What are Methadone Clinics and Why Do We Need Them?

As the director of the LA-based Harm Reduction Network, I am acutely focused on all paths that lead to recovery. Unfortunately, all too often medication for addiction treatment, especially methadone, is stigmatized and difficult to access. 

Stakeholders, like me, are working towards opening more methadone clinics. 

Why do we need methadone clinics?

Drug overdoses have skyrocketed in recent years. More than 107,000 Americans were estimated to have died of overdoses in 2021 alone. Not to mention, less than 12% of teens and adults with opioid use disorder received medication to help them stop misusing opioids. 

However, methadone has been successful in helping people escape opioid addiction by dampening the cravings of withdrawal. One way we can combat the overdose epidemic is by making sure methadone clinics are available to everyone who needs them.

How are methadone clinics regulated?

Methadone is regulated internationally as a Schedule I controlled substance under the United Nations Single Convention on Narcotic Drugs of 1961. Sixty years later not much in regard to dispensing it has changed.

Unlike in Canada or Britain, methadone cannot be prescribed at a typical clinic in the United States. It can be dispensed only by federally regulated Opioid Treatment Programs (OTPs) that are required to provide counseling.

In California, finding and licensing a site can take a year and getting Medi-Cal certification once a provider is already operating requires additional time. The OTP also has to front the costs of physicians, nurses, counselors and security.

How did the COVID pandemic affect access to methadone clinics?

Access to methadone was expanded at the start of the COVID-19 pandemic to allow more patients to take home doses, rather than visit a clinic every day. A qualitative study of patients at an OTP in San Francisco indicates that broader access to treatment was not associated with harm. L.A. health officials have long been frustrated by the lack of methadone treatment on Skid Row, but opening a new clinic isn’t a simple task. 

What does the future of methadone clinics look like?

A promising piece of legislation currently in Congress, is H.R.6279, the Opioid Treatment Access Act of 2022, states: “Notwithstanding, a registrant that is dispensing narcotic drugs to individuals for maintenance treatment or detoxification treatment shall not be required to have a separate registration to incorporate one or more mobile medication units into the registrant’s practice to dispense such narcotics at locations other than the registrant’s principal place of business or professional practice, so long as the registrant meets such standards for operation of a mobile medication unit as the Attorney General may establish.”.