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Addiction Treatment Forum

Addiction Treatment Forum

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

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Newsletter

2022

Mobile methadone in New York

Alison Knopf April 29, 2022
The unrolling story of methadone vans in New York is being enthusiastically assisted by Allegra Schorr. She heads the Coalition of Medication-Assisted Treatment Providers and …
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Many SUD bills under consideration by Congress

Alison Knopf April 28, 2022
This month, the U.S. House Energy and Commerce Subcommittee conducted a hearing focusing19 bills, most of them focusing on substance use disorders (SUDs). One of …
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Study: Low-Barrier-to-Treatment-Access Programs Help Patients Experiencing Homelessness Enter MMT and Stay in Treatment

Barbara Goodheart, ELS April 18, 2022
Patients with opioid use disorder (OUD) experiencing homelessness face an increased risk of opioid overdose and death, compared with patients with OUD who are housed. …
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NY announces reimbursement for methadone vans

Alison Knopf March 30, 2022
Last week Gov. Kathy Hochul of New York announced the availability of up to $1 million for establishing vans to provide medications, including methadone and …
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SAMHSA issues guidance on take-home flexibility extensions

Alison Knopf March 30, 2022
The Substance Abuse and Mental Services Administration (SAMHSA) this month (March 2022) issued guidance on its extensions of exemptions for methadone take-home rules going beyond …
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methadone

NASEM meeting on methadone focused on how to expand access using primary care 

Alison Knopf March 21, 2022
On March 3-4, the National Academy of Sciences, Engineering, and Medicine (NASEM) hosted a workshop on how to expand access to methadone. We covered the entire …
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AATOD to sponsors of methadone reform bills: Keep OTPs involved in dispensing

Alison Knopf March 7, 2022
The American Association for the Treatment of Opioid Dependence (AATOD) on March 2 sent letters to the sponsors of proposals which would liberalize methadone regulations. …
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New York OTPs Call for Help from Flush State Budget

Alison Knopf February 24, 2022
With opioid overdoses at the highest level ever and still going up – more than 100,000 a year – this is not the time for …
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Some support from AATOD in Markey-Paul bill, but NAMA-R supports it all

Alison Knopf February 23, 2022
Like the Norcross bill introduced in the House of Representatives last year (see https://atforum.com/2021/12/norcross-bill-modernize-methadone-treatment/) the Markey-Paul bill to allow pharmacy dispensing of methadone (see https://atforum.com/2022/02/bill-pharmacy-dispensing-methadone-senate/) …
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Mount Sinai Beth Israel Streamlines Procedures in COVID-19, Speeds Medication Delivery to OTP Patients

Barbara Goodheart, ELS February 17, 2022
Early in the COVID-19 pandemic, experts at Mount Sinai Beth Israel (MSBI)—one of the largest systems in the U.S. for delivering medications for opioid use …
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Bill to Allow Pharmacy Dispensing of Methadone Introduced in the Senate

Alison Knopf February 16, 2022
A bill to allow pharmacies to dispense methadone for opioid treatment was introduced in the Senate Feb. 10 by Senators Edward J. Markey (D-Mass.) and …
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Yngvild Olsen to be Director of CSAT

Alison Knopf February 9, 2022
Both a medical doctor, an OBOT provider, and an OTP director, Yngvild Olsen, M.D. is well-known to the methadone and buprenorphine treatment fields. Last month she became …
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Ideas for Research on Methadone Treatment, from NIDA task force

Alison Knopf January 25, 2022
Last year a commentary on the Methadone Access Research Task Force, created by the National Institute on Drug Abuse Clinical Trials Network, recommended ways to …
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Buprenorphine Availability in Jails and Prisons up: More than 433% with COVID rules: Study

Alison Knopf January 25, 2022
Buprenorphine for the treatment of opioid use disorder in prisons and jails started increasing with the COVID-19 pandemic, researchers analyzing sales data have found. Despite …
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Dropouts due to Inadequate Dosing: Greater than 50% of Patients

Alison Knopf January 19, 2022
More than 50% of patients treated with methadone or buprenorphine drop out of treatment, mostly with lower than recommended doses, a recent study conducted in …
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FDA: Tell your Dentist if you take Buprenorphine

Alison Knopf January 19, 2022
The Food and Drug Administration (FDA) on January 12 said it will require a warning about possible dental problems caused by dissolving buprenorphine in the …
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Obituary: Richard Saitz, M.D., M.P.H.

Alison Knopf January 17, 2022
Richard Saitz, M.D., M.P.H., internationally and locally respected in alcohol and drug addiction research, died January 15 from pancreatic cancer. Dr. Saitz, who changed the …
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Two Studies Look at Effects of Relaxed COVID-19 Restrictions on OTPs—and Come Up With Different Answers

Barbara Goodheart, ELS January 13, 2022
“No Home to Take Methadone to,” a story recently published on this website, investigated the effects of relaxed COVID-19 restrictions on opioid treatment programs (OTPs). …
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Federal Government Announces First-Ever Harm Reduction Grants

Alison Knopf January 4, 2022
The end of last year marked the first-ever announcement of federal grants for harm reduction — $30 million to be spent on programs which distribute …
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Harm Reduction Initiatives Take Hold in White House

Alison Knopf January 4, 2022
The end of 2021 saw several aggressive new harm reduction initiatives coming out of the federal Office for National Drug Control Policy (ONDCP) and the …
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Obituary: Bowman, Recovery Advocate

Alison Knopf January 4, 2022
Paul Edward Bowman, an advocate of recovery who worked closely with the methadone and buprenorphine community, died late last year. The 58-year-old was a peer …
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2021

Longtime NY SOTA Retiring, Puryear Moving to Position

Alison Knopf December 21, 2021
The post occupied by Belinda Greenfield, Ph.D., as New York’s Opioid Treatment Authority (SOTA) for 15 years, will be taken by Lesley Puryear, LMSW, in …
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Norcross to Introduce Bill to ‘Modernize’ Methadone Treatment

Alison Knopf December 21, 2021
With much support from many – but not the American Association for the Treatment of Opioid Dependence (AATOD), because of the omission of opioid treatment …
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“No Home to Take Methadone to”: Study Reveals Inequities in Addiction Care

Barbara Goodheart, ELS December 17, 2021
Key inequities in addiction care could be managed by correcting shortcomings uncovered in a recent qualitative study. The study was published in Journal of Substance Abuse …
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SAMHSA Continues Relaxed Take-Homes

Alison Knopf November 23, 2021
Relaxed take-home rules for methadone patients were announced in March 2020 as a result of COVID-19, to limit the requirements for on-site dosing for many …
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Harm Reduction Proponent, Medical Doctor Nominated to Head OASAS

Alison Knopf November 15, 2021
For the first time in recent history, New York is slated to have a medical doctor instead of a bureaucrat running the Office of Addiction …
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Methadone Induction for Inpatients: Working with OTPs, but Stabilizing Quickly

Alison Knopf November 4, 2021
Many hospital-based physicians are not comfortable with methadone, although they are very comfortable with morphine and a lot of other opioids used for pain. When …
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STUDY: OUD Disclosure Can Be Helpful, or Devastating; Study Participants Offer Advice

Barbara Goodheart, ELS October 21, 2021
Stigma—negative beliefs and misperceptions, based on misinformation or lack of information—has long plagued people with opioid use disorders (OUDs), whether they’re in treatment or not. …
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ONDCP on CDC’s Latest OD Data

Alison Knopf October 18, 2021
On October 13 the federal Centers for Disease Control and Prevention (CDC) released provisional death data showing a record number of 99,106 overdose deaths in …
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AATOD Calls for OTP Reforms, Including Relaxing Rules

Alison Knopf October 5, 2021
The American Association for the Treatment of Opioid Dependence (AATOD) is recommending that federal regulators relax rules regarding methadone treatment by opioid treatment programs (OTPs). …
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REVIEW ARTICLE: How Long Should OAT Last? A Month? A Year? Or…Forever?

Barbara Goodheart, ELS October 4, 2021
The review article summarized here delves into a timely question: How long should treatment for opioid addiction last? The authors, Anjali Dhanda, MD, and Edwin Salsitz, …
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How an Online Interview Can Help Programs Monitor Patient Progress, Identify Problems

Alison Knopf September 24, 2021
Patients in treatment for opioid use disorder (OUD) may have other conditions that need treatment, and ignoring them can lead to relapse. An online assessment …
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Helping SUD Providers Help Diverse Patients: Race, Incarceration, Pain, PTSD

Alison Knopf September 24, 2021
Race: In “Can You See Us? Providing Culturally Competent Treatment for Persons of Color,” presenters at CCSAD (Cape Cod Symposium on Addictive Disorders) in September, …
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STUDY: Do Health Care Costs and Service Usage Increase When Prisoners Are Treated for OUD, Then Released?

Barbara Goodheart, ELS September 16, 2021
With the risk of fatal overdose at least ten times higher in released prisoners than in the general population, there’s a clear need for treating …
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The Need for Medications and Psychotherapy in Treatment

Alison Knopf September 15, 2021
“I said I will never work for anyone who just makes you throw pills at the wall and see what sticks,” said Hans Watson, DO, …
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methadone

Details on How to Use Methadone Vehicles: Two OTPs’ Experience

Alison Knopf September 3, 2021
Two treatment providers with many years’ experience using mobile methadone outlined their lessons learned and more in an August 11 webinar hosted by the American …
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SAMHSA Okays Use of SAPT Block Grant to Procure Methadone Vans from For-Profits

Alison Knopf August 18, 2021
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Kloxxado: Nasal Spray Naloxone Launched

Alison Knopf August 16, 2021
Kloxxado, approved by the Food and Drug Administration in April for treatment of opioid overdose (see https://atforum.com/2021/06/naloxone-nasal-spray/), is now officially on the market. And the …
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STUDY: “Is MAT Cost Effective?” Answer: A Resounding “Yes!”

Barbara Goodheart, ELS August 16, 2021
We’ve long known that opioid use disorder (OUD) is a significant cause of morbidity and mortality, and that far too many people lack access to …
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SAMHSA Issues New and Revised TIP 63 on Medications to Treat OUD

Alison Knopf August 12, 2021
Last week, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a new Treatment Improvement Protocol 63 (TIP 63) on treatments for opioid use …
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AATOD Sponsors August 11 Webinar: “How-to” on Mobile Methadone

Alison Knopf August 10, 2021
The new Drug Enforcement Administration (DEA) regulations allowing brick-and-mortar opioid treatment programs (OTPs) to dispense methadone in vans took effective July 28. The American Association …
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Legal Action Center Report Warns Hospitals of Legal Liability for Failing to Care for OUDs

Alison Knopf July 23, 2021
Hospital emergency departments (EDs) risk legal liability by not referring patients to treatment with methadone or buprenorphine, and for not offering such treatment themselves, according …
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ONDCP director nominated: It’s Gupta

Alison Knopf July 15, 2021
West Virginia doesn’t have a stellar history when it comes to treating opioid use disorder. In 2018, it led the nation in opioid-related problems (https://atforum.com/2018/09/west-virginia-leads-nation-opioid-problems/). …
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Scoping Review: Interim Methadone Services Can Offer a Lifesaving Hand When Someone Desperately Needs Help

Barbara Goodheart, ELS July 13, 2021
When someone with an opioid use disorder (OUD) seeks help at a busy opioid treatment program (OTP), interim methadone services—providing up to 120 days of …
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DEA Okays Methadone Vans if Operated by OTPs

Alison Knopf July 8, 2021
As of July 28, licensed opioid treatment programs (OTPs) can operate vans which dispense methadone. The final rule, issued June 28 by the Office of …
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emergency department

When emergency departments make referrals, are they sending them to treatment?

