Podcast Episode Demystifying Methadone & Breaking Barriers in Opioid Treatment

In this After the Fact episode, Pew’s Substance Use Prevention and Treatment (SUPTI) team?talks about the stigma surrounding opioid use disorder, the barriers to care, and how expanding access to methadone can help.

Receiving methadone has been historically complicated. People typically needed to go to a "Opioid Treatment Program (OTP)" also known as a "methadone clinic" everyday to take the medication, but those rules quickly changed during the pandemic and the OTP's were forced to provide more take-home doses. Pew's SUPTI team, along with drug researchers around the country, jumped on the opportunity to answer a very important question: Was expanding access to methadone safe and effective?

The answer was yes. And through the research conducted during the pandemic and the work of the Pew's program team, the federal rules were made permanent. This was a positive step forward, but there is still a lot of work to be done. The story of access goes much deeper and the system of treatment remains difficult to access in most states.

Listen here to find out why:

Creating this episode was an eye-opening journey. The history of opioid treatment is profoundly complex, and access to treatment—or lack thereof—has been marred by stigma since the earliest regulations. Even the Harrison Act of 1914, which aimed to control narcotics, was subsequently criticized for criminalizing substance use instead of addressing drug dependence.

As I delved deeper into the history, I discovered that many efforts to control substance use occurred in the aftermath of wars, when veterans returning home needed pain management. Even methadone, the treatment discussed in the episode, was developed in the 1930s as a response to morphine shortages.(Source)

This trend of post-war drug use was true for the war in Vietnam too. According to the NIH, 1 in 5 of the enlisted troops were using heroin habitually at some time during their tour. In the early 1970's President Nixon took sweeping action to regulate drug use. He called drugs "public enemy number one" and spent hundreds of millions on enforcement and treatment. (Source)

Today more than 2 million Americans suffer from opioid use disorder, yet only about one in four receive any form of care. (Pew) Access to treatment is still more difficult than many realize and often depends on where you live.

Jordan Scott, an advocate for those with substance use disorders in Pennsylvania, shares her powerful personal story in the episode. She reflects on the incremental changes spurred by the pandemic, noting:

"We could draft the most perfect piece of legislation regarding methadone and get it passed through Congress. We still have to shift the culture, and that’s not easy. But I don’t want to be all doom and gloom. I remind myself to celebrate every single win because we’re talking about systemic reform, and it’s incremental."

The episode also features individuals working tirelessly in this field, including Dr. Brandee Izquierdo, director of behavioral health programs at Pew; Frances McGaffey, associate manager for Substance Use Prevention and Treatment at Pew; and Erin Davis, manager of communications at Pew. Their work goes beyond opioid use, taking a broader view to identify upstream prevention strategies. Dr. Izquierdo explains:

"Statistically, the average age of youth substance use is around 14. If we can provide interventions for our youth population, we might mitigate substance use disorders and better understand why people are falling into addiction in the first place."

Although work continues there is some evidence that opening up access is helping. According to recent CDC data, the number of opioid overdose deaths over the past year is the lowest in 4 years.?

I’m incredibly proud of this episode and the way it highlights a bright spot in this challenging work. Special thanks to Emily Chow , our amazing showrunner, and Magen Wetmore for co-producing this with me. Deep gratitude to Dr. Brandee Izquierdo , Frances McGaffey, Jordan Scott , and Erin Davis for their invaluable collaboration and expertise. Finally, a huge shout out to the creative team that helped bring this to life: Mary Markley , Julia Barnes , Alfred Schoeninger , Matthew Milios , Giuliana Pence , Dan LeDuc , and Antonio Villaronga .

To learn more visit: https://www.pewtrusts.org/en/research-and-analysis/articles/2024/12/13/the-long-journey-for-reasonable-opioid-care

#Methadone #OpioidTreatment #podcast

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