Science

Top government researchers call for easier access to the drug that treats opioid use disorder:

Top addiction researchers in the US government are calling for wider regulation of methadone – a drug that could reduce dependence on opioids – rather than how it is currently made available.

Nina Volkow, director of the National Institute on Drug Abuse (NIDA), made the remarks on Wednesday during the annual STAT Summit, a two-day event that gathers experts from various health and medical fields. Volkow to address summit Wednesday afternoon about “confronting the addiction epidemic” in America

In his comments, reported by STAT News, Volkow was clear about his desire for methadone to be available by prescription. Currently, people who use methadone have to visit clinics daily to pick up the drug, and specialized clinics are few and far between in some areas.

methadone-distorted-daily
Methadone is given daily, often in liquid form, in specialized clinics.

Hoang Dinh Nam


“Absolutely no reason why not [to allow prescription of methadone]” Volkow told the summit, according to State News. “There are countries where physicians are providing methadone and the results are really as good as they [at] Methadone Clinic.”

Daniel Patrick Garrett, a methadone user and director and founder of Tennessee Harm Reduction, told CBS News that Volkow’s comments represent a positive step forward.

“It’s great. It’s great,” he said. “I wish it was sooner… I think these comments are a step in the right direction.”

Jeffrey Bratberg, a clinical professor at the University of Rhode Island College of Pharmacy, said he read Volkow’s comments with “great enthusiasm,” though he cautioned that physicians would need education and training to address opioid use disorder. How best to treat

“Methadone has saved countless lives in Canada, Australia, many countries in Europe and around the world, and has provided care safely and effectively in more places,” he told CBS News.

Volkow also called for allowing pharmacists to dispense methadone with a prescription from physicians. Previously, she has called for similar access, including a NIDA blog post in August in which she said methadone and similar treatments have been proven to have an effect.

“The full opioid agonist methadone (in use for half a century) and the partial agonist buprenorphine (first approved two decades ago) have proven to be life-saving, preventing patients from using opioids illegally, allowing them to lead healthy and successful lives.” are able to live. and facilitate recovery,” she wrote.

According to the Pew Research Center, in 2019, more than 400,000 people in the US took methadone for addiction treatment, out of an estimated 1.6 million people who experienced opioid use disorder that year.

In 2021, provisional data from the Centers for Disease Control and Prevention estimates that approximately 107,000 Americans will die of drug overdoses. The vast majority — about 81,000 — of those overdoses were opioids.

Methadone is a full-opioid agonist, and restrictions are in place to prevent diversion of the substance. But according to a 2021 report from NIDA, methadone diversion is most common when the drug is used to treat pain, not opioid use disorders.

The drug is present in some overdoses: In August of 2022, the substance was involved in 3.2% of overdoses, according to NIDA, but that’s a decline from January 2019, when it was present in 4.5% of overdoses. This decrease also overlaps with the loosening of methadone regulations by the Substance Abuse and Mental Health Services Administration during the coronavirus pandemic, and the NIDA data does not clarify whether other substances are involved in overdoses, or if those who die are opioid overdoses. Were taking methadone to treat use disorder or pain.

methadone controversy
Methadone can be given in liquid or pill form.

Niall Carson – PA Images/PA Images/Getty Images


Volkow’s comments also come amid a complicated landscape for treating opioid use disorder. A drug similar to methadone, called buprenorphine, is less strictly regulated and has similar effects, but doesn’t always work to treat dependence on fentanyl, as referenced in Volkow’s 2022 blog. a synthetic opioid that has entered the US drug supply. A 2021 study published in the Journal of Addiction Medicine found that people who use buprenorphine to treat fentanyl dependence may still experience severe withdrawal symptoms in some phases of treatment.

Food and Drug Administration as well recently warned about the risks of xylazine, an animal sedative and pain reliever that has entered the country’s illegal drug supply. Bratberg said, while the symptoms of xylazine use are similar to those of opioid use, the substance is not an opioid and therefore cannot be treated with drugs such as methadone.

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