Alison Knopf June 29, 2021
Emergency departments have long been able to give patients methadone to treat opioid use disorder (OUD) for three days. But there are problems with that: …
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telehealth

Methadone treatment reform: A middle ground?

Alison Knopf June 29, 2021
There are many bills and proposals which would loosen up treatment with methadone or buprenorphine. The better-known proposals to get rid of the X-waiver for …
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NSM to AATOD Board: Be Proactive to Avoid Big Professional Liability Claims

Alison Knopf June 16, 2021
Krista Mayes, director of the addiction treatment provider program of NSM insurance, group, talked recently about the importance of prevention for opioid treatment programs (OTPs). …
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Two Studies Describe Differences in OTP Responses to COVID-19: What Can We Learn?

Barbara Goodheart, ELS June 9, 2021
In these pages of Addiction Treatment Forum we feature two studies describing experiences at opioid treatment programs (OTPs) during COVID-19. The first study, from Bronx/Montefiore …
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FDA Approves Higher Dosage of Naloxone Nasal Spray

Alison Knopf June 2, 2021
The U.S. Food and Drug Administration has approved a higher dose naloxone hydrochloride nasal spray product to treat opioid overdose. The newly approved product delivers …
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OTP Clinicians’ Responses to Telemedicine and Changes in Methadone Service Delivery During COVID-19: A Qualitative Study

Barbara Goodheart, ELS May 26, 2021
During the COVID-19 pandemic, opioid treatment programs (OTPs) have been given some flexibility in dispensing methadone and using telemedicine and other patient services, such as …
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Reimagining Patient Care: Bronx OTPs Share Lessons Learned During COVID-19

Barbara Goodheart, ELS April 27, 2021
When COVID-19 forced Bronx opioid treatment programs (OTPs) to change the way they operated, the OTPs made dramatic changes and saw better outcomes in just …
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Community Medical Services Reaches Out To Harm Reduction

Alison Knopf April 22, 2021
Community Medical Services (CMS), which opened two new opioid treatment programs (OTPs) in Wisconsin and Arizona recently, is the first program in the country to …
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Flaws In Idea Of Expanding Access To Methadone Via FQHCs And Chain Pharmacy

Alison Knopf April 21, 2021
A recent study hypothesized that distribution of methadone in Ohio via Federally Qualified Health Centers (FQHCs0and pharmacies left out so many realities facing methadone treatment …
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New OTP in Tennessee Opens

Alison Knopf April 19, 2021
The Talbott Legacy Centers (TLC) announced the opening of a new opioid treatment program (OTP) in Maryville, Tennessee in April. With service delivery starting April …
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X-waiver Changes Progressing Through Congress Amid Some Concerns From OTPs And Patients

Alison Knopf April 19, 2021
Three bills going through Congress would change the way buprenorphine treatment is delivered, mainly eliminating the x-waiver, the training required for the special Drug Enforcement …
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Mass. Sheriff And R.I. OTP Work Together To Provide Treatment During Pandemic

Alison Knopf April 19, 2021
The Hampden County (Massachusetts) Sheriff is helping men and women with opioid use disorder (OUD) receive treatment at CODAC Behavioral Health Care, the largest outpatient …
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Women with OUD Are at Risk for Poor Reproductive and Sexual Health Outcomes; OTP Staff and Providers Suggest Effective Interventions

Barbara Goodheart, ELS March 3, 2021
Women with opioid use disorder (OUD) face many challenges, among them the risk of poor outcomes in conditions involving reproductive and sexual health (RSH). Factors …
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How to Attend AATOD

Alison Knopf March 1, 2021
AATOD’s Las Vegas conference will be virtual, but still fun. Attendees at the April conference of the American Association for the Treatment of Opioid Dependence (AATOD) …
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Vaccines and PPE for OTP Patients And Staff: A Work In Progress, Still

Alison Knopf February 12, 2021
Writing in the “Points of View” section of the New England Journal of Medicine in January, Joshua A. Barocas, M.D., assistant professor of medicine at …
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Extended Take-homes: More Good News in New York

Alison Knopf February 12, 2021
Extended Take-homes: More Good News in New York The expansion of methadone take-homes was highlighted as a positive move in New York by Governor Andrew Cuomo …
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Study Report: Implementing Open Access in OTPs; A Good Idea? Counselors Share Their Thoughts and Experiences

Barbara Goodheart, ELS January 25, 2021
Let’s say you’re a counselor in an opioid treatment program (OTP), and your methadone maintenance treatment (MMT) program suddenly launches an open-access initiative. Within days …
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2020

Update on Washington and OTPs for end of 2020

Alison Knopf December 21, 2020
End of year activities in Washington, D.C. are full of important messages for opioid treatment programs (OTPs). Among the things to watch, as we head …
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Generic Buprenex

ATForum December 21, 2020
One of the public health concerns about prescription opioids, including for pain, is diversion, but injectables can help avoid those concerns. Last spring Hikma released …
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Proposed bills would infuse opioid use disorder treatment with new funds

Alison Knopf November 24, 2020
Two bills passed by Congress and heading to the Senate would be very helpful to opioid treatment programs (OTPs) and other treatment providers, and their …
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To Mallinckrodt: Thank you from AT Forum

ATForum October 20, 2020
We all want to thank Mallinckrodt for almost 30 years of support. This wonderful company provided support from the beginning of the newsletter, which first …
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CODAC Works With BH Link For Behavioral Health 24/7 Urgent Care

Alison Knopf October 9, 2020
Rhode Island supported the development of Behavioral Health Link, BH Link, a 24-7 urgent care program for addiction and mental illness. The goal is to …
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Study: COVID-19 Threatens the Incarcerated With Loss of Life-Saving OAT Treatment

Barbara Goodheart, ELS September 29, 2020
For people with opioid use disorder (OUD), getting into or staying in an opioid agonist treatment (OAT) program while in jail or prison has never …
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Why OTPs Need To Stay In The Mix: The Shatterproof Yelp-like Pilot

Alison Knopf September 28, 2020
When Shatterproof launched its new ATLAS (Addiction Treatment Locator, Assessment, and Standards Platform) project, funded largely by insurance companies, as a pilot in six states, …
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New OTPs In Tennessee, Where Medicaid Now Covers Methadone/OTP

Alison Knopf September 3, 2020
This summer, the Tennessee Health Services and Development Agency (HSDA) granted a Certificate of Need (CON) for the establishment of a new opioid treatment program …
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Pinnacle Ceo On Aegis Acquisition 2 Months Before Covid Hit

Alison Knopf August 19, 2020
When Pinnacle Treatment Centers acquired California-based Aegis Treatment Centers this year, it gained 10,000 patients and 36 opioid treatment programs (OTPs) in its expansion. This …
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Can Jail-Based MMT Lower Costs and Help Prevent Recidivism?

Barbara Goodheart, ELS August 17, 2020
Jail-based methadone maintenance treatment (MMT) sounds great in theory, but it’s rarely implemented. Yet opioid use disorders are common, with about 23% of state prisoners …
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Extended Methadone Take-homes During COVID: Nothing But Success

Alison Knopf July 8, 2020
Since March, when the Substance Abuse and Mental Health Services Administration (SAMHSA) relaxed rules for methadone take-homes to decrease exposure to the coronavirus, opioid treatment …
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STUDY: Saving Lives by Launching Buprenorphine Treatment in the ED: What Clinicians Need to Know

Barbara Goodheart, ELS July 8, 2020
It’s a scene that’s repeated countless times every day across the U.S. Siren blaring, an ambulance jolts to a stop at the entrance to a …
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STUDY: Is ACA Medicaid Expansion Fueling the Opioid Epidemic, or Is It Saving Lives?

Barbara Goodheart, ELS June 12, 2020
This is such an important question to resolve! Especially now, with more than a dozen states yet to decide on Medicaid expansion, while studies—some pro, …
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How Stavros 24-7 Clinics Handle the Pandemic

Alison Knopf May 27, 2020
When the pandemic hit the epicenter of New York City in mid-March, Nicholas Stavros’ 24-7 clinics across the country were already preparing. “We got in …
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How the North Carolina SOTA Responded to the Pandemic

Alison Knopf May 27, 2020
When the pandemic hit full force in mid-March, the State Opioid Treatment Authorities (SOTAs) had to move fast. They regulate opioid treatment programs (OTPs) in …
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STUDY: Risk Factors EDs Can Use to Identify Patients With Substance-Related Encounters Who Are at High Risk of Fatal Opioid ODs

Barbara Goodheart, ELS May 14, 2020
Lacking alternative resources, many people with substance use disorders (SUDs) visit emergency departments (EDs), especially after an overdose (OD). This gives care providers an opportunity …
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New Georgia OTP Takes Patients and Deals With the Pandemic

Alison Knopf April 30, 2020
Gateway Treatment Centers in Ellijay, Georgia, opened January 7—just a few weeks before the pandemic hit. But it was prepared.  The program currently has over 50 …
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AATOD Concerns about Harm Reduction Initiative During Pandemic

Alison Knopf April 15, 2020
During the week of April 6, a sign-on letter circulating in the harm reduction and patient advocacy fields provoked some strong feelings. The letter focuses …
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Provisions in CARES Act Affecting OTPs

Alison Knopf April 2, 2020
The CARES Act revises 42 CFR Part 2 (confidentiality of substance use disorder patient records) eliminating consent, except for the first time, after which they …
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Study Report: Pharmacy-Based Methadone Distribution

Barbara Goodheart, ELS April 2, 2020
Eight investigators from medical centers in the U.S. and Canada recently looked into methadone access in the U.S., and evaluated the current availability of methadone …
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OTP Regulations Loosened Due to Pandemic

Alison Knopf March 26, 2020
Opioid treatment programs (OTPs) that dispense methadone got a fast and clear release from regulations due to the coronavirus/COVID-19 pandemic. The Drug Enforcement Administration (DEA) …
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AATOD Releases Guidance for OTPs on coronavirus/COVID-19

Alison Knopf March 25, 2020
Make sure you have enough medication. Follow infectious disease protocols. Protect your workforce and patients. These are some of the recommendations from the American Association for …
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COVID-19 Resources

ATForum March 17, 2020
https://www.samhsa.gov/sites/default/files/programs_campaigns/medication_assisted/telemedicine-dea-guidance.pdf https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines/covid-19-guidance-otp https://www.samhsa.gov/sites/default/files/otp-guidance-20200316.pdf https://www.samhsa.gov/sites/default/files/sample-otp-covid-19-faqs.pdf https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implications-individuals-substance-use-disorders https://www.samhsa.gov/sites/default/files/tips-social-distancing-quarantine-isolation-031620.pdf https://www.appropriations.senate.gov/imo/media/doc/032520%20Title-By-Title%20Summary%20FINAL.pdf
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DEA Proposes Mobile Methadone at Last

Alison Knopf March 2, 2020
The federal Drug Enforcement Administration (DEA) has published its long-awaited proposal for opioid treatment programs (OTPs) to deliver methadone via mobile units, bringing the medication …
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Buprenorphine Effectively Treats OUD, But Most Patients Quit Treatment Too Early—Risking Relapse, Overdose, and Other Potentially Fatal Events

Barbara Goodheart, ELS February 25, 2020
Here’s something most people in the field know: buprenorphine treatment lowers the risk of overdose and death in people with opioid use disorder (OUD).  And here’s …
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Explaining Quality of Care in New Jersey, as State Looks at More Regulations for OBOTs

Alison Knopf February 25, 2020
“We’re penalized because we’re so highly regulated and there is little or no oversight over office-based opioid treatment.” This is Margaret B. Rizzo, executive director …
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methadone

Study Favors Better Insurance Reimbursement for Methadone Maintenance

Barbara Goodheart, ELS February 25, 2020
The problem of methadone underuse isn’t new—but the authors of a recently published paper offer ways to fix the situation; ways that are both new …
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Surprise Speaker at NYSAM Focuses on Advantages of Comprehensive Care

Alison Knopf February 25, 2020
The surprise speaker was Mark W. Parrino, MPA, president of the American Association for the Treatment of Opioid Dependence (AATOD). And he was standing in …
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Incarcerated People Are Entitled to Medications for Their OUD; So Why Aren’t They Getting Them?

