Tennessee Proposes New Regulations Harmful to Patients, Quality Treatment and Best Practice

National Alliance for Medication Assisted Recovery
 
Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA

On December 19, 2011 the state of Tennessee is proposing new regulations for methadone. A hearing is scheduled for January 5, 2012 (State will accept written comments until January 19th).

Here are some of the proposed regulations:

The screening process: Patient must have two documented unsuccessful attempts at detoxification or drug-free treatment within a 24-hour period. (Page 14)

Dose: Doses greater than 100 milligrams of methadone requires written notification to the SOTA, greater than 120 milligrams need SOTA approval prior to administration and greater than 140 milligrams shall include a peak and trough test. (Page 21)

Take Home Medication: Patients on a monthly with 1 positive drug screen will be put on a weekly schedule for two weeks or more. (Page 24)
.
Administrative Discharge for Drug Use: A fourth positive drug test in 6 months will result in immediate discharge or ASW. (Page 26)

Central Registry: A propsed Central Registry with no comment on how confidentiality will be maintained or even where it will be stored. (Page 29)

It must also be noted that many new proposals in the new regulation are good treatment, however they appear cumbersome resulting in excessive paper work so counselors do not have quality time to see patients. There must be a better way to do it such as the federal government whose regulations are very basic while the treatment requirements are in the accreditation guidelines. This also allows the federal the make changes when necessary without approval from Congress. Like the first federal regulations the Tennessee proposed regulations are written with good intent but the result is likely not to be what was intended.

Tennessee Needs Our Help

Patients and residents of Tennessee that are family please follow the instructions in the attached Announcement. A copy of the legislators in the state Senate and Assembly is included. You should also send a copy to the Secretary of State and TN SOTA whose addresses are below.

Out of State Patients the Hearings scheduled for January 5, 2012 needs to have patients write their feelings and why some of these regulations hamper recovery rather than support it. You can send a letter to the following:


DO NOT SEND TO:

Tre Hargett
SECRETARY OF STATE
State Capitol
Nashville, TN 37243-1102
Phone: (615) 741-2819

MAIL LETTERS TO:

Kurt Hippel, Esq.
Tennessee Department of Mental Health
Office of Licensure and Review
4255th Ave. North, 3rd Floor
Cordell Hill Building
Nashville, TN 37243

Jason Carter
TN SOTA
Cordell Hull Bldg. 5th Floor
425 5th Ave. North
Nashville, TN 37243
Phone: (615) 532-6736
Fax: (615) 741-6602
jason.carter@state.tn.us

Download Announcement
Download TN Senate Members
Download TN Assembly Members
Download Proposed TN Regulations
Download Press Release (PDF)

Revised: January 6, 2012

Governor LePage Believes Maine Should Stop Paying for Methadone Help Change His Mind

National Alliance for Medication Assisted Recovery
 
Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA

He Says:

Maine Care will pay for Methadone when most insurance carriers won't. Someone can go to the Discovery Center in Bangor. They can request an increase and receive it that day. They have no programs for decreasing or getting off methadone. They compare it to having Diabetes! On top of paying for methadone, they all get reimbursed for travel from PenCap! It is a legal drug dealer and we the tax payers are footing the bill!

We Have Heard It Before, Haven’t We?

During December many advocates primarily professionals have written letters to the governor. However, as you can see from his comments he has not been convinced and is obviously cynical about the information he has received. Usually NAMA Recovery does something similar but instead our letter voices the concerns of patients on behalf of the patients being affected, or in this case methadone patients in Maine. Our letter notes the same evidence and research about methadone that the advocates that are professionals use. Our new project Stop Stigma Now even included a DVD with the letter. But NAMA Recovery can do something different and perhaps better because we can tell the governor how methadone has changed our lives.

What Can We Do?

Instead of writing the usual letter we are asking patients to write a letter to the governor to tell him that methadone does work and that we are the proof!

And we can ask our professional friends to hand out this information to patients. Programs can help by telling patients.

See Attached Instructions
Download Press Release (PDF)

NAMA-Recovery Demands Rescinding of Ban on Use of Federal Funds for Syringe Exchange

National Alliance for Medication Assisted Recovery
 
Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA


The National Alliance for Medication Assisted Recovery (NAMA-Recovery) demands an immediate reversal of the ban on use of federal funds for syringe exchange imposed in the omnibus spending bill. The FY 2012 omnibus, passed by both houses of Congress in December, reinstates a complete ban on use of federal funding for syringe exchange programs. This reversal of federal policy represents a huge step backward in the fight to eliminate hepatitis C and other blood-borne viruses, despite numerous studies demonstrating that access to sterile syringes reduces the incidence of HIV and viral hepatitis and is good public health policy benefiting communities across our nation.

