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)
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…
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SAMHSA and FDA reduce counseling recommendations for buprenorphine
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…
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The First 24 Hours
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…
What’s happening with all the NPRMs and bills?
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…
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NABH responds to “cartel” and “profits” comments against OTPs by lawmakers pushing office-based methadone bill
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…
Are OTPs cartels? Congressman Norcross says they are
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…
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DEA proposes permanent telemedicine flexibilities for buprenorphine and controlled substances
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.…
Review: Hmmm… Methadone or Bupe for OUD? Or … LSD or THC?
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…
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Update on Alabama
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.…
Massive spending bill includes huge changes for SUD field: No more x-waiver, increases for treatment
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…
SAMHSA proposal to update methadone regulations: Welcome news for OTPs and patients
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.…
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Lived Experience: A Refreshing New Voice
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,”…
AMERSA report OTP medical director discusses possibility of psychosis as a result of rapid methadone taper
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…
First-of-a-kind OTP census shows vast majority of patients treated with methadone
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…
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Study: OTP Retention Unaffected by Benzodiazepines
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…
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OTPs facing increasing pressure from supporters of OTAA
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…
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Part 3: Methadone in Rhode Island corrections, the psychology of working with another discipline
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…
Mythbusting on AATOD and methadone/buprenorphine bills
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…
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