Barbara Goodheart, ELS February 25, 2020
There’s no question that opioid use disorder (OUD) is extremely common in incarcerated people. And yet, this group rarely receives medication treatment for OUD (MOUD).  Moreover: Each …
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Introducing Steve Woolworth, New Evergreen CEO

Alison Knopf February 25, 2020
Steve Woolworth, PhD, the new CEO of Evergreen Treatment Services, has big shoes to fill. Molly Carney, the longtime CEO, is retiring, and Dr. Woolworth—at …
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Three Separate Programs Under One OTP Umbrella at Behavioral Health Group

Alison Knopf February 25, 2020
In Colorado, some opioid treatment programs (OTPs) governed by federal methadone regulations are combining the office-based opioid treatment (OBOT) protocol with OTP. This means that …
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Lawmakers Urge DEA to Move on Mobile Vans, Telemedicine

Alison Knopf February 25, 2020
Congress is getting annoyed with the stalling by the Drug Enforcement Administration (DEA) on mobile vans and telemedicine for treatment for opioid use disorder (OUD). A …
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2019

AATOD Conference Recap: ‘Out of the Shadows’

Alison Knopf December 9, 2019
There were more than 1,800 attendees at the 2019 conference of the American Association for the Treatment of Opioid Dependence (AATOD), held October 19-23 at …
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Top Honors at AATOD Award Ceremony Go to Gilbert Gerra, MD; Zachary Talbott

Alison Knopf December 9, 2019
The crowning glory for many attendees of the American Association for the Treatment of Opioid Dependence (AATOD) is the award banquet. Not only is it …
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Mobile Vans a Hot Topic at AATOD–And Now

Alison Knopf December 9, 2019
The open board meeting is the traditional opening work-sleeves session at the conference of the American Association for the Treatment of Opioid Dependence (AATOD). It’s …
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Telehealth Offers Best Opportunity for Treatment Expansion

Alison Knopf December 9, 2019
There is great interest in telehealth in all of health care, including treatment for opioid use disorder (OUD). One of the trickiest aspects of telehealth, …
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New Face of Criminal Justice: Welcoming MAT

Alison Knopf December 9, 2019
There is a growing partnership between corrections/criminal justice and treatment for substance use disorder (SUD)—especially, treatment for opioid use disorder (OUD). For example, the Florida Association …
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Cannabis for OUD: Not so Fast, Politicians

Alison Knopf December 9, 2019
Politicians like the idea of cannabis as a way to cure society’s opioid ills. It’s popular (almost everyone in health care, including many opioid treatment …
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Report: Why OUD Statistics Continue to Worsen, and What OTPs Can Do to Help 

Barbara Goodheart, ELS December 9, 2019
The statistics tell the story: Rates of opioid use disorder (OUD) and its consequences continue to rise. Yet we have effective treatments: methadone, buprenorphine, and …
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Review Article: Methadone Legend Dr. Kreek on Opioid Addiction Treatment

Barbara Goodheart, ELS December 9, 2019
Almost exactly a half-year ago we highlighted an excellent review article on opioid use disorder (OUD) by Drs. Carlos Blanco and Nora Volkow of the …
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When Early Dropout From Opioid Agonist Therapy Seems Likely, Identifying Problems and Taking Action May Help Keep Patients in Treatment

Barbara Goodheart, ELS October 11, 2019
Too often, patients drop out early from opioid agonist therapy and lose the many benefits it offers. Is there some way to intervene early and …
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Vermont's Hub and Spoke System

Vermonters Speak Out About MOUD in the State’s Hub-and-Spoke System

Barbara Goodheart, ELS October 11, 2019
Vermonters didn’t hesitate when recently asked to share their opinions about the state’s hub-and-spoke (H & S) medication treatment for opioid use disorder (MOUD). Instead, …
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Relative Costs and Benefits of Methadone vs. Buprenorphine in OUD

Barbara Goodheart, ELS October 11, 2019
It’s generally accepted that medication-assisted treatment (MAT) with methadone or buprenorphine is more effective than nonpharmacologic treatment in opioid use disorder (OUD). But what about the …
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COMPA Members Use Telemedicine in Clinical Trial to Assess Hepatitis C Management in Methadone-Maintained Patients

Alison Knopf October 11, 2019
Twelve opioid treatment programs (OTPs) in New York State are participating in a $7 million clinical trial integrating treatment of hepatitis C virus (HCV) infection …
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AATOD Concerned About SAMHSA Proposal to Drop PDMP Restriction

Alison Knopf October 11, 2019
The American Association for the Treatment of Opioid Dependence (AATOD) is concerned about recent initiatives that would reduce confidentiality for patients with opioid use disorder …
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Providers Oppose Allowing Law Enforcement Access to Patient Records

Alison Knopf October 11, 2019
Now that all the comments are in and counted, the votes are clearly against allowing law enforcement to have access to all patient records. The …
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AATOD Conference 2019

AATOD Conference: Out of the Shadows and the Continuum of Care

Alison Knopf October 11, 2019
AATOD Conference: Out of the Shadows and the Continuum of Care Every 18 months the American Association for the Treatment of Opioid Dependence (AATOD) holds the …
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CMS Proposes Rates for Medicare Reimbursement for OTPs

Alison Knopf October 11, 2019
The federal government’s approval of Medicare reimbursement for opioid treatment programs (OTPs) was a huge win for patients and programs. Now, the details need to …
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addiction treatment

NIMBY Doesn’t Affect Only OTPs

Alison Knopf October 11, 2019
Even buprenorphine treatment programs are being chased out of town—at least, if the towns have anything to say about it. This happened to ReVIDA Recovery …
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prison cell

CODAC To Provide Induction for MAT in Massachusetts Prisons

Alison Knopf October 11, 2019
In another move toward expansion of opioid treatment programs (OTPs) in correctional settings, CODAC Behavioral Healthcare is now providing induction to (and maintenance on) medication-assisted …
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Rural Areas Have the Longest Drive Times for OTPs

Alison Knopf October 11, 2019
It should come as no surprise that rural areas have longer drive times to opioid treatment programs (OTPs) than urban ones. A research letter published in …
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security, privacy

AATOD, NAMA Concerned About Law Enforcement Threats to Patient Confidentiality

Alison Knopf September 12, 2019
The American Association for the Treatment of Opioid Dependence (AATOD) is concerned about recent initiatives that would reduce confidentiality for patients with opioid use disorder …
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methadone

SAMHSA Proposes Putting Methadone Information Into PDMPs

ATForum August 23, 2019
In the long-awaited rulemaking amending 42 CFR Part 2, the Substance Abuse and Mental Health Services Administration (SAMHSA) said August 22 it will now allow …
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Why Patients With OUDs and Co-Occurring Mental Illness May Have a Better Chance in an OTP Than in Other Treatments

Barbara Goodheart, ELS August 7, 2019
When a patient with an opioid use disorder (OUD) fails to respond to treatment—despite the best efforts of counselors in the substance use disorder (SUD) …
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methadone

He Wanted to Live, But He Chose to Die—To Access Methadone

Barbara Goodheart, ELS August 7, 2019
In a report published in the July issue of Health Affairs, addiction specialist Jessica L. Gregg, MD, told the poignant story of a patient she …
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Add ASAM to “X the x-waiver” Movement

Alison Knopf August 7, 2019
For months, the position of the American Society of Addiction Medicine (ASAM) on the move to deregulate the prescribing of buprenorphine for opioid use disorder …
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Buprenorphine a Focus of AMA Opioid Task Force

Alison Knopf August 7, 2019
A report out from the American Medical Association (AMA) this summer recommends closing the treatment gap to address the opioid epidemic. Buprenorphine was the main …
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Methadone Now Allowed in Upstate NY Prison, If Inmates Come From Rikers OTP First

Alison Knopf August 7, 2019
A new program in New York has finally made it possible for methadone patients in the KEEP program at the New York City Rikers jail—the …
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Role of Counseling in OTPs

Alison Knopf August 7, 2019
Many people have questions about the role of counseling in methadone maintenance treatment, sometimes suggesting that nothing is needed but the medication itself. The Substance …
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OTP Responds to Shooting at Baltimore Clinic Across the Street

Alison Knopf August 7, 2019
Two people died after a shooting at the highly respected Man Alive opioid treatment program (OTP) in Baltimore on July 15—the shooter, and one other …
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Susan Caille Emerson

Susan Caille Emerson, 1951–2019

Barbara Goodheart, ELS June 4, 2019
We have lost our publisher, Sue Emerson. It happened on April 18, following a short illness. Just a year or so earlier we’d celebrated an …
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Review Article: NIDA Experts Dr. Blanco and Dr. Volkow on Opioid Use Disorder

Barbara Goodheart, ELS June 4, 2019
A new review paper by Carlos Blanco, MD, PhD, and Nora Volkow, MD, nicely summarizes current and future management of opioid use disorder (OUD)—as one …
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medicaid

Study: Medicaid Expansion Under ACA Can Increase Access to OAT—But Better Access May Be Within Reach

Barbara Goodheart, ELS June 4, 2019
When Medicaid expansion was enacted under the Affordable Care Act (ACA), expectations were that patients with opioid use disorders (OUDs) in specialty substance use settings …
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42 CFR Part 2 Still Under Threat

Alison Knopf June 4, 2019
Despite years of attempting to do away with the regulation that protects the confidentiality of substance use disorder (SUD) treatment records—with almost all treatment organizations …
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Keeping All Three OUD Medications in Congress’ Eye

Alison Knopf June 4, 2019
The key to keeping methadone and opioid treatment programs (OTPs) in the sights of appropriators is the phrase “all three medications” when referring to “MAT” …
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OTPs, Profit, and Not-for-Profit: What’s the Fuss About?

Alison Knopf June 4, 2019
Does for-profit status connote anything at all about the quality of treatment, about how well patients are cared for, about the responsibility of the program …
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Medicare Part D Insurers Are Making the Opioid Crisis Even Worse: It’s Much Tougher Now to Prescribe Buprenorphine, Easier to Prescribe Opioids

Barbara Goodheart, ELS April 7, 2019
Almost 90% of Medicare Part D insurance companies covered at least one buprenorphine product without restriction back in 2007—but in 2018, only 35% did so. Yet …
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Prior Authorizations of OUD Medications Are at Times Dangerous, and May Violate Federal Parity Laws; the SUPPORT Act Fails to Help

Barbara Goodheart, ELS April 7, 2019
The SUPPORT for Patients and Communities Act—the massive piece of legislation signed into law on October 24, 2018—is not going to take care of the …
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Increasing Access to MAT: What Is the Role of Harm Reduction?

