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Some people who are being treated for opioid use disorder are able to take their methadone medication at home sooner or schedule telehealth appointments in a way they couldn’t always do before.
For the first time in more than two decades, the U.S. Department of Health and Human Services is making significant changes to regulations governing opioid treatment programs, or OTPs. Proven and accredited programs that provide medications such as methadone or buprenorphine to people with opioid use disorder. The only approved programs where people can get methadone treatment are, a A drug approved to treat opioid use disorder By reducing and eliminating cravings and neutralizing or blocking the effects of opioids.
A Final ruleIt will update the OTP rules, which is scheduled to be published on Friday. The reforms include expanding eligibility for patients to receive their methadone treatment at home, allowing them to initiate treatment via telehealth and allowing nurse practitioners and physician assistants to prescribe medications.
These improvements are intended to “meet people where they are,” says HHS. Secretary Xavier Becerra said and to make treatments more accessible.
“If you’re trying to take care of your family, get a new job, maybe go back to school and stay in recovery, you can get treatment through telemedicine, it’s a really life-changing thing to help someone,” said author counselor Rachel Pryor.
“Being able to take methadone at home so you don’t have to go back and forth to the methadone clinic every day, that helps you keep your job and get your life back,” she said. We’re trying to help people keep their lives together.
Becerra has heard how quickly life can spin out of control. On Wednesday he He met four young peopleThrough the Drug Abuse Prevention Organization CADCAAffected by the nation’s ongoing drug abuse crisis.
Ladrick Smith, a student at Morehouse College In Atlanta, he tells Becerra about his friend who started running away at a young age and started doing drugs and is now in prison. They still stay in touch, Smith said, and his friend never thought his life would turn out this way.
“We need to do more to catch people before they get out of control, and out of control, in this case, it could be jail for a friend, or they could overdose and possibly die,” Becerra said. To do this, we need to know how to best reach people.
During the Covid-19 pandemic, regulations around telemedicine to treat opioid use disorders have been relaxed, and recent updates to OTP regulations make these telemedicine options sustainable.
“This final rule represents a historic modernization of OTP regulations to help more Americans receive effective treatment for opioid use disorder,” said Dr. Miriam Delphine-Ritmon, HHS assistant secretary for mental health and substance abuse and substance abuse and psychiatric lead at the Health Services Administration, or SAMHSA. In a written statement.
“While this rule change will help anyone who needs treatment, it will be particularly beneficial for those in rural areas or those with low incomes where reliable transportation is difficult,” she said. “In short, this update will help those most in need.”
Access to opioid use disorder medications remains an ongoing issue for people in the United States, said Dr. Noah Krawczyk, an assistant professor in the Department of Population Health at NYU Grossman School of Medicine. Center for Opioid Epidemiology and PolicyNot involved with HHS.
Recent efforts by officials to expand access to treatment are “great,” Krawczyk said, but there is still more work to do to make both harm-reduction equipment and drugs accessible to those who need them most. for instance, Not all US states She said have an opioid treatment program and these Geographical differences affect access.
“Historically, how medications for opioid use disorder have been regulated has made it very difficult to replicate. For example, methadone, which we’ve had since the 70s, has been a very limited evidence-based treatment. In the US, you can now only get it through an opioid treatment program, a specialized clinic with very specific licensing and in most cases It’s not available in the provinces,” Krawczyk said.
“There’s a lot of stigma around these drugs,” she said. “People have a negative view of methadone. They think that if you’re taking one of these drugs, you’re replacing one drug with another, which is a huge myth, because they’re extremely effective in helping people achieve many different goals, including staying alive.”
The latest legislation to update OTP regulations is one of a series of recent measures taken by the Biden-Harris administration to combat the nation’s ongoing overdose epidemic.
HHS also announced Thursday that some federal grant funds may be used to purchase test strips for xylazine, an animal sedative commonly known as tranq. This means that agencies such as local health departments, first responders or health systems can use grants to purchase xylazine test strips to prevent overdoses and other drug-related injuries.
“We want communities to have the resources to purchase these testing kits,” said Captain Christopher Jones, director of SAMHSA’s Center for Substance Abuse Prevention.
Test strips are commonly used to detect the presence of fentanyl in recreational drugs xylazine test strips They are being widely distributed. Fentanyl a A powerful synthetic opioid It is 100 times more powerful than morphine and 50 times more powerful than heroin. Xylazine is not an opioid, but a sedative commonly used in veterinary medicine.
“By 2021, we have made it clear that fentanyl test strips are an authorized service for these donors. The xylazine test strips we are making public are also an approved use for these donors, Pryor said. “Xylazine is the scariest thing on the streets today, along with fentanyl.”
When Xylazine is added to fentanyl products or other medications, the risk of overdose increases.
“Xylazine, because it increases the sedative effect, increases what opioids already do to reduce the rate of breathing and increase the risk of overdose. It can prolong or intensify the effect, so it is more dangerous,” Krawczyk said. “This is definitely a current issue that we need to learn about and do a lot more to put out research papers and educate people about how to deal with xylazine in medicine and medicine.”
The White House has declared fentanyl laced with xylazine to be A. The threat to the United States. A report published last year by the U.S. Centers for Disease Control and Prevention found that among 21 states where xylazine was found, the monthly share of fentanyl overdose deaths rose from 3 percent of deaths in January 2019 to nearly 11 percent in June 2022 — a nearly fourfold increase.
Overall, the number of drug-related overdose deaths in the United States is increasing, albeit at a slower rate. The death toll peaked in May and changed little in the following months until August.
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according to Temporary data From the CDC’s National Center for Health Statistics, more than 112,000 people died of drug overdoses in the 12-month period ending in August.
“Drug overdoses reach every part of our society, taking lives and causing immeasurable suffering to families and communities. That’s why President Biden has made his unity agenda a key priority. We have made important progress, but we still have a lot of work to do,” Becerra said in a written statement.
But we have tools, evidence-based strategies, and a collective commitment across our nation to fight the overdose epidemic. “HHS is focused on the full range of solutions needed to address drug abuse. We will continue to use every lever available to fight this and save lives. This includes focusing on prevention as well as expanding treatment and outreach to those struggling with substance use disorders.
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Earlier this week, HHS – through SAMHSA – released an updated toolkit on how to prevent and respond to overdoses. The latest of Overdose Prevention and Response Toolkit It has additional classes for specific audiences, including people who use drugs, people who take prescription opioids, first responders and healthcare professionals.
The hope is that these recent HHS actions, including the final rule on opioid treatment programs, will reduce overdose deaths, Jones said.
“When we see more than 110,000 overdose deaths, we need to pull all the stops on overdose, and drug treatment for opioid use disorder is one of the strongest evidence-based practices we have,” he said. “We know it reduces the risk of death by 50%. And so this rule is modernizing how we provide drug treatment in opioid treatment programs so that more people have access to it.”