SAMHSA Issues Four Advisories to Expand Methadone Treatment for Opioid Use Disorders

Strategic Insights -

SAMHSA's Center for Substance Abuse Treatment (CSAT) has issued four advisories to help healthcare providers implement methadone treatment for opioid use disorders (OUDs). The advisories, which were praised by two top opioid treatment program (OTP) executives, aim to expand access to methadone treatment in hospital settings, state prisons, and correctional facilities.

The four advisories are titled: "Expanding Access to Methadone Use in Hospital Settings," "Guidelines for Implementing Medications for Opioid Use Disorder Treatment in State Prisons," "Naloxone Saturation Policy Academy Retrospective Report," and "Clinical Considerations for Methadone Treatment of Opioid Use Disorder in Correctional Facilities." The advisories provide clear and factual language to explain the rules and regulations surrounding methadone treatment, aiming to eliminate stigma and increase access to treatment.

Key Takeaways:

  • The 72-hour rule, which allows hospitals to prescribe and dispense 72 hours' worth of methadone to patients with OUD, is now normalized by the advisory and aims to eliminate stigma.
  • The advisory will help hospitals in New York and other states to implement the 72-hour rule, which was previously prohibited due to legislation.
  • Experts agree that SAMHSA's guidance is clear, factual, and accessible to both laypeople and providers, reducing barriers to methadone treatment.
  • The hospital advisory is seen as a crucial step in reducing opioid overdose deaths and improving access to treatment for patients with OUD.
  • Experts highlight the importance of trust between the emergency department, pharmacy department, and OTP staff in implementing the 72-hour rule effectively.
  • Concerns about lowering the risks of lethality associated with methadone treatment, particularly in cases of 100% fentanyl utilization, require communications and understanding between pharmacy, risk management, and emergency departments.

Statistics:

  • 72 hours: the amount of time for which methadone can be prescribed and dispensed to patients with OUD according to the advisory.
  • 2: the number of states where the 72-hour rule was previously prohibited for hospitals, including New York.
  • 100%: the frequency of fentanyl utilization cited by experts as a concern for lowering the risks of lethality associated with methadone treatment.
  • 1-3 days: the duration of treatment with a moderately low dose of methadone that is considered not to have the same potential for lethality as it did 5 years ago.

Sources:

  • "Expanding Access to Methadone Use in Hospital Settings" - SAMHSA advisory
  • "Guidelines for Implementing Medications for Opioid Use Disorder Treatment in State Prisons" - SAMHSA advisory
  • "Naloxone Saturation Policy Academy Retrospective Report" - SAMHSA advisory
  • "Clinical Considerations for Methadone Treatment of Opioid Use Disorder in Correctional Facilities" - SAMHSA advisory
  • https://library.samhsa.gov/sites/default/files/methadone-treatmenthospital-setting-pep25-02-007.pdf
  • https://library.samhsa.gov/sites/default/files/oud-treatment-stateprisons-pep25-02-003.pdf
  • https://library.samhsa.gov/sites/default/files/oud-treatment-stateprisons-pep25-02-003.pdf
  • https://library.samhsa.gov/sites/default/files/oud-correctionalfacilities-pep25-02-005.pdf