Alison Knopf April 7, 2019
There are moves—important and funded ones—to support the expansion of medication-assisted treatment (MAT), but those moves apply mostly to office-based opioid treatment (OBOT) providers, not …
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Expanding OTPs Into Corrections in Maryland

Alison Knopf April 7, 2019
One of the most important initiatives occurring in methadone treatment for opioid use disorders (OUDs) is taking place in prisons and jails. In many states, …
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Corrections: Big Focus for OTPs

Alison Knopf April 7, 2019
As authorities start recognizing the need to treat opioid-dependent detainees in jails and prisons, rather than let them detox cold turkey, the importance of opioid …
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CMS and SAMHSA Visit OTPs in Preparation for Bundled Rate for OTPs

Alison Knopf April 7, 2019
The federal Center for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have started preparations for setting a …
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methadone

Trouble Ahead: Shifts in Funding Limit Access to Methadone, Threaten Treatment Expansion

Barbara Goodheart, ELS February 21, 2019
With opioid overdoses now killing more people than traffic accidents or HIV infection—more than 45,000 lives were lost to overdoses in 2017—you’d think that most …
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When There Are Corporate Changes, Patient Treatment Should Continue Without a Hitch

Alison Knopf February 21, 2019
There have been significant changes at Acadia Healthcare Company, which operates many opioid treatment programs (OTPs) among its 600 facilities. Last December, amid reports that …
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Cannabis and OTPs: What Next?

Alison Knopf February 21, 2019
Not only is cannabis—marijuana—legalized for recreational use in many states; it’s also legal for medical use in even more states, and some states are even …
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Alcohol: The Elephant In the OTP Room

Alison Knopf February 21, 2019
The world of addiction has a deeply embedded image of the oft-cited elephant in the room: substance use disorder in a family member, a fellow …
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Integrated Care Model in Canada Includes Pharmacy

Alison Knopf February 21, 2019
Canadian Addiction Treatment Centres (CATC), based in Toronto, has over 14,000 patients, 80% of whom are taking methadone. Unlike in the United States, patients in …
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Field Loses Pioneer and ‘Honorary Patient’ Tom Payte

Alison Knopf February 21, 2019
James Thomas Payte, MD, died January 22 at the age of 87. A pioneer in the treatment of opioid use disorder with methadone, Dr. Payte …
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children

The Shocking Facts About Opioid Deaths in the Very Young

Barbara Goodheart, ELS January 18, 2019
Yale researchers have uncovered startling data about the number of children and adolescents (younger than age 20) dying from opioid poisoning. The general belief—until the Yale …
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The “Three-Day Rule” Needs To Be Extended to Allow Longer Treatment With Methadone or Buprenorphine

Alison Knopf January 18, 2019
In 2017, Gail Groves Scott, MPH, manager of the Substance Use Disorders Institute at the University of the Sciences in Philadelphia, wrote a passionate piece …
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How OTPs Can Help Pain Patients With OUDS: SAMHSA

Alison Knopf January 18, 2019
Can opioid treatment programs (OTPs) help pain patients who no longer need opioids for pain? Absolutely, says Elinore F. McCance-Katz, MD, PhD, assistant secretary for …
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confidential

42 CFR Part 2 Still a Target for 2019

Alison Knopf January 18, 2019
Perhaps the best example of what can happen to loss of confidentiality is the story of the Boston Medical Center nurse, who, doing exactly what …
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In-House, On-Site Pharmacy Provides Convenience and Minimizes Stigma, Enhancing Retention

Alison Knopf January 18, 2019
In opioid treatment programs (OTPs) in the United States, all pharmacy is “in-house,” meaning that patients are dispensed medication by nurses in the facility. There …
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2018

Loretta Finnegan

MATER Center Director, on the Importance of Dr. Finnegan’s Work—Which Continues—and the Need to Treat Mothers for Trauma

Alison Knopf December 17, 2018
Loretta Finnegan, MD, a champion of medication-assisted treatment with methadone, developed her scoring system for newborns more than 40 years ago. The Finnegan Neonatal Abstinence …
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Opportunities for Partnership Between OTPs and Prisons, Jails

Alison Knopf December 17, 2018
Although the general attitude toward methadone and buprenorphine is not favorable on the part of many workers in correctional facilities, the trend is changing. This …
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Caught in Chaos—When Pregnant Women With OUD Are Incarcerated; How OTPs Can Help

Barbara Goodheart, ELS December 17, 2018
Case Report This is the story of a young woman with a 15-year history of severe opioid use disorder (OUD), intermittent hospitalization, and incarceration, who becomes …
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DEA’s Foot-Dragging on Mobile Vans Gets Worse

Alison Knopf December 17, 2018
More than two years ago, just before Donald Trump was elected president, Demetra Ashley, associate deputy assistant administrator of the office of diversion control with …
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AATOD Policy Paper Looks at Methadone and Buprenorphine, OTPs and DATA 2000 Practices

Alison Knopf December 17, 2018
In a far-reaching policy paper to be published next year, a draft copy of which was obtained by AT Forum, the American Association for the …
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Most Important Aspect of Congress’ Opioid Bill: Medicare for OTPs

Alison Knopf November 5, 2018
The 660-page opioid bill that passed Congress and was signed October 24 by President Trump has important provisions for opioid treatment programs (OTPs). The most …
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confidential

42 CFR Part 2: It’s Still Under Threat, Misunderstood; But OTP Patients Need It!

Alison Knopf November 5, 2018
42 CFR Part 2 protects the privacy of patient substance use disorder (SUD) treatment records. It’s been under siege for 10 years, but so far, …
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When OTP Patients Face Surgical Pain, OTP and Surgical Staff Work Together to Help

Barbara Goodheart, ELS November 5, 2018
Health care teams are brought up short when they see the words opioid use disorder on the chart, and the patient is scheduled for surgery. …
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Toolkit Helps Women State Legislators With Opioid Bills

Alison Knopf November 5, 2018
Healthy Women, a group that has been active for 30 years, is expanding its work around policy and advocacy, and recently released a toolkit for …
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In Memoriam: Bob Newman

Alison Knopf November 5, 2018
I spent hours visiting with Robert Newman, MD, beloved methadone advocate, over the past 30 years. He gave me my first tour of a large …
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Challenges to Hiring and Retaining Good Workers in OTPs

Alison Knopf October 3, 2018
As the opioid crisis continues, opioid treatment programs (OTPs) are going to face big challenges in the workforce, experts say. “We’re going to face a …
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BAART Sues California City Over NIMBY Blocking Of Clinic

Alison Knopf October 3, 2018
This summer, Bay Area Addiction Research and Treatment (BAART) sued the city of Concord, California after a three-year effort to site its methadone clinic there. …
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Study: Lack of Nearby OTPs Puts Methadone Patients at  Risk of Early Death

Barbara Goodheart, ELS October 3, 2018
Under federal law, newly enrolled methadone patients must attend a methadone program six days a week, so caregivers can watch as patients are dosed. But here’s …
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Expanding OTP Access In California, Where Waiting Lists Are Not Used

Alison Knopf October 3, 2018
California technically doesn’t have waiting lists for opioid treatment programs (OTPs). When a program is full, the operator can ask the state for an increase …
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HHS Supportive of MAT Prescribing by Nurse Anesthetists, Midwives

ATForum September 27, 2018
“Nurse anesthetists can give any drug in the [operating room]; they put you under; and they’re very trained in pain management”… that would seem an …
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Opioid Bills in Congress: Focus on Medicare and OTPs – Updated August 25, 2018

Alison Knopf September 4, 2018
As the Senate gets ready to vote on opioid legislation, advocates urge people to contact their members of Congress to call for comprehensive coverage by …
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confidential

42 CFR Part 2 Faces Tough Going in Congress

Alison Knopf September 4, 2018
When the U.S. House of Representatives passed H.R. 6082 last June methadone patients worried that they would lose their confidentiality. The bill would remove a …
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How New York Uses Its STR Funds to Enhance Treatment

Alison Knopf September 4, 2018
To use its more than $50 million in funding from the State Targeted Response (STR) to the Opioid Crisis, New York State first identified its …
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As the NAS Crisis Worsens, a New Study Offers Treatment Guidelines

Barbara Goodheart, ELS September 4, 2018
The incidence of neonatal abstinence syndrome (NAS) has been climbing steadily, according to a 2016 Morbidity and Mortality Weekly Report from the Centers for Disease …
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Research Report: In Appalachia, Pregnant Women With OUD Encounter Barriers to Treatment

Barbara Goodheart, ELS September 4, 2018
Appalachia is an area long known for beautiful scenery, coal mining, and devastating poverty. And now the area around central Appalachia has become the epicenter …
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West Virginia Leads the Nation With Its Opioid Problems; But Could Change Be Coming?

Barbara Goodheart, ELS September 4, 2018
It’s a lovely state, nestled in the tree-covered Appalachian mountains—but West Virginia, the state hardest hit by the opioid crisis, faces serious problems. According to …
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Opioid Bills in the Senate: Focus on Medicare and OTPs

ATForum August 6, 2018
By Alison Knopf “I don’t think there’s a single legislator who isn’t interested” in passing opioid bills, Mary Bono, former Republican Congresswoman from California, told AT …
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law books, gavel, scales

Drug Use During Pregnancy Is Not Child Abuse: Experts Weigh in On Pennsylvania Court Decision

ATForum July 20, 2018
“The Pennsylvania Supreme Court is considering whether a pregnant woman’s use of illegal drugs qualifies as child abuse under state law. In May, the Drug …
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medicaid

Has the Medicaid Expansion Issue Finally Been Settled? If so, What’s the Best Way to Make Expansion Work?

Barbara Goodheart, ELS June 18, 2018
Much has been written about the impact of Medicaid expansion on the opioid crisis and access to medication-assisted treatment (MAT). A group associated with amfAR, …
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buprenorphine

SAMHSA Gives No Information on How Many Patients Are on Buprenorphine or How Well They Are Doing

Alison Knopf June 18, 2018
Opioid treatment programs (OTPs) must submit a plethora of information on their services to the Substance Abuse and Mental Health Services Administration (SAMHSA). Office-based outpatient …
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Profiles of Today’s OTP Leaders

Alison Knopf June 18, 2018
Plenty of opioid treatment program executives are leaders in the field, but their names don’t get out nearly enough. This article is meant to change …
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Ann Jamieson

Ann Jamieson

ATForum June 18, 2018
Ann Jamieson, MS, aged 46, is the Chief Operating Officer and Director of Professional Development for Maric Healthcare, a Tulsa, Oklahoma-based company operating OTPs across …
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Jason Kletter

Jason Kletter

ATForum June 18, 2018
Jason Kletter, PhD, aged 47, is the President of BayMark Health Services, where he has worked for 25 years in operational, management, and executive roles. …
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Robert C. Lambert

Robert C. Lambert

ATForum June 18, 2018
Robert C. Lambert, MA, aged 54, president and executive director of Connecticut Counseling Centers, Inc., began as an entry level counselor in the center’s Methadone …
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Christine Martin

Christine Martin

ATForum June 18, 2018
Christine Martin, LMFT, CACII, aged 35, is director of clinical services for Center for Behavioral Health, North Charleston, South Carolina. She started working as an …
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Stacey Pearce

Stacey Pearce

ATForum June 18, 2018
Stacey Pearce, aged 43, Chief Compliance Officer at Alliance Recovery Centers, in Georgia, started working in an OTP in 1995 as a part-time receptionist. “It …
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Allegra Schorr

Allegra Schorr

ATForum June 18, 2018
Allegra Schorr, aged 56, is president of the Coalition of Medication-Assisted Treatment Providers and Advocates (COMPA). Ms. Schorr has over 25 years of experience in …
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Nick Stavros

Nick Stavros

ATForum June 18, 2018
Nick Stavros, age 39, CEO of Community Medical Services, presided over the recent sale of the OTP platform to the private equity firm, Clearview Capital. …
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Zac Talbott

Zac Talbott

ATForum June 18, 2018
Zachary C. Talbott (“Zac”), aged 35, a native of Tennessee, is administrator and program director of Counseling Solutions Treatment Centers, based in Georgia. When he …
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States Are Legalizing Nonprescription Syringe Sales in Pharmacies; How Well Is That Working?

