Methadone has long been regarded as a life-saving medication for opioid use disorder that keeps people from experiencing debilitating withdrawal or seeking dangerous street drugs. But to the U.S. government, it’s a highly regulated Schedule II substance akin to cocaine, meth, or fentanyl, making the drug difficult to access. As the nation’s overdose crisis worsens, the New Republic looks at how methadone could be more widely used to help those struggling with addiction—but isn’t due to price, over-regulation, and stigmatization. Strict rules curtail access to methadone and dictate how and where it is dispensed, mostly in specialized urban clinics that are out of reach to those in rural areas. The federal government bans primary care doctors from prescribing it and pharmacies from dispensing it. And unlike buprenorphine, another medical treatment for OUD, methadone can only legally be dispensed at one of these clinics, which usually have long waitlists or financial costs. For patients, breaking one of the rules can lead to dismissal from the program which was likely difficult to get into in the first place. The Biden administration has recently signaled its intention to make such medications more widely available, via mobile methadone vans, for example, as part of broader harm reduction initiatives. This would be welcome at a time when overdose rates have reached record levels and we have the tools and resources to start reducing fatalities today—but are not taking advantage of them.
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Rosenthal Center for AddictIon Studies