Access to sterile syringes has been proven a cost effective and life saving measure. Syringe exchange programs also connect people who use drugs to constant and repeated contact with substance use treatment and medical care. For the two years since the lifting of the original ban, syringe exchange programs around the country have worked closely with local law enforcement and health officials to make syringe access a part of their communities’ HIV and viral hepatitis prevention strategies to great effect. This setback will result in nothing less than an avalanche of new infections and dramatic increases in medical costs at a time of great financial strain for individuals and governments.

NAMA-Recovery Executive Director Joycelyn Woods said “In this times when the cost of medical care is rising it is prudent and good public health policy to provide access to sterile syringes. Even more important are the lives including families and children that will be affected by these medieval attitudes.” Woods continued, “NAMA-Recovery will continue our support for syringe exchange and strategies needed to prevent a new infections among the next generation of injection drug users. We implore Congress and the Administration to reverse this policy.”

The National Alliance for Medication Assisted Recovery is an organization of patients, healthcare professionals, friends, and associates working together for greater public understanding and acceptance of the use of medication assisted treatment in the recovery from opioid addiction. NAMA-Recovery, founded in 1988, has Chapters throughout the United States and International Affiliates in 19 countries across the globe.

In Recognition of Recovery Month 2011 NAMA Recovery with FAVOR and the ATTC Announce “In My Own Words..." Essay Contest

National Alliance for Medication Assisted Recovery
Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA

For Release:
August 26, 2011

In Recognition of Recovery Month 2011 NAMA Recovery
in collaboration with FAVOR and the ATTC National Office
Announce the 4th Annual “In My Own Words…” Essay Contest
On Medication Assisted Treatment and Recovery

NEW YORK, NY, August 26, 2011 – The Addiction Technology Transfer Center (ATTC) National Office, in partnership with Faces & Voices of Recovery and NAMA Recovery, announces the 4th annual “In My Own Words…” essay contest. This year the essay is on Medication Assisted Treatment (MAT), such as methadone or buprenorphine for opioid addiction and acamprosate or naltrexone for alcohol addiction, and recovery to share YOUR STORY.

As a person in long-term recovery with the assistance of MAT, you have a unique perspective to share about your own journey. Your story highlights how medication, in combination with counseling and other recovery support, can transform lives.

The contest begins September 1, 2011 and ends October 1, 2011 in recognition of Recovery Month. In your own words, write an essay (250 words or less, typed, double spaced in 12 point font) in which you tell us about your medication-assisted recovery experience. Please use the following statements as the basis for your response:

How MAT has supported my recovery from addiction...
I continue to be committed to recovery because...

The First Place Winner will receive $500, Second Place $250 and Third Place $100.

The top 20 essays will be compiled in a commemorative booklet and available to the public on the ATTC Network (www.ATTCnetwork.org) and Essay Contest Partners’ Websites, www.facesandvoicesofrecovery.org and www.methadone.org. Previous contests have focused on behavioral healthcare professionals, High School/ College students in recovery, and families. Essays from these contests can be found at: ATTCnetwork.org

For more information about the essay contest and how to enter it see the attached flyer.

###

Download Flyer

Nominations Open Richard Lane/Robert Holden Patient Advocacy Award

National Alliance for Medication Assisted Recovery
Press Release

Contact Persons:
Joycelyn Woods, Executive Director, edirector@methadone.org
Roxanne Baker, President, president@methadone.org
Phone/Fax: 212-595-NAMA

For Release:
July 1, 2011

Nominations Open
Richard Lane/Robert Holden Patient Advocacy Award

NAMA Recovery is proud to announce that nominations are now open for the Richard Lane and Robert Holden Patient Advocacy Award.

The History

Richard Lane was a long-term heroin user who, upon release from prison in 1967, was instrumental in establishing one of the Nation’s first methadone treatment programs, ManAlive in Baltimore, Maryland. In 1974, he became the Executive Director of ManAlive and remained in that position until his death in 1994. He also served as Vice President of the American Methadone Treatment Association (now AATOD) and as Vice Chairman of the Governor’s Council on Alcohol and Drug Abuse in Maryland. Richard was a passionate advocate for methadone treatment and, by disclosing his own treatment experiences, provided inspiration to patients and colleagues alike.

Robert Holden was also a recovering heroin user, who later became the Director of PIDARC, an outpatient methadone treatment program in the District of Columbia. He was a friend of Richard Lane and succeeded Richard Lane’s term of office as the Vice President of the American Association for the Treatment of Opioid Dependence.

This award was established in 1995 and recognizes extraordinary achievements in patient advocacy.

The Criteria for Nomination

The following criteria should be applied in making your selection:

• Only one (1) nominee can be submitted to the Conference Awards Committee. There may be a number of nominees, who will be fielded by NAMA Recovery in the medication assisted treatment MAT (i.e. methadone and/or buprenorphine) patient advocacy movement, however, NAMA Recovery will be responsible for submitting only one (1) “consensus” nominee to receive this honor.
  