Barbara Goodheart, ELS June 18, 2018
Nonprescription sales of syringes in pharmacies are being met with some enthusiasm, some resistance, and a tinge of stigma. But they offer an accessible, affordable, …
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Methadone Patients Don’t Feel “Disabled,” But They Do Have a Protected “Disability” Under the ADA

Alison Knopf June 18, 2018
Patients in opioid treatment programs (OTPs) are protected under the Americans with Disabilities Act (ADA). This means that an employer can’t refuse to hire them …
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OTPs in Florida: Needs-Assessment Changes Underway

Alison Knopf June 18, 2018
Florida Governor Rick Scott signed HB 21 in March, providing more than $65 million to support opioid treatment. This included $16.5 million for medication-assisted treatment …
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New York map

AATOD Conference Recap: Field Has Funding, Now Needs Infrastructure

Alison Knopf April 17, 2018
There were more than 2,000 attendees at the 2018 conference of the American Association for the Treatment of Opioid Dependence (AATOD), held at the Marriott …
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Dr. McCance-Katz

An Interview With Dr. McCance-Katz On Importance of Medications and Psychosocial Treatment

Alison Knopf April 17, 2018
Elinore F. McCance-Katz, MD, PhD, assistant secretary for mental health and substance use at the Department of Health and Human Services, and head of the …
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Department of Justice Tells State Attorney General: ADA Protects People On MAT

Alison Knopf April 17, 2018
For the first time ever, the Department of Justice (DOJ) has sent a letter to a state attorney general, stating that judges generally may not …
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security, privacy

With “Open-Access,” Methadone Treatment Can Increase Patient Census and Eliminate Waiting Lists: Research

Alison Knopf April 17, 2018
In a study of “open access” treatment with methadone maintenance, reducing barriers to treatment led to a tripling of the patient census and elimination of …
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MAT During Incarceration Reduces Overdose Deaths

Alison Knopf April 17, 2018
Medication-assisted treatment (MAT) for opioid use disorder provided to incarcerated individuals sharply reduced overdose deaths after the inmates were released, researchers in Rhode Island have …
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MOTHER Study Babies Thrive at Three Years; AT Forum Talks With Lead Authors

ATForum April 17, 2018
It’s long been known that medication-assisted treatment (MAT), with adequate doses of methadone or buprenorphine, can stabilize women during pregnancy and prevent relapse. But a …
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When Mom Is Better Than Morphine: Shorten Stay and Decrease Costs For Babies With Methadone-Related NAS

Alison Knopf April 17, 2018
When Loretta Finnegan, MD, a champion of medication-assisted treatment with methadone, developed her famous scoring system for newborns—more than 40 years ago—mother and infant dyad …
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White House Wants Americans To Share Addiction Stories On New Website

ATForum April 6, 2018
“Could a new website serve as a way to bring attention to the opioid crisis? The White House thinks so, as it recently launched a new website called …
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Dr. Jana Burson Blog: Guest Dosing at Opioid Treatment Programs

ATForum March 26, 2018
“Guest dose unto others as you would have others guest dose unto you.” I think all opioid treatment program physicians should follow this twist on the …
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Attorney General Sessions Announces DEA Surge to Combat Prescription Drug Diversion

ATForum February 11, 2018
  “Attorney General Jeff Sessions announced yesterday that, over the next 45 days, the Drug Enforcement Administration (DEA) will surge Special Agents, Diversion Investigators, and Intelligence …
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AATOD Board Meeting Features Visits With Lawmakers, ONDCP, DEA, and SAMHSA

Alison Knopf February 11, 2018
The annual board meeting last December of the American Association for the Treatment of Opioid Dependence (AATOD) was more than just a meeting. Eight board …
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California Moving Forward on Hub and Spoke, Care Teams

Alison Knopf February 11, 2018
California has embraced the hub-and-spoke concept in implementing its State Targeted Response (STR) to the Opioid Crisis funding from the 21st Century Cures Act. The …
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Vermont Hub-and-Spoke Evaluation: No Opioid Overdoses, and a Sharp Drop—96%—in Opioid Use

Alison Knopf February 11, 2018
The hubs—OTPs—treat patients who have been assessed as needing the OTP level of care. These patients are given methadone, buprenorphine, or naltrexone. Patients in the …
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How OTPs Can Help Reduce Stigma: The Boston Experience

Alison Knopf February 11, 2018
Boston is not the only city with a powerful push by academics and providers for medication-assisted treatment (MAT), but it’s definitely one with a high …
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Research Report: Getting More Methadone Patients Into HCV Treatment

Barbara Goodheart, ELS February 11, 2018
Here’s an eye-catching statistic: only about 3% of the world’s population is infected with hepatitis C virus (HCV)—but the infection rate in methadone users is …
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Moving Ahead on Methadone in Corrections

Alison Knopf February 11, 2018
People who get incarcerated—in prisons or jails—tend to be people with more advanced addiction. If they have opioid use disorders, they typically spend their term …
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Poll: Americans Consider the Opioid Crisis a Major Problem—but Not a National Emergency

Barbara Goodheart, ELS February 11, 2018
Results of Seven Merged National Polls, 2016 and 2017, New England Journal of Medicine – February 1, 2018 How serious is the opioid crisis? Data from …
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2017

AT Forum Turns 25: Reporting on Opioid Use Disorders and Medication-Assisted Treatment

ATForum December 13, 2017
For a quarter-century AT Forum has served as a source of support and encouragement for the opioid addiction community, as well as an advocate of …
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Health Care Uncertainty Leaves Questions for OTPs; Self-Pay May Continue

Alison Knopf December 13, 2017
In one respect, opioid treatment programs (OTPs) have an advantage over most areas of health care, when it comes to uncertainty about insurance in the …
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Opioid STR Grant Funding Formula Stays in Effect for Year 2

Alison Knopf December 13, 2017
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that the funding formula for the $1 billion Opioid State Targeted Response (STR) grant allocation …
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24/7 Access to OTPs Opened in Arizona With Federal STR Funds

Alison Knopf December 13, 2017
Arizona is using some of its Opioid STR (State Targeted Response) money, granted under the 21st Century Cures Act, to expand access to Opioid Treatment …
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Older Adults with Opioid Use Disorders—The Forgotten Generation

Barbara Goodheart, ELS December 13, 2017
They’ve been called a “growing and understudied population”—people who need treatment, yet find it hard to obtain or to pay for. So, many do without …
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Need for Medicare Reimbursement for OTPs Cited in DC Briefing

Alison Knopf December 13, 2017
Senior citizens are not immune from opioid use disorders (OUDs), but Medicare does not cover treatment in an Opioid Treatment Program (OTP). The American Association …
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FDA: Keep Patients on Methadone or Buprenorphine, Even if They Test Positive for Benzodiazepines

Alison Knopf December 13, 2017
The practice of ending treatment if patients test positive for benzodiazepines was discouraged in no uncertain terms by the Food and Drug Administration (FDA) last …
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How President Trump’s Opioid Commission Supports OTPs and Comprehensive Treatment

Alison Knopf December 13, 2017
On November 1, the White House released the long-awaited final report on the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The report …
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“Adolescent Opioid-Related Deaths are Soaring…”— An Update

Barbara Goodheart, ELS December 13, 2017
An article in our August-September newsletter on the rise in adolescent opioid-related deaths included recommendations from several government and medical sources—virtually all of them suggesting …
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NIDA Launches Tools for Assessing Adolescents’ Risk of Opioid Use Disorder, Opening the Door to Medication-Assisted Treatment

Barbara Goodheart, ELS December 13, 2017
The National Institute on Drug Abuse (NIDA) has launched two online screening tools—BSTAD and S2BI—to assess the risk of substance use disorder in adolescents aged …
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Still Under a Moratorium, OTPs in West Virginia Finally Get Medicaid Payments

Alison Knopf December 13, 2017
Last fall, West Virginia got its Medicaid 1115 waiver approved, allowing, among other things, Medicaid to pay for treatment in opioid treatment programs (OTPs). The …
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AATOD Releases Recommendations on Siting OTPs in Era of Growth

Alison Knopf October 24, 2017
The American Association for the Treatment of Opioid Dependence (AATOD) has released recommendations on siting opioid treatment programs (OTPs). The guidelines are meant to encourage …
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FDA Says Benzodiazepine Use Not a Bar to Treatment With Methadone or Buprenorphine for Opioid Addiction 

Alison Knopf October 24, 2017
Citing the harms of untreated opioid use disorders, the federal Food and Drug Administration (FDA) says that benzodiazepine use should not preclude the use of …
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It’s Official: Heroin Is Once Again More Popular Than Rx Opioids

Barbara Goodheart, ELS October 24, 2017
Many health professionals have suspected it for a while, and now it’s official: a study published in October in Health Affairs, and written up by …
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Study Reveals Surprising Results: White Patients in OUD Treatment Are Significantly Less Likely to Receive Methadone or Buprenorphine

Barbara Goodheart, ELS October 24, 2017
This was a study of specialty treatment for opioid use disorders (OUDs) in publicly funded programs in the U.S. Investigators at Johns Hopkins who turned …
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Adolescent Opioid-Related Deaths Are Soaring; We Can’t Wait “Until Things Get Worse”!

Barbara Goodheart, ELS October 24, 2017
In September of last year, the American Academy of Pediatrics (AAP) issued a policy statement calling for making drug therapy available to adolescents with opioid …
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SAMHSA Issues Brief Update on Use of Medication-Assisted Treatment

Barbara Goodheart, ELS October 24, 2017
This update from the Substance Abuse and Mental Health Services Administration (SAMHSA) reports trends in the use of methadone, buprenorphine, and extended-release, injectable naltrexone—an option …
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OTP Leader Ed Higgins Leaves Legacy for the Field

Alison Knopf October 24, 2017
Longtime methadone and opioid treatment program (OTP) advocate and professional Edward J. Higgins died peacefully at home in Toms River, New Jersey on October 8. Mr. …
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Expect Opioid STR Grant Money to Be Scrutinized After One Year

Alison Knopf August 11, 2017
Of the $1 billion in federal grants going out to states in 2017 and 2018 to respond to the opioid epidemic, 80% must go to …
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Community Medical Services in Arizona: Working with Corrections, Drug Courts

Alison Knopf August 11, 2017
It has become clear that many people with opioid use disorders (OUDs) end up in jails and prisons. Immediately cut off from their source, they …
Read More

Policies Limiting Rx Opioids Aren’t Working; It’s Time to Expand MAT and Evaluate Other Options

Barbara Goodheart, ELS August 11, 2017
Prescription opioids are still getting much of the blame for the current opioid overdose crisis, yet heroin and synthetic opioids—fentanyl, carfentanil, and tramadol—have become the …
Read More

Aegis Telehealth Makes Buprenorphine Treatment More Convenient for Patients

Alison Knopf August 11, 2017
Imagine opioid treatment program (OTP) patients being able to get counseling and prescriptions from their own smartphone, while sitting in the comfort of their home. …
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Buprenorphine Reimbursement in OTPs Advances in California

