America's Top Addiction Researcher Says Doctors Should Be Allowed to Prescribe Methadone Directly

To reverse the addiction crisis, patients need access to more treatment options with fewer barriers. 

That’s why Dr. Nora Volkow, director of the National Institute on Drug Abuse and the United States’ top addiction researcher, recently voiced her support for deregulating methadone. 

What is methadone?

Methadone is one of three safe and highly effective medications to treat opioid use disorder.

The medication is an opioid agonist that binds tightly to the body’s opioid receptors. It has the most long-lasting therapeutic effects. Taken orally once daily, methadone reduces cravings and withdrawal symptoms. It’s most often used for patients who have a more severe opioid addiction. 

As powerful fentanyl continues to contaminate the US drug supply and intensify withdrawal symptoms for people using street opioids, methadone is more important than ever as a treatment option. 

But methadone is heavily regulated. Patients must report to a methadone clinic every day to receive their medication, usually in addition to counseling. For many people, this is a big barrier to accessing the treatment. 

Why is methadone access so restricted?

Those in favor of regulation point to the medication’s potency, and cite risks of misuse or overdose as reasons for the requirements. 

 “Roughly 3% of opioid overdoses involve methadone, according to a recent NIDA estimate,” STAT reports. “Though it’s not clear how many of those involved other opioids — and whether, in those cases, methadone was prescribed for pain or addiction, or obtained illegally.”

For someone with a severe substance use disorder, initiating methadone treatment is a safe and effective choice.

For these patients, it’s actually the lack of access to treatment that intensifies their risk of drug misuse, overdose, and even death.

“There are countries where physicians are providing methadone, and the outcomes are actually as good as those they get [at] methadone clinics,” Dr. Volkow said. 

In fact, we’ve already test-driven a version of this scenario in the U.S. During initial COVID-19 lockdowns, the Substance Abuse and Mental Health Services Administration (SAMHSA) relaxed regulations around methadone and allowed an increase in take-home doses for patients. Take-home doses nearly doubled during this time period, and no negative health outcomes were reported.

So should American doctors be allowed to directly prescribe methadone to patients? 

“There’s absolutely no reason why not,” Dr. Volkow said. “We have a pretty powerful health structure in the United States, and we should optimize it to maximize access to treatment for people with substance use disorders or other conditions. And that includes methadone.” 

Shatterproof believes effective addiction treatment can and should begin in a doctor's office. 

Rapid access to treatment is one of the most important of Shatterproof’s National Principles of Care. By immediately meeting patients where they are and reducing roadblocks on the road to recovery, more lives can be saved. 

Forcing patients to travel to specialty clinics and arrange each day around receiving their medication prevents them from living normal lives. By empowering doctors and even pharmacists to more easily dispense the medication when needed, more Americans can find and keep their footing in recovery.