Advocacy Alert: SAMHSA Extends the Methadone Take-Home Flexibility for One Year While Working Toward a Permanent Solution

December 9, 2021

via SAMHSA

The Substance Abuse and Mental Health Services Administration (SAMHSA) is extending the methadone take-home flexibilities for one year, effective upon the eventual expiration of the COVID-19 Public Health Emergency. This exemption is a continuation of the take-home medication flexibilities that SAMHSA put in place in March 2020 and is in keeping with the newly announced Health and Human Services (HHS) Overdose Prevention Strategy. SAMHSA is also considering mechanisms to make this flexibility permanent.

The March 2020 exemption was issued to protect public health by reducing the risk of COVID-19 infections among patients and health care providers. While the take-home flexibility achieved that goal, it also proved to have other benefits for patients in Opioid Treatment Programs (OTP). SAMHSA allowed Opioid Treatment Programs to dispense 28 days of take-home methadone doses to stable patients for the treatment of opioid use disorder, and up to 14 doses of take-home methadone for less stable patients, who the OTP determines can safely handle this level of take-home medication.

"The methadone take-home flexibility has received widespread support among patients, service providers, and state authorities," said HHS Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Ph.D., the leader of SAMHSA. "Innovative treatment solutions like this are in line with the Biden-Harris Administration's efforts to make it easier to connect Americans to effective recovery solutions and support."

Preliminary studies show that nearly two years after the exemption was first granted, stakeholders report increased engagement with treatment, improved patient satisfaction, and very few incidents of misuse or diversion of medication. The flexibility promotes individualized, recovery-oriented care by allowing greater access for people who reside farther away from an OTP location or who lack reliable transportation. Fewer visits also means people generally have more time to work, care for loved ones, and conduct other routine activities in their daily life.

"This may also reduce stigma for those seeking treatment, while providing more equitable access to care as telehealth in OTPs is expanded," added Dr. Delphin-Rittmon.

For more information about the methadone flexibilities, please read this guidance with frequently asked questions.

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