Alison Knopf August 11, 2017
Opioid treatment programs (OTPs) still use methadone as their main medication, especially in states where there is no reimbursement for the far more costly buprenorphine. …
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Mobile Vans for OTPs: Getting Closer to Reality

Alison Knopf August 11, 2017
The Drug Enforcement Administration (DEA) is not yet ready to talk about mobile vans. The agency is likely to release new licensing regulations, which will …
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Faces & Voices of Recovery Honors Two OTP Leaders

Alison Knopf August 11, 2017
At its July 17 “America Honors Recovery” gala, Faces & Voices of Recovery awarded Mary Jeanne Kreek, MD, and Mark Parrino, MPA, two top honors. …
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Fentanyl Analogues Not Resistant to Narcan® (Naloxone)

ATForum August 2, 2017
“Contrary to recent news reporting, there are no fentanyl analogues resistant to Naloxone. News reports indicated a “new” fentanyl analogue, acrylfentanyl, was “extremely powerful” and …
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Rapid Growth in Medicaid Spending on Medications to Treat Opioid Use Disorder and Overdose

ATForum August 2, 2017
“This brief gives policymakers and the public perspective on the scope of potential Medicaid spending increases needed to address the opioid crisis. Between 2011 and …
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Number of OTPs Tops 1,500 For First Time Ever

Alison Knopf June 2, 2017
For the first time in the history of opioid treatment programs (OTPs)–federally regulated clinics that dispense methadone and other medications to treat opioid use disorders—there …
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Amid Beltway Disarray, Field Sees Bright Spot in McCance-Katz Nomination

Alison Knopf June 2, 2017
President Trump, along with Republican members of Congress, is calling for a repeal of the Affordable Care Act (ACA)—which many believe jeopardizes treatment coverage. And …
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AATOD, Acadia, and 433 Others Protest Health Care Bill as Destructive to Opioid Treatment

Alison Knopf June 2, 2017
President Trump promised to repeal the Affordable Care Act (ACA), and although it took some negotiating, he got what he wanted from the House of …
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SAMHSA Issues Opioid STR Grants

Alison Knopf June 2, 2017
On April 19, the federal Department of Health and Human Services (HHS) released the first round of funding for the two-year State Targeted Response (STR) …
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Research Results: Lowering the Risks of Death for Patients Receiving Methadone or Buprenorphine

Barbara Goodheart, ELS June 2, 2017
Evidence is growing that two key factors help determine the risks of death in patients being treated for opioid dependence: which medication the patients are—or …
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Poll: The Public Speaks Out About Opioid Misuse 

Barbara Goodheart, ELS June 2, 2017
Results of a Poll Released by the American Psychiatric Association (APA) -May 1, 2017 To get some perspective on this story, let’s picture a teenager who …
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Report from NASADAD – ONDCP to State Directors: Increase Access to Treatment 

Alison Knopf June 2, 2017
Single state authorities (SSAs) are on the front lines of the opioid epidemic. They’re in charge of overseeing the Substance Abuse Prevention and Treatment (SAPT) …
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When Facing NIMBY, Be Transparent: The Lesson From Buffalo, NY

Alison Knopf June 2, 2017
Not in my back yard (NIMBY)—that’s how to best describe the feeling in local neighborhoods where residents say they support treatment for substance use disorders, …
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AATOD Issues Five-Year Plan: Bottom Line Focus Is Still on Stigma

Alison Knopf April 13, 2017
The five-year plan of the American Association for the Treatment of Opioid Dependence (AATOD) has a goal of increasing access to care in opioid treatment …
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Study: Benzodiazepines + Prescription Opioids = Caution Needed!

Barbara Goodheart, ELS April 13, 2017
Benzodiazepines help patients cope with severe anxiety, panic disorder, or sleep problems; prescription opioids can help relieve severe pain. When prescribed appropriately and with sufficient …
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California Will Use Cures Act $80 Million To Expand Treatment With Hub-And-Spoke System

Alison Knopf April 13, 2017
The Cures Act, signed in December 2016 by President Obama, gave $920 million over a two-year period to states to devote to opioid use disorder …
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SAMHSA Develops MAPS Project to Determine Where OTPs Are Needed

Alison Knopf April 13, 2017
The Center for Behavioral Health Statistics and Quality (CBHSQ) has been hard at work determining where in each state opioid treatment programs (OTPs) are needed, …
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Buprenorphine Dispensing Problems in Virginia: Coal Country Rules

Alison Knopf April 13, 2017
The Virginia Board of Medicine, backed by the state, has banned the use of buprenorphine with the exception of treating pregnant patients in both office …
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Why Women Use—and Misuse—Opioids

Barbara Goodheart, ELS April 13, 2017
How different are women from men, when it comes to using—and misusing—opioids? More different than you might think, it turns out, according to CDC Vital Signs, …
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Tennessee Bill Would Place Full Liability on OTPs for Car Accidents

Alison Knopf April 13, 2017
A bill winding its way through the Tennessee legislature would make opioid treatment programs (OTPs) liable for any injury or death caused by a patient …
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Mobile Vans: Not Ready for Prime Time

Alison Knopf April 13, 2017
Yes, there are regulations in preparation to address the use of mobile vans to dispense medication-assisted treatment. When connected to brick-and-mortar opioid treatment programs (OTPs), …
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AATOD Issues Benzodiazepine Guidelines

Alison Knopf April 13, 2017
On April 6, the American Association for the Treatment of Opioid Dependence (AATOD) released its long-awaited report, Guidelines for Addressing Benzodiazepine Use in Opioid Treatment …
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Final Rule For 42 CFR Part 2 Retains Core Confidentiality Protections

Alison Knopf February 13, 2017
The final rule on 42 CFR Part 2, issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) in January, essentially keeps the confidential …
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AATOD’s Goal of Doubling Number of OTPs Has Strong SAMHSA Support

Alison Knopf February 13, 2017
Over the next three years, the number of opioid treatment programs (OTPs) in the country will double, from 1,400 to 2,800, pledges Mark Parrino, MPA, …
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$1 Billion for Opioids from Cures Act, but ACA Repeal Could Undercut the Benefits

Alison Knopf February 13, 2017
 In December, the 21st Century Cures Act was signed by President Obama, providing $1 billion over two years to address opioid addiction. The law also …
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Legal Action Center: Free Toolkit Will Help Challenge Criminal Justice and Child Welfare Agencies Who Require Patients to Stop Taking Methadone and Other Medication-Assisted Treatment

Alison Knopf February 13, 2017
A new toolkit from the Legal Action Center can help patients, especially those taking methadone, understand their rights when they are told that they must …
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Research Results: Opioid Agonist Treatment Versus Detoxification in Lowering the Costs of Crime

Barbara Goodheart, ELS February 13, 2017
A recent study compared opioid agonist treatment (OAT) and detoxification in patients with opioid use disorders. The goal was to see which treatment approach is …
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Virginians Vote: Support Treatment—Not Jail—For Drug Users*

Barbara Goodheart, ELS February 13, 2017
Treatment, not jail time—that’s what most people who misuse opioids should be offered, say Virginia voters. More than 6 out of 10 Virginians recently polled …
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Fighting Stigma: Down With “Drug Users”; Up With . . ?

Barbara Goodheart, ELS February 13, 2017
There’s a movement afoot to banish short, snappy, offensive terms like “addict,” “drug users” and “abuse,” and replace them with terms unlikely to perpetuate stigma. And …
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2016

Medicaid Coverage for Addiction Treatment Varies Dramatically

ATForum December 13, 2016
“A study published Monday in the journal Health Affairs found significant disparities in Medicaid coverage for addiction treatment among the states. “Researchers sought to determine the …
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Use of Needle Exchange Programs Up Dramatically In 10 Years: CDC

ATForum December 13, 2016
“Although there was a significant increase in the use of syringe services programs (SSPs)—more commonly known as needle exchange programs—across the United States over the …
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Election: OTPs Should Be Vigilant, But Optimistic

Alison Knopf December 6, 2016
How will the election of Donald Trump as president of the United States, with far-ranging changes in administration officials and policy, affect opioid treatment programs …
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AATOD Conference Recap

Alison Knopf December 6, 2016
Double the number of opioid treatment programs—from 1,400 to 2,800—in the United States over the next three years: that was the main message from Mark …
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AATOD Plenaries: Standing-Room-Only Interest in OTPs, MAT

Alison Knopf December 6, 2016
Mark Parrino, MPA, made no secret of his plan to double the number of opioid treatment programs (OTPs) within three years, from 1,400 to 2,800. …
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Top Honors at AATOD Award Ceremony Go to Michael Botticelli, Others in Field

Alison Knopf December 6, 2016
A centerpiece of the American Association for the Treatment of Opioid Dependence (AATOD) is the award banquet, honoring leaders for their work in the field. It …
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Introduction: The AATOD White Papers

Alison Knopf December 6, 2016
Produced by the American Association for the Treatment of Opioid Dependence (AATOD) under a contract with the Substance Abuse and Mental Health Services Administration, three …
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Health Homes in Vermont: Start Some Patients on Buprenorphine in OTPs, Transfer to OBOT (Part I in a Series of AATOD White Papers)

Alison Knopf December 6, 2016
The American Association for the Treatment of Opioid Use Disorders (AATOD) this year issued three landmark white papers on improving access to medication-assisted treatment (MAT) …
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How OTPs Can Integrate Care With Other Health Care Providers (Part II in a Series of AATOD White Papers)

Alison Knopf December 6, 2016
The second white paper issued this year by the American Association for the Treatment of Opioid Dependence (AATOD) focused on coordination of care. Essential steps …
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Criminal Justice System: The Need to Educate the Courts, Corrections, and the Child Welfare System (Part III in a Series of AATOD White Papers)

Alison Knopf December 6, 2016
The American Association for the Treatment of Opioid Dependence (AATOD) issued three white papers this year that focus on methadone and buprenorphine treatment for opioid …
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Surgeon General’s Report Focuses on Science, Medications

Alison Knopf December 6, 2016
The U.S. Surgeon General’s report on alcohol and drugs—the first ever devoted to this topic—should be a reference document for every opioid treatment program (OTP) …
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Innovative OTP Integrates Buprenorphine Maintenance Treatment; Patients and Caregivers Benefit 

Barbara Goodheart, ELS December 6, 2016
An innovative hospital, one of the largest in New York City, has successfully integrated buprenorphine maintenance treatment (BMT) into its established opioid treatment program (OTP), …
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Vermont’s Hub-and-Spoke System Could Be Model for OTPs

Alison Knopf October 11, 2016
In Vermont’s opioid treatment system, devised ingeniously by Gov. Peter Shumlin with Affordable Care Act funding more than five years ago, opioid treatment programs (OTPs) …
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NIMBY: Even in an Opioid Epidemic, OTPs and Patients Fight an Uphill Battle

Alison Knopf October 11, 2016
Opioid treatment programs (OTPs) across the country have been engaged in battles to locate, in the case of new facilities, and to expand, in the …
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Patient Advocate Calls On Federal Government to Fight NIMBY

Alison Knopf October 11, 2016
Jocelyn Woods, MA, executive director of the National Alliance for Medication Assisted Recovery (NAMA-R), has a lot to say about NIMBY-ism. As the lead advocate …
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Health Policy Takes Aim at Two Epidemics—OUD in Pregnancy and NAS in Newborns

Barbara Goodheart, ELS October 11, 2016
A comprehensive review article in Obstetrics and Gynecology summarizes troubling data on the epidemic of opioid use disorder (OUD) during pregnancy, and the subsequent sharp …
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RI Health Homes Initiative: Improving Wellness for The Patient, And The Bottom Line for Medicaid