• The nominee must have been involved in the field of methadone and/or buprenorphine advocacy for a period of five (5) years.
  




• The nominee must have been actively engaged in methadone and/or buprenorphine advocacy for a period of five (5) years.
  




• The nominee must have made meaningful and consistent contributions, which have had a significant impact on opioid treatment within a state or region of the United States.
  




• For each nominee a Nomination Form must be completed and submitted with two (2) Letters of Support. The Nomination Form is included with this announcement and can also be downloaded from the NAMA Recovery website: http://www.methadone.org/richard_lane_award.html
  




• Additional information about the award can be found at the NAMA Recovery website http://www.methadone.org/richard_lane_award.html.
  




• NAMA Recovery will be responsible for collecting all the submissions for nomination including a Selection Committee that will decide on the final candidate. The Candidate’s Name, Nomination Form and at least two (2) Letters of Support describing the nominee’s achievements will be submitted to the Awards Committee for the final approval.
  




• The Deadline for Submission is Monday, August 22, 2011. The completed Nomination Form along with at least two (2) Letters of Support should be sent to Joycelyn Woods at edirector@methadone.org.
  

Previous Winners of the Award

1995, Arizona Richard Lane
2001, St. Louis Joycelyn Woods
2007, Atlanta Anthony Scro
2009, New York Walter Ginter
2010, Chicago Lisa Mojer-Torres

This Award will be bestowed upon the recipient at the Awards Banquet Ceremony during AATOD's next National Conference which will convene in Las Vegas.

The recipient will be provided with a roundtrip Coach Class airfare in addition to up to two (2) nights in the hotel. The individual will also be able to attend the Conference (May 5-9, 2011).

Deadline: August 22, 2011
Email Nominations To: Joycelyn Woods
edirector@methadone.org

If you have any questions about the award contact Joycelyn Woods at edirector@methadone.org or by telephone at (718) 742-7804.

Download Press Release

Download Nomination Form

Download Criteria

Go to Award Webpage

PRESCRIPTION DRUG ABUSE PREVENTION AND TREATMENT ACT OF 2011

(S. 507)

BILL SUMMARY

PROBLEM: LACK OF EDUCATION

Solution: Provider Education

• Background: Currently, there are no specific education or certification requirements for practitioners to fulfill before prescribing methadone or other opioid pain relievers. Linking education to the existing Drug Enforcement Administration registration system would help ensure that physicians get the education and support they need to safely prescribe these powerful drugs.

• Proposed Change: Require the Department of Health and Human Services (HHS) to establish a mandatory and comprehensive practitioner education program for methadone and other opioids, in collaboration with relevant professional societies. Completion of this education program will be required as part of the Drug Enforcement Administration’s (DEA) current registration process used to authorize practitioners to prescribe, dispense and administer controlled substances.

• Reason for Change: Under the Controlled Substances Act, the DEA must register practitioners who prescribe controlled substances like methadone or other opioid pain relievers. However, there is no federal education requirement for those who prescribe these drugs. For example, methadone stays in the body after its pain relieving effect has worn off – resulting in a greater risk of overdose. It is necessary for practitioners to be properly educated about the complicated nature of methadone and other opioid pain relievers so that they can properly and safely prescribe these powerful drugs.

Solution: Consumer Education

• Background: There is a knowledge gap about the dangers of prescription pain relievers and how to avoid diversion and misuse. Forty percent of teens believe that prescription drugs, even if they are not prescribed by a doctor, are “much safer” to use than illegal drugs. Sixty-four percent of teens (12-17) who have abused pain relievers say they got them from friends or relatives, often without their knowledge.

• Proposed Change: Provide competitive grants to states and community organizations to educate consumers and communities about safe and appropriate use of prescription pain relievers, including methadone.

• Reason for Change: Consumers need to know how to understand the dangers of prescription drug misuse as well as how to safely use controlled substances when prescribed for them. For example, methadone has a long half-life of between 8 - 59 hours, however, the analgesic effect is usually only felt for between 6 - 12 hours. This long half-life coupled with a significantly shorter analgesic effect means that is possible for dangerous levels of methadone to accumulate in the body as consumers take additional methadone seeking pain relief. High levels of methadone can lead to respiratory distress, cardiac arrhythmia and even death.

PROBLEM: LACK OF WIDESPREAD CLINICAL GUIDELINES

Solution: Controlled Substances Clinical Standards Commission

• Background: There is widespread agreement that prescribers need better information and guidelines for safe prescribing of controlled substances including methadone and other opioids, and that health care professionals face significant challenges when trying to balance the need for legitimate pain relief with the need to prevent misuse of opioid pain relievers -- yet widely agreed-upon clinical guidelines are not in use.

