Abuse Directors (NASADAD) and the American Association for the Treatment of Opioid Dependence (AATOD) revealed how many programs and patients are in Opioid Treatment Programs (OTPs). All 1,826 OTPs were surveyed; the response rate was 85%. From that response, the census…

Continue Reading First-of-a-kind OTP census shows vast majority of patients treated with methadone

Benzodiazepines

Study: OTP Retention Unaffected by Benzodiazepines

Barbara Goodheart, ELS
December 1, 2022

In the setting of open-access opioid treatment programs (OTPs), the authors of this study in Drug and Alcohol Dependence sought to determine if patients with benzodiazepine exposure at study entry would have retention rates similar to those without benzodiazepine exposure. Comparing the retention rate for the two groups, the authors found that baseline benzodiazepine exposure…

Continue Reading Study: OTP Retention Unaffected by Benzodiazepines

OTPs facing increasing pressure from supporters of OTAA

Alison Knopf
November 22, 2022

The Opioid Treatment Access Act (OTAA) would allow non-opioid-treatment-provider (OTP) physicians with training in addiction to prescribe methadone for opioid use disorder (OUD). This is from Section 4, the highly contested OTAA provision, which the big proprietary OTPs oppose (see the recently launched https://programnotapill.com/) but which some of the smaller ones are in favor of. Leave…

Continue Reading OTPs facing increasing pressure from supporters of OTAA

Part 3: Methadone in Rhode Island corrections, the psychology of working with another discipline

Alison Knopf
November 21, 2022

Getting methadone in prison: It takes work When a correctional system entertains the idea of something established medicine accepts as gold standard – namely, medication-assisted treatment (MAT) with methadone or buprenorphine for opioid use disorder (OUT) – there is an uphill battle ahead, even for those within the system who believe in it. In Rhode…

Continue Reading Part 3: Methadone in Rhode Island corrections, the psychology of working with another discipline

Mythbusting on AATOD and methadone/buprenorphine bills

Alison Knopf
November 10, 2022

The American Association for the Treatment of Opioid Dependence (AATOD) and Opioid Treatment Programs (OTPs) have been at the forefront of trying to reform methadone treatment, always with an eye on patient safety and quality treatment, also while making treatment more accessible. But, as AATOD president Mark Parrino puts it, it’s important to ask “Access…

Continue Reading Mythbusting on AATOD and methadone/buprenorphine bills

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