Alison Knopf October 11, 2016
People with opioid use disorders are a small percentage of Medicaid enrollees, but they represent a significant percentage of costs in terms of emergency department …
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Marijuana Testing: Advice From SAMHSA and the Joint Commission

Alison Knopf October 11, 2016
In this day of medical marijuana in some states, and recreational marijuana as well, what is a treatment program to do when it comes to …
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Tennessee Patients’ Lack of Access at Root of Georgia’s OTP Moratorium

Alison Knopf August 11, 2016
Georgia’s 67 opioid treatment programs (OTPs) aren’t enough to treat everyone in the state who needs it, but some of the need appears to be …
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Tips From Top OTP Executives on Recruiting and Retaining Counselors

Alison Knopf August 11, 2016
Finding and keeping good counselors in an opioid treatment program (OTP) isn’t easy, no matter what state you’re in. Salaries need to keep pace with …
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Early Intervention for OTPs: Education and Awareness Needed

Alison Knopf August 11, 2016
Why don’t more patients go to opioid treatment programs (OTPs) earlier in their disease? For several reasons. First, the guidelines of the Substance Abuse and Mental …
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OTPs Should Not Report Patient Information to PDMPs, But Should Use PDMPs For Patient Care

Alison Knopf August 11, 2016
The Substance Abuse and Mental Health Services Administration (SAMHSA) regulates opioid treatment programs (OTPs) and promulgates 42 CFR Part 2, the confidentiality rule protecting patient …
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Research Results: Prescription Drug Monitoring Programs Help Reduce Opioid-Related Deaths

Barbara Goodheart, ELS August 11, 2016
On July 14 Sen. Joe Manchin (D-WV), along with Sens. Amy Klobuchar (D-MN) and Angus King (I-ME), introduced the Prescription Drug Monitoring Act, to require …
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Recently Released Resources

ATForum August 11, 2016
Whitepaper: “Models of Integrated Patient Care through OTPs and DATA 2000 Practices” available for download at: http://atforum.com/2016/07/aatod-issues-first-whitepapers-otp-patient-quality-care-continuity-services/ Source: American Association for the Treatment of Opioid Addiction …
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AATOD Releases Second Whitepaper, Focusing on “Integrated Service Delivery Models for Opioid Treatment Programs in an Era of Increasing Opioid Addiction, Health Reform and Parity”

ATForum July 27, 2016
“The first section is written by Dr. Kenneth Stoller and Dr. Mary Ann Stephens in the Department of Psychiatry and Behavioral Sciences in the John …
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Longtime Confidentiality Rule: SUD Consent Provisions Up for Change

Alison Knopf June 7, 2016
In a process that began six years ago and is likely to continue for months, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) …
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AATOD Responds to HHS Buprenorphine-Cap Proposal

Alison Knopf June 7, 2016
 Opioid treatment programs (OTPs) have been concerned about a proposal to raise the number of patients a physician can treat with buprenorphine, because they want …
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Counseling in OTPs: A Necessary Part of Treatment with Medication

Alison Knopf June 7, 2016
Counseling is a required component of an opioid treatment program (OTP) under the Substance Abuse and Mental Health Services (SAMHSA) guidelines. It’s also what differentiates …
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Psychosocial Intervention and Medications in Treating Opioid Use Disorders: A Review

Barbara Goodheart, ELS June 7, 2016
Opioid overdose rates have risen to epidemic levels, underscoring the need for comprehensive treatment of opioid misuse. Effective medications are available, but there’s “a dearth …
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When OTP Patients Are in the Criminal Justice System: Collaborate and Communicate

Alison Knopf June 7, 2016
Drug courts, corrections, and in fact the entire criminal justice system is undergoing a sea of change relative to medication-assisted treatment (MAT) for opioid addiction. …
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A Significant Decline in Criminal Charges Seen With Methadone Treatment—not With Buprenorphine Treatment  

Barbara Goodheart, ELS June 7, 2016
 A key goal in addiction treatment is to reduce the criminal activity associated with substance use disorders. Several studies have shown that a reduction does …
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Methadone or Buprenorphine? Letting Patients Choose May Improve Outcomes

Barbara Goodheart, ELS April 18, 2016
Although either methadone or buprenorphine can treat opioid use disorders effectively, patients may have good reasons to prefer one or the other. Giving patients a …
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Joint Commission Makes Key Changes in Accreditation Standards for OTPs

Alison Knopf April 18, 2016
A host of changes in accreditation standards are coming for opioid treatment programs (OTPs) from the Joint Commission. The standards are based on the Substance …
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How Treatment in an OTP Is Paid for: It Costs a Lot More Than the Price of the Medication

Alison Knopf April 18, 2016
A December 30 article in Modern Healthcare blithely described the cost of methadone—the medication—as $4,000 a year, and went on to repeat the error several …
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Employment Rights for People on MMT: SUDS, HIV, Hepatitis

Alison Knopf April 18, 2016
Five years ago, the U.S. Equal Employment Opportunity Commission (EEOC) ordered Hussey Copper to pay $85,000 because the Leetsdale, Pennsylvania-based company refused to hire a …
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Success Story: Advocate Opens First OTP, Second to Open This Spring

Alison Knopf April 18, 2016
Counseling Solutions opened its first opioid treatment program (OTP) in Chatsworth, Georgia, in February, with the second, in Murphy, North Carolina, set to open this …
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Death of an Important Voice in the Addiction Field: Stewart Leavitt Leaves a Legacy

Alison Knopf April 18, 2016
When Stewart B. Leavitt, PhD, died in February at age 70, the methadone maintenance field lost an important advocate. The founding editor when AT Forum …
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Medicaid Coverage of Methadone Essential in Treatment Access for Opioid Use Disorders: Study

Alison Knopf February 11, 2016
States that have Medicaid funding for methadone treatment are far more likely than states without such funding to have Medicaid-enrolled patients in treatment programs, researchers …
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AATOD Board Meeting With Federal Officials: Buprenorphine Cap Main Issue

Alison Knopf February 11, 2016
The two-day meeting of the board of directors of the American Association for the Treatment of Opioid Dependence (AATOD), which took place in December in …
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Administrative Withdrawal: Discharging OTP Patients for Nonpayment

Alison Knopf February 11, 2016
Opioid treatment programs (OTPs), like other health care providers, are not required to provide patient care without charge. If a patient can’t pay, and has …
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Stigma Article Series: Part I – Patients With Opioid Addiction Continue to Face Stigma  

Barbara Goodheart, ELS February 11, 2016
Publisher’s Note: Despite the current buzz about the expansion of opioid-agonist treatment, stigma continues to prevail. This is the first in a series of four …
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Stigma Article Series: Part II – Watch Your Language! Stigmatizing Patients Who Have Addiction Disorders Can Worsen Clinical Care

Barbara Goodheart, ELS February 11, 2016
In two editorials published soon after he was appointed senior editor of the Journal of Addiction Medicine, Richard Saitz, MD, MPH, FACP, DFASAM, briefly discussed …
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Stigma Article Series: Part III – News Media Contribute to Stigma Directed at People Who Misuse Opioids

Barbara Goodheart, ELS February 11, 2016
On December 1, Psychiatric Services in Advance, an online service of the American Psychiatric Association, published “Criminal Activity or Treatable Health Condition? News Media Framing …
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Stigma Article Series: Part IV – Fighting Stigma Against Opioid Treatment Programs: People and Education Are Needed

Alison Knopf February 11, 2016
The best way to fight stigma against opioid treatment programs (OTPs) is to bring the programs themselves out in the open—and that’s finally starting to …
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Patient Advocates: Leading Peer Specialists in OTPs

Alison Knopf February 11, 2016
The growth of the patient advocate movement in opioid treatment programs (OTPs) is a benefit for patients and for management. Patient advocates will be the …
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2015

The Intersection of Pain and Addiction: OTPs Brace For More Patients

ATForum December 4, 2015
The ongoing efforts to reduce prescribing of opioids should have an effect on opioid treatment programs (OTPs), because some of the patients who are being …
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Mark Parrino: Policy Responses to Opioid Epidemic Should Include Comprehensive Treatment

ATForum December 4, 2015
During the past year, key government agencies, medical associations, policy makers, the media, and families have finally realized that we’re in the midst of the …
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Barriers to OTP Expansion

ATForum December 4, 2015
There’s a question on the minds of everyone who is involved with opioid treatment programs (OTPs) and reads the headlines: If we’re in such a …
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Providing Naloxone to OTP Patients and Family Members: A Good Idea

ATForum December 4, 2015
Five patients at the opioid treatment program (OTP) where Jana Burson, MD, serves as medical director have rescued people—not patients—with naloxone they obtained from her …
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Profiling and Comparing Opioid Users: A Possible Tool for Intervention

ATForum December 4, 2015
In the August/September issue of the Addiction Treatment Forum newsletter we discussed a review article, “Long-Term Course of Opioid Addiction,” published in the Harvard Review …
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Beny Primm Leaves Legacy of Wisdom and Compassion in Methadone Treatment and HIV/AIDS

ATForum December 4, 2015
Beny Primm, MD, a leader in the treatment of opioid addiction and AIDS, died October 16 at the age of 87 after a long battle …
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Dr. Jana Burson Blog – Injecting Buprenorphine (Suboxone, Subutex)

ATForum November 16, 2015
“I know why addicts inject buprenorphine (Subutex): they think it saves them money. Over the long run, however, I doubt that’s true, given the hidden …
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ASAM, Federal Officials Join to Promote MAT for Opioid Use Disorders

ATForum October 9, 2015
On September 24 the American Society of Addiction Medicine (ASAM), with the support of top federal health officials, released a mobile application and pocket guide …
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In The Age of Parity, Payers Still Put Up Barriers to OTP Reimbursement

ATForum October 9, 2015
Medicare, Medicaid, and commercial insurance—all three programs are putting up barriers to reimbursement for treatment in an opioid treatment program (OTP), but the situation is …
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Counties to Get the Purse Strings for SUD Services Under California Waiver: OTPs, Already In a Good Spot, Worry About Changes

ATForum October 9, 2015
A massive change in the way California Medicaid pays opioid treatment programs (OTPs) and other programs for services related to substance use disorder (SUD) was …
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Methadone Split-Dosing: Less NAS, Better Maternal Recovery

ATForum October 9, 2015
Cases of neonatal abstinence syndrome (NAS)—a group of withdrawal symptoms that sometimes afflict newborns—increased about threefold between 2000 and 2009, reflecting a fivefold rise in …
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John McCarthy, MD, ABPN, Answers Questions About the Methadone Split-Dosing Protocol  

ATForum October 9, 2015
AT Forum:  Your protocol for pregnant patients at the Bi-Valley clinic calls for giving split methadone take-home doses. How do you manage the safety issues …
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Opioid Addiction: A Review of Long-Term Patterns and Consequences

ATForum October 9, 2015
Despite widespread news coverage, extensive research, and effective treatments, opioid addiction is reaching new heights—not only in the U.S., but in many parts of the …
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OTPs Can Help Support Primary Care Buprenorphine Prescribers

ATForum October 9, 2015
Opioid treatment programs (OTPs) can do “all the heavy lifting” when it comes to counseling and wraparound services for patients with opioid use disorders (OUDs), …
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Retrospective: Vincent Dole Would Be Disappointed In the Stigma MMT Patients Face Today

