Joint Letter Urging Congress to Pass the Modernizing Opioid Treatment Access Act (S. 644/H.R. 1359)

Dear Speaker Johnson, Majority Leader Schumer, Minority Leader Jeffries, Minority Leader McConnell, Chair Rodgers, Ranking Member Pallone, Chair Jordan, Ranking Member Nadler, Chair Sanders, and Ranking Member Cassidy:

The undersigned organizations, representing a broad base of stakeholders, write today to urge legislators to include S. 644/H.R. 1359 – the Modernizing Opioid Treatment Access Act (MOTAA) as a priority in any year-end legislative package. This bipartisan legislation would responsibly expand access to methadone treatment for opioid use disorder (OUD) in medical settings and areas where it is not available now. M-OTAA has gained increasing support in both the Senate and House and has already passed out of the Senate HELP Committee.

Opioid overdose accounts for over 70,000 preventable American deaths each year, more than the total number of American deaths in the Vietnam War. Methadone treatment has been shown to reduce the chances of dying by over 50% among patients with OUD. Beyond saving lives, methadone is superior to any other OUD treatment for retaining individuals in care, thus promoting sustained recovery and increased quality of life. Unfortunately, methadone is inaccessible to thousands of Americans who could benefit from it due to a 50-year-old provision in federal law, currently interpreted to require dispensing from federally certified Opioid Treatment Programs (OTPs, i.e., specialized ‘methadone clinics’). That is why passing M-OTAA this Congress is critical. M-OTAA would expand access to methadone treatment for OUD by enabling board-certified addiction specialist physicians to prescribe it in their usual clinic settings, utilizing patients’ existing pharmacies, under the oversight of the same federal regulatory bodies that already ensure safety monitoring at OTPs. Several regions in the US – including the entire state of Wyoming – do not have any OTPs. Confining methadone to OTPs effectively denies treatment to countless individuals who may benefit, disproportionately harming rural communities and other under-resourced health settings and fostering racial, gender, and geographic inequity. Passing M-OTAA would make it more likely that patients with OUD can access methadone care in their communities, with expert guidance and monitoring by physicians board-certified in addiction medicine or addiction psychiatry, without the onerous, non-evidence-based requirements and logistical barriers that often hinder key elements of recovery like employment and parenting.

Opponents of M-OTAA argue that methadone’s benefits are largely due to its frequent administration through the OTP system. Yet data from the COVID-19 public health emergency, which temporarily shifted methadone treatment to more unsupervised use to facilitate physical distancing, demonstrated improved treatment engagement and patient satisfaction, without causing increases in methadone-related overdoses. This research shows broadly that making it
easier for people to access their medication outside of unnecessarily rigid take-home restrictions can enhance treatment access without sacrificing safety. Acknowledging the benefits of more flexible methadone access during the pandemic, SAMHSA recently made the pandemic era OTP flexibilities permanent, representing an incremental step forward for methadone access. However, methadone remains fettered by antiquated regulatory and siloed treatment delivery systems that preclude it from meeting the immense and urgent need for OUD treatment in this country. The next step toward expanding patient access to methadone is through MOTAA’s empowerment of addiction specialist physicians to prescribe methadone for pharmacy dispensing.

We are unified in our support of M-OTAA and our strong belief that it will help turn the tide on the overdose crisis facing our nation, saving thousands of constituents’ lives while promoting treatment and recovery.

Sincerely,