Two years after rules overhaul, have methadone clinics really changed?
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- SAMHSA issued a long-awaited overhaul of opioid treatment program (OTP) regulations in 2024, allowing greater flexibility on take-home methadone and making counseling optional rather than a condition of receiving medication.
- Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, said more than 75% of OTPs have provided more take-home medication, with retention in treatment significantly increased as a result.
- An AATOD and National Association of Addiction Treatment Providers survey gathered responses from 241 clinics — roughly 10% of OTPs nationwide — and found more than 70% had adopted at least half of SAMHSA's recommended practice changes.
- Dustin Mets, CEO of Ohio-based behavioral health clinic CompDrug, reported that the share of patients still in treatment three months after first seeking care rose an average of 17% following implementation of the changes.
- The new rules eliminated two long-standing requirements: that patients be addicted to opioids for over a year, and that they fail other treatments twice before being admitted to a methadone clinic.
- Aaron Ferguson, a leader in the Liberate Methadone movement, countered that the survey likely suffers from selection bias, arguing most larger providers haven't been proactive and that clinics in conservative states are largely ignoring the changes.
Why it matters: Surveyed clinics reported a 17% jump in three-month treatment retention after implementing the changes, and more than 70% adopted at least half the recommended practices — but with only 10% of OTPs responding, the nationwide picture of reform remains uncertain, and critics argue the patients most likely to benefit are being excluded from feedback loops.
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