ATForum August 14, 2015
Twenty years ago, AT Forum published an interview with Vincent P. Dole, MD, about his vision for methadone maintenance treatment (MMT). The interview was full …
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SAMHSA Awards $11 Million in Grants to Treat Opioid Use Disorders

ATForum August 14, 2015
In late July the Substance Abuse and Mental Health Services Administration (SAMHSA) announced which 11 states were the winners of about $1 million each in …
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To Reduce Opioid Treatment Program Legal Liability, Practice Good Medicine— And Document It

ATForum August 14, 2015
If your patient tests positive for illicit drugs while in treatment at your opioid treatment program (OTP), you need to take steps—and document those steps—to …
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ASAM Guideline Shows What It Takes To Treat Opioid Use Disorders: Medications and Support

ATForum August 14, 2015
In May, the American Society of Addiction Medicine (ASAM) issued a practice guideline on medications for treating opioid use disorders. Meant to guide clinicians in …
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Don’t Ignore Benzodiazepines in the Opioid Epidemic: Massachusetts  

ATForum August 14, 2015
In April of 2014, Richard D. Lewis posted    “Opiates and benzos: A deadly cocktail of drugs” on southcoasttoday.com. South Coast is the southern coastal region …
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New Medications for Hepatitis C Gradually Making Interferon a Drug of the Past

ATForum August 14, 2015
Interferon, a traditional medication sometimes used in combination with ribavirin or other medications to treat hepatitis C infections, has unpleasant side effects, including nausea, fatigue, …
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Methadone Dose-capping Still Continues in Practice, If Not in Policy

ATForum June 3, 2015
Dose-capping—limiting the amount of methadone a patient can take on a daily basis—was ruled “contrary to the current state of the medical literature and the …
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Success! New York Medicaid to Reimburse OTPs for Buprenorphine

ATForum June 3, 2015
Opioid treatment programs (OTPs) are finally able to bill Medicaid for buprenorphine treatment in New York, Allegra Schorr, president of the Coalition of Medication-Assisted Treatment …
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Access to HCV Screening, Testing, and Medications for Patients in Opioid Treatment Programs (Part III in a series)

ATForum June 3, 2015
What can patients in opioid treatment programs (OTPs) expect when seeking screening, v testing, and medication for hepatitis C  virus (HCV) infection? Their former or current …
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CMS Proposes Extending Parity to Medicaid Managed Care

ATForum June 3, 2015
On April 6, just after the national meeting of the American Association for the Treatment of Opioid Dependence (AATOD), the federal government issued a proposed …
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Opportunities for Medication-Assisted Treatment Access and Expansion: The Time Is Right

ATForum June 3, 2015
The heroin and prescription-opioid epidemic are intersecting with the Affordable Care Act and parity, creating new access to treatment. This is an exciting time for …
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AATOD Conference Recap, Progress Report, and Future Challenges

ATForum May 8, 2015
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cocaine spoon and needle

Heroin Use Levels Off in U.S., But Still High: Report

ATForum April 23, 2015
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New OTP Accreditation Guidelines Will Not Allow Mid-Levels

ATForum April 21, 2015
Special Feature ATForum article. Read More…
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Opioid Treatment Program Accreditation Guidelines Will Not Allow Mid-Levels; SAMHSA Will Work with States on Exemptions

ATForum April 21, 2015
The final revised guidelines for opioid treatment programs (OTPs) were released March 31 by the Substance Abuse and Mental Health Services Administration (SAMHSA). Timed to …
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HHS Actions to Address Opioid-Drug Related Overdoses and Deaths in U.S.

ATForum April 6, 2015
Read More…
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SAMHSA Proposed Budget Encourages MAT for Treating Opioid Use Disorders

ATForum April 3, 2015
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released its budget request for fiscal year 2016, with some good news for opioid treatment …
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To Be Part of Integrated Health Care, You May Need an Electronic Health Record and an In-House Clinic

ATForum April 3, 2015
Electronic health records (EHRs) are needed when opioid treatment programs (OTPs) work in coordination with other health care providers─which isn’t very often. But that’s starting …
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Good News for Patients in Opioid Treatment Programs: Treatments for Hepatitis C Infection Are Becoming Affordable (Part II in a series)

ATForum April 3, 2015
The outlook for patients in opioid treatment programs (OTPs) who need affordable treatment for hepatitis C virus (HCV) infection has improved markedly since we reported …
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Lawyers in Kentucky Drug Court Case Wants Physicians, Not Judges, to Decide on MAT

ATForum April 3, 2015
A landmark lawsuit aimed at getting Kentucky drug courts to accept medication-assisted treatment (MAT) for opioid use disorders was filed March 9 by Lexington-based attorney …
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Legal Action Center Report: Medication-Assisted Treatment a Key Solution to the Opioid Epidemic

ATForum April 3, 2015
The Legal Action Center released a report in March focusing on medication-assisted treatment (MAT). The report stressed that MAT is a key solution to the …
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Jerry Rhodes, from CRC to Acadia, Muses on Future of the Field

ATForum April 3, 2015
When Acadia Healthcare announced that it planned to acquire CRC Health Group last year, CRC CEO Jerry Rhodes continues championing opioid treatment programs (OTPs). At …
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MAT Federal Lawsuit Against the State of Kentucky

ATForum March 11, 2015
“Two law firms have teamed up to file a federal lawsuit against the state of Kentucky for its practice of forbidding opiate addicts from receiving …
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Health Care Reform One Year Later: Medicaid Much Better Than Commercial Insurance for Opioid Treatment Programs

ATForum January 13, 2015
A year ago, the Affordable Care Act (ACA), with the expansion of Medicaid and the inclusion of private insurance subsidies, took effect. In the states …
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Overcoming Obstacles to Opioid Treatment Expansion: The North Dakota Example

ATForum January 13, 2015
We’re well into one of the worst opioid addiction epidemics in recent memory, and one would expect that opioid treatment programs (OTPs) would be rapidly …
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For-Profit Opioid Treatment Programs Leading the Growth Curve

ATForum January 13, 2015
If it weren’t for proprietary financing interests, there would be little growth in opioid treatment programs (OTPs), according to Mark Parrino, MPA, president of the …
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A Tough Challenge for Opioid Treatment Programs: Linking Hepatitis C Patients With Affordable Testing and Treatment Services

ATForum January 13, 2015
Finally, there’s good news for the many patients in opioid treatment programs (OTPs) who are infected with hepatitis C virus (HCV). New medications with success …
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Thanks To ADA Lawsuit, Johnson City, Tennessee May Open Doors to Opioid Treatment Programs

ATForum January 13, 2015
Tri-Cities Holdings has been trying to site an opioid treatment program (OTP) in Johnson City, Tennessee, and finally, things are looking up. After a federal …
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California’s Reaction to Obamacare: Medi-Cal Better Than Commercial Plans

ATForum January 13, 2015
Alex Dodd, president and CEO of Aegis Treatment Centers, divides Obamacare─the Affordable Care Act (ACA)─into Covered California, which is commercial insurance with subsidies for people …
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NJ Supreme Court Rules Pregnant Woman on Methadone Not Guilty of Child Abuse

ATForum January 13, 2015
A December 22 unanimous ruling by the New Jersey Supreme Court reversed a lower court decision, which had found that a mother could be charged …
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How Opioid Treatment Programs Can Prepare For and Manage DEA Inspections

ATForum January 13, 2015
Mark W. Caverly, who was an investigator for 31 years, in charge of diversion policy with the Drug Enforcement Administration (DEA), was policy chief of …
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2014

Drug-Overdose Deaths Have More Than Doubled in the U.S.

ATForum December 4, 2014
Opioids and heroin are two of the greatest offenders…  
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Dr. Clark

The Legacy of Dr. H. Westley Clark

ATForum December 4, 2014
SAMHSA Blog by Pamela S. Hyde.
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Kade Appointed Acting Director of CSAT in Wake of Clark’s Retiring

ATForum October 27, 2014
Daryl W. Kade, MA, has been appointed acting director of the Center for Substance Abuse Treatment (CSAT) for the Substance Abuse and Mental Health Services …
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Increasing the Buprenorphine Patient Cap: Threat to Patient Care

ATForum October 27, 2014
Over the summer, steps have been taken to increase the “cap”—the number of patients a physician can treat—with buprenorphine/naloxone. The American Association for the Treatment …
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“The Talk”—When Patients Want to Switch from Methadone to Buprenorphine

ATForum October 27, 2014
Most advocates in the field oppose the idea of a stable patient who is doing well on methadone switching to buprenorphine provided by an office-based …
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Research: Buprenorphine Treatment for Opioid Addiction: Opportunities, Challenges, and Strategies

ATForum October 27, 2014
Buprenorphine/naloxone has been available in the U.S. for both opioid treatment programs (OTPs) and office-based opioid treatment (OBOT) since 2003. While OBOT physicians can prescribe …
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Primary Care Clinic Next to Opioid Treatment Program Provides Stigma-free Care

ATForum October 27, 2014
In Texas, people in the uninsured and indigent population die on average 29 years sooner because they don’t have access to primary care, says Allison …
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Attracting New Patients to Your Opioid Treatment Program: The Importance of Word of Mouth and Referrals

ATForum October 27, 2014
In many parts of the country, how to market to attract new patients to opioid treatment programs (OTPs) is a moot point. There are waiting …
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AATOD Policy Paper: Raising Buprenorphine Patient Cap Could Hurt Patient Care

ATForum August 19, 2014
The opioid overdose epidemic has led to a call by some to raise the 100-patient cap on buprenorphine, which can be dispensed and prescribed by …
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Changes in Confidentiality Regulations Would Hurt Opioid Treatment Program Patients, Damage Privacy

ATForum August 19, 2014
The long process of reviewing 42 CFR Part 2, the regulation that governs confidentiality of alcohol and drug abuse treatment records, is underway. The law …
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ONDCP’s Michael Botticelli on the Importance of OTPs in Treating Opioid Use Disorders

ATForum August 19, 2014
Michael Botticelli, acting director of the Office of National Drug Control Policy (ONDCP) and a longtime friend of medication-assisted treatment (MAT), dating from his years …
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Medicaid Managed Care, New Insurance Rules Coming to New York Opioid Treatment Programs

ATForum August 19, 2014
There are big changes coming up for opioid treatment programs (OTPs) and other substance use disorder (SUD) programs in New York State. Starting next year, …
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Research Report: Dosage Trends in Methadone Maintenance Treatment Programs: Significant Improvement, But Still Below Evidence-Based Standards

ATForum August 19, 2014
The sharp rise in heroin use and prescription opioid abuse in recent years underscores the need for effective treatment for opioid addiction. Yet previous studies …
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Research Report: Patients Treated With Methadone vs. Buprenorphine: Differences in Demographic Characteristics and Treatment Outcomes

ATForum August 19, 2014
A study published online May 12, 2014 in Substance Abuse compared demographic characteristics and treatment outcomes of 252 patients enrolling in a methadone maintenance treatment …
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Life Concerns of Prescription Opioid and Heroin Users—What Are They, and How Do They Differ?

ATForum August 19, 2014
The daily worries and instabilities that plague opioid-dependent patients can make it difficult for providers to deliver effective long-term substance-abuse and medical treatment. Lack of …
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crack cocaine

Research Abstract: Cocaine Use Among Opioid Users: Is All Cocaine the Same?

ATForum August 15, 2014
Results suggest that it may not be appropriate to consider powder and crack cocaine as diagnostically and clinically equivalent… Journal of Addiction Medicine
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ASAM State Medicaid Coverage of Addiction Treatment in the US

ATForum August 15, 2014
As part of ASAM’s “Advancing Access to Addiction Medications” pr