• Proposed Change: Create the Controlled Substances Clinical Standards Commission to establish patient education guidelines, appropriate and safe dosing guidelines for all forms of methadone, benchmark guidelines for the reduction of methadone abuse, appropriate conversion factors for transition patients from one opioid to another, guidelines for the initiation of methadone for pain management, and consensus guidelines for the treatment of pain management with prescription opioids. In creating such guidelines, the Clinical Standards Commission would be required to collaborate with outside experts, health care professional societies, patient representatives, and others.

• Reason for Change: As the number of methadone prescriptions has significantly increased in recent years, so has the number of methadone related deaths. A standards commission will compliment the current oversight structure by providing evidence-based information to improve guidance for the safe and effective use of opioid pain relievers as well as methadone for both pain management and opioid addiction treatment.

Solution: National All Schedules Prescription Electronic Reporting Act (NASPER)

• Background: Currently 38 states have enacted legislation requiring prescription drug monitoring programs (PMPs), and many states were able to fund these initiatives in part from grants available through the Harold Rogers Prescription Drug Monitoring Program. A second program created in 2005 through the National All Schedules Prescription Electronic Reporting Act (NASPER), would provide even more assistance, but has only recently been funded with $2 million in each of FY2009 and FY2010.

• Proposed Change: This legislation would appropriate $25 million a year for NASPER to establish interoperable prescription drug monitoring programs within each state.

• Reasons for Change: The Harold Rogers Prescription Drug Monitoring Program allows states to establish their own requirements with regard to controlled substances monitored and information shared between states. NASPER goes a step further in mandating that all state prescription drug monitoring programs submit data for Schedule II, III, and IV drugs and requires interoperability between states to reduce diversion and doctor shopping across state lines.


PROBLEM: NO UNIFORM REPORTING SYSTEM FOR OPIOID-RELATED DEATHS

Solution: National Opioid Death Registry

• Background: There is no comprehensive national database of drug-related deaths in the United States, nor is there a standard form for medical examiners to fill out with regard to opioid-related deaths.

• Proposed Change: Create a National Opioid Death Registry to track all opioid-related deaths and related information. Also, establish a standard form for medical examiners to fill out which would include information for the National Opioid Death Registry.

• Reasons for Change: Since there is no comprehensive database of methadone-related deaths, the number of deaths may actually be underreported. In order to truly reduce the number of methadone-related deaths, quality data must be collected and made available.

MISCELLANEOUS PROVISIONS

• Improving Patient Safety: Opioid treatment programs will be required by law to make acceptable alternative arrangements for the safe distribution of methadone for patients who are not permitted take home doses on days where the clinic is closed.

• Moratorium on 40-mg Methadone Diskettes: For two years, no provider may prescribe and no pharmacy or opioid treatment clinic may distribute 40-mg methadone diskettes unless the prescription or dispensation is consistent with DEA policy.

• Annual Report on Effectiveness: No later than September 30, 2012 the Secretary will report to Congress the effectiveness and evaluate the success of efforts to reduce opioid addiction and methadone-related deaths including the impact of health care provider and patient education.

Download Legislation

Download FACT SHEET

Lisa Mojer-Torres (1956-2011)

National Alliance for Medication Assisted Recovery
Press Release
Contact Persons:
Roxanne Baker, President, president@methadone.org
Joycelyn Woods, Executive Director, edirector@methadone.org
Phone/Fax: 212-595-NAMA

 

It is with great sadness that the Board of Directors of the National Alliance for Medication Assisted Recovery (NAMA Recovery) announces the passing of our friend and member of the board Lisa Mojer-Torres, Esq. We will miss her deeply.

Lisa Mojer-Torres, 54, of Lawrenceville, NJ lost her battle with ovarian cancer April 4, 2011. Daughter of the late Joseph R. Mojer, Lisa is survived by her beloved husband, Rolando Torres Jr.; her two loving sons, Matthew and Liam Torres, and her mother, Gwendolyn Walters Mojer. Also surviving are her brothers, Steven Mojer and his wife Maryjane and Michael Mojer and his wife Kim; a sister-in-law, Vivian Torres; nephews, Tyler and Jessie Mojer and nieces, Heather and Leah Mojer and Emily Jordan.

She received her B.A. from Boston University and her J.D. from the University of New York. Lisa was licensed to practice law in both New York and New Jersey. She passed the bar exam for both states the first time and months apart an incredible accomplishment for any student of law. However upon passing the bar exam she was informed that because she was taking methadone she would have to be supervised. Lisa was incensed because she had done nothing wrong. She challenged the decision and won the right to practice law in both states without supervision. This experience was the motivating force for her decision to use her knowledge of law for advocacy.

Lisa served as the recovery advocate for the New Jersey Division of Addiction