For almost thirty years, I have diligently been working to help Alabama with the Opioid crisis. I continue to serve on the Alabama Governor’s Opioid Council (past and present Governors) and co-serve on the National Boards related to treatment. I also take great pride in serving on the “National Stop Stigma Now” Board with leading experts in the field…

Continue Reading Email from Staats-Combs to Clanton Mayor, Chilton County law enforcement

This story should be subtitled “Still crazy in Alabama.” Here’s this report from Susan Staats -Combs, owner and director of Shelby County Treatment Center and Chilton County Treatment Center, two opioid treatment programs (OTPs) in Alabama. “At one point in history, you could see discrimination all over the web,” she recounted recently, referring to discrimination against methadone patients and…

Continue Reading NIMBY in full force in Alabama

Moving forward in 2023, with a huge proposed rulemaking change for opioid treatment programs (OTPs) (see https://atforum.com/2022/12/samhsa-proposal-update-methadone-regulations/), AT Forum talked to three executives – Megan Marx, director of integrated care at Oregon Recovery and Treatment Centers in Parker, Oregon; Jason Kletter, Ph.D., president of Baymark Health Services, based in Lewisville, Texas; and Nick Stavros,. CEO…

Continue Reading Next steps for OTPs: Three executives on their vision for the future

Last month in New York, a new kind of opioid treatment program (OTP) opened. It is operated by Outreach Development Corporation and will be open 6 days a week, serving patients on Long Island. A one-time grant of $206,000 from federal funding administered by the New York State Office of Addiction Services and Supports (OASAS),…

Continue Reading New kind of OTP: Integrated treatment with medications and more under one roof

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

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

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

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

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

Continue Reading Lived Experience: A Refreshing New Voice

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

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

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

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

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

Continue Reading Study: OTP Retention Unaffected by Benzodiazepines

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

Continue Reading OTPs facing increasing pressure from supporters of OTAA

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

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

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

Continue Reading Mythbusting on AATOD and methadone/buprenorphine bills