National Alliance for Medication Assisted Recovery
Joycelyn Woods, Executive Director, firstname.lastname@example.org
Roxanne Baker, President, email@example.com
Ericka Lear PA NAMA 814-695-1014
July 26, 2010
Methadone Under Attack in Pennsylvania Voice Your Opposition
to Pennsylvania’s Methadone Accountability Package
In May Pennsylvania legislators announced at a press conference a number of bills that would be introduced. They claim that the intent is to increase safety, fiscal accountability and reduce the use of illicit methadone in an effort to reduce methadone overdose deaths the legislation is based on prejudice and ignorance. Methadone treatment is already strictly regulated at both the federal and state levels more than any medication or medical treatment. Nevertheless as in the past opioid treatment programs are the focus.
Here is what the legislation would do:
- Patients would need a designated driver when starting methadone or increasing dosage and get tested more often for other drugs that in combination with methadone impair driving.
Response: Numerous studies have reported that stable patients can perform as well as any non methadone patient driver. Federal and state regulations already require toxicology tests that are sufficient.
- Driving with more than the prescribed dose of methadone would constitute driving under the influence, and driving with methadone in combination with alcohol or other drugs would constitute "high-impairment" DUI.
Response: How would one determine if a patient has taken more than their required dose? There is no way.
- Methadone clinics must be open seven days a week - up from six - to curtail selling of "take home" doses.
Response: This is an unnecessary expense and should be decided and based on each individual OTPs needs.
- Clinics must give all startup patients an opioid antagonist drug The Antagonist Challenge Test.
Response: This is a barbaric practice that was used by a few states over thirty years ago. It is dangerous and most certainly will result in deaths.
- Clinics must test for a certain type of sedative and dispense methadone to patients only if a psychiatrist attests to its necessity.
Response: This is already a federal requirement and unnecessary.
- Patients couldn't take home doses for six months - up from three.
Response: Take home doses should be based on a patient’s responsibility and both the federal government and state have requirements that patients must meet which are quite rigid.
- The industry would need to create protocols to determine when patients are no longer benefiting methadone and clinics would discharge these patients.
Response: All patients benefit or they would leave.
- Patients would have funding for one year.
Response: Excellent if this applies to all patients encouraging persons to enter treatment.
- Patients would need to patronize the nearest clinic, to reduce alleged abuse of transportation subsidies.
Response: Most patients already do this.
- The state's methadone support system would be audited.
Response: The state already inspects, licenses OTP and responds to complaints in addition to SAMHSA accreditation and licensing and DEA requirements.
- The state would create a Methadone Death Review Team to gather data and figure out how to reduce the number of fatalities.
Response: NAMA Recovery would be in support of this. The team should include professionals, policy makers and patient advocates. Standards need to be developed about what constitutes a methadone death and those in combination with other substances.
- The state would develop screening standards for methadone candidates.
Response: The federal government and state already have requirements.
- The state would standardize intake procedures, warn potential patients of the risk and advise them of alternative strategies.
Response: The federal government and state have standard intake procedures.
- Treatment plans would lay out a schedule for getting off methadone within two years, unless there's good reason.
Response: Treatment plans should be focused on recovery getting one’s life together not a schedule to get off.
- Patients would get a minimum two hours counseling per week.
Response: OTP caseloads are greater than other types of addiction treatment. Counseling needs to be on using a who needs it basis. Forced counseling requirements diverts the counselors attention from patients that need their time thus insuring that nobody gets what they need. A counselor with the standard 50 patient caseload would have to work 100 hours a week.
- Clinics would screen patients for other drugs at the start and every two weeks.
Response: Regular screening is already part of the federal and state regulations. Every two weeks is costly and unnecessary.
- Patients couldn't drive for the first two weeks - or a month, if they test positive for other drugs.
Response: This would mean that no patients could not drive for the first 2 weeks since they must test positive for drugs at admission.
- Clinics must develop plans to curtail illicit sale of methadone by patients.
Response: The federal regulations already require this of each program as well as most states.
- Patients may take home doses only if it's consistent with a treatment plan, there's minimal risk of abuse, it would help in treatment and the client hasn't abused take home previously.
Response: Actually federal and state requirements already require this and including an additional 6 requirements.
- Programs could discharge patients who sell doses or who threaten or commit violence.
Response: These are the two reasons that programs already administratively discharge patients.
Sources: State Sens. John H. Eichelberger Jr., R-Blair, Mike Stack, D-Philadelphia, and Kim Ward, R-Westmoreland.
Methadone maintenance treatment has been thoroughly researched and carefully evaluated for over four decades. It has received more scientific scrutiny and evaluation than any other medical treatment or human service program. Most evaluations have shown that, when correctly implemented, the treatment is capable of producing remarkable improvements in patients who were previously dysfunctional heroin addicts. Methadone maintenance patients throughout the world have been restored to productive lives, relations with families and children have been reestablished, many have furthered their educations, obtained employment and improved their physical and mental health. Nevertheless, contrary to scientific evidence, methadone maintenance treatment remains a controversial issue among substance abuse treatment providers, public officials and policy makers, the public at large and the medical profession itself.
Download the following:
Copy of this press release
Letters sent by NAMA Recovery
Announcement the Methadone Accountability Package
What Can You Do? and Sample Letter
List of Pennsylvania's House Represenataives & Addresses
List of Pennsylvania's Senators & Addresses
Sign the Petition Opposing the Methadone Accountability Package