Opioid treatment programs (OTPs) have always been able to dispense buprenorphine on the same basis as methadone, but now they can dispense take-home buprenorphine more liberally than take-home methadone. This has given rise to many questions about how new patients should be selected for which medication—the appeal of take-homes is clear, but that doesn’t necessarily mean … [Read more...] about Methadone vs. Buprenorphine: How Do OTPs and Patients Make the Choice?
Despite decades of accumulated data on the effectiveness of medication-assisted treatment (MAT), gaps remain between evidence-based standards and current practices. The authors of a recent study attribute these gaps largely to “regulatory constraints and pervasive suboptimal clinical practices.” The study appeared in August in Health Affairs; the authors are affiliated with … [Read more...] about Treatment of Opioid Dependence: A Call for an Evidence-Based Approach
Some states are making opioid treatment programs (OTPs) health homes under a federal strategy that is part of the Affordable Care Act (ACA). Under the initiative, which comes from the Centers for Medicare and Medicaid Services (CMS), states can pay OTPs extra money to serve as “health homes” for their patients, meaning that the OTPs will help clients manage both their physical … [Read more...] about OTPs as Health Homes: Extra Money for Care Management
The NIMBY (Not In My Back Yard) syndrome is one significant challenge for opioid treatment programs (OTPs), which can’t operate if they can’t get approval from municipalities. Methadone maintenance treatment has been proven effective and producing good outcomes for five decades, but that isn’t preventing politicians from pandering to prejudice and discrimination. Still, the … [Read more...] about NIMBY and Other Problems: Still an Uphill Battle For OTPs, But Hope Seen In Patient Advocacy
Data from the first large randomized U.S. trial comparing treatment retention of methadone and buprenorphine patients confirm what a Cochrane review—generally considered the Gold Standard—and other studies have found: treatment retention is much higher with methadone than with buprenorphine, although the two are equally effective in suppressing illicit opioid use. The current … [Read more...] about Keeping OTP Patients in Treatment Longer: Methadone vs. Buprenorphine