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Some people being treated for opioid use disorder will soon be able to take their methadone medication home or schedule a telehealth appointment in a way they weren’t able to do before.
For the first time in more than 20 years, the U.S. Department of Health and Human Services is significantly updating the regulations governing opioid treatment programs (OTPs). Accreditation and accreditation program that provides medications such as methadone and buprenorphine to people diagnosed with opioid use disorder. These are the only accredited programs that allow people to access methadone treatment. Drugs approved to treat opioid use disorder By reducing craving and withdrawal symptoms and blunting or blocking the effects of opioids.
a final ruleScheduled to be published on Friday, the OTP regulations will be updated. The updates include expanding eligibility for patients to take home doses of methadone treatment, starting treatment via telemedicine, and allowing nurses and physician assistants to order the drug.
HHS Secretary Xavier Becerra said these updates are aimed at “meeting people where they are” and making treatment more accessible.
“If you’re looking to take care of a family member, get a new job, go back to school and continue your recovery, being able to receive treatment via telehealth is a life-changing way to help someone else’s life.” “Stay well,” said Rachel Pryor, Counsel to the Secretary.
“Being able to take your methadone dose home eliminates the need to travel back and forth to a methadone clinic every day, helping you keep your job and get your life back,” she said. “We just want to help people keep their lives together.”
Becerra has heard firsthand how quickly life can spiral out of control. On Wednesday he I met four young peoplethrough drug abuse prevention organizations. CADCAthose affected by the nation’s ongoing drug use crisis.
Ladaric Smith, Morehouse College student In Atlanta, he told Becerra about a friend who started vaping at a young age, then turned to drugs, and is now in prison. Smith said they still keep in touch and that her friend never intended for her life to spiral like that.
“We need to do more to catch people before they get out of control, which could result in your friend going to prison or dying from an overdose.” said Becerra. “To do that, we need to know how to reach people better.”
During the COVID-19 pandemic, regulations regarding the use of telemedicine to treat opioid use disorder have been relaxed, and recent updates to OTP regulations have made these telemedicine options permanent, Pryor said. Stated.
“This final rule represents a historic modernization of OTP regulations that will help connect more Americans to effective treatment for opioid use disorder,” said HHS Assistant Secretary for Mental Health and Substance Use. said Dr. Miriam Delphine Ritmon, leader in abuse and mental health issues. the Health Services Administration, or SAMHSA, said in a written statement.
“While this rule change will help everyone in need of treatment, it will especially impact rural and low-income populations where reliable transportation is difficult, if not impossible.” she stated. “In short, this update will help those most in need.”
Access to medications to treat opioid use disorder is an ongoing issue for people in the United States, said Dr. Noah Kracik, assistant professor in the Department of Population Health at New York University’s Grossman School of Medicine and member of the Society for Health Sciences. Stated. Center for Opioid Epidemiology and Policyis not affiliated with HHS.
Recent efforts by authorities to expand access to treatment are “fantastic,” Krawczyk said. However, there is still work to be done to ensure that both harm reduction tools and medicines are available to those who need them most. for example, Not all counties in the US There is an opioid treatment program, she said. Geographical disparities impact access.
“Historically, the way opioid use disorder treatments have been regulated has made it very difficult to spread them. For example, the most evidence-based treatments that have been available since the ’70s The law on methadone is very restrictive. In the United States, this treatment is currently only available through opioid treatment programs, which have very clear licensure and are not available in most counties. It’s a special clinic that’s not available,” Kracik said.
“There’s a lot of stigma against these drugs,” she says. “People have a negative concept about methadone. They think that if you’re taking one of these drugs, you’re replacing one drug with another, but these drugs This is a very big misconception because it is very effective and helps people achieve various goals, including survival.”
The final rule updating OTP regulations is the latest in a series of recent steps taken by the Biden-Harris Administration to combat the nation’s ongoing overdose epidemic.
HHS announced Thursday that certain federal grants are now available to purchase test strips for xylazine, an animal sedative commonly known as tranq. This means that grant recipients such as local health departments, emergency responders, and health care systems can use this funding to purchase xylazine test strips as a tool to prevent overdoses and other drug-related harms. means.
“We want to ensure that communities have the resources to purchase these test strips so that individuals can know what’s going on with their drug supply,” said Capt. Christopher Jones, director of the SAMHSA Substance Abuse Prevention Center. I am thinking of doing so.”
Test strips are commonly used to detect whether recreational drugs contain fentanyl. xylazine test strips It is becoming increasingly widely available. Fentanyl is powerful synthetic opioid It is about 100 times more potent than morphine and 50 times more potent than heroin. Xylazine is not an opioid, but a sedative commonly used in veterinary medicine.
“In 2021, we made it clear to these grant recipients that the use of fentanyl test strips is permissible. It means the recipient of the money is allowed to use it,” Pryor said. “Xylazine, along with fentanyl, is a very scary thing that’s out there today.”
When xylazine is added to fentanyl products or other drugs, the risk of overdose can increase.
“Xylazine adds to the effects that opioids already have in that it adds a sedative effect, slowing breathing and putting you at risk of overdosing. Because of that, it’s more dangerous,” Kracik said. “This is definitely an emerging issue and we need to learn and do more in terms of getting test strips and educating people about the drug supply and how to deal with xylazine medically. there is.”
The White House has declared fentanyl, including xylazine, to be a hazardous substance. New threats facing the United States. A report released last year by the U.S. Centers for Disease Control and Prevention found that among 21 jurisdictions, the monthly share of fentanyl overdose deaths in which xylazine was detected will increase from about 3% of deaths in January 2019 to June 2022. It turned out that it rose to nearly 11% in April. This corresponds to an almost 4x increase.
Overall, the number of drug-related overdose deaths in the United States continues to rise each month, but the pace appears to be slowing. The death toll hit a record high in May and remained largely unchanged in the months leading up to August.
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according to Preliminary data More than 112,000 people died from drug overdoses in the 12 months ending in August, according to the CDC’s National Center for Health Statistics.
“Drug overdoses are pervasive in every corner of society, taking lives and inflicting untold suffering on families and communities, which is exactly why President Biden has made it a key priority of his unified agenda. We have made important progress, but there is still much work to do,” Becerra said in a written statement.
“But we have the tools, evidence-based strategies and a common national effort to combat the overdose epidemic,” he said. “HHS is focused on all the solutions needed to address substance use. We will continue to use every tool at our disposal to tackle this problem and save lives. It includes a focus on prevention as well as expanded treatment and engagement of people who suffer from the disorder.”
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Earlier this week, HHS, through SAMHSA, released an updated toolkit on how to prevent and respond to overdoses.latest version Overdose Prevention and Response Toolkit Includes appendices for specific audiences, such as drug users, people taking prescription opioids, first responders, and health care workers.
These latest HHS actions, including the final rule for opioid treatment programs, are expected to reduce overdose death rates, Jones said.
“With over 110,000 overdose deaths, we need to pull all the levers necessary to curb overdoses and ensure that drug treatments for opioid use disorder are based on the strongest evidence we have. “It’s one of the best practices,” he said. “We know this reduces the risk of death by 50%. Therefore, this rule modernizes the way drug treatment is delivered in opioid treatment programs and makes it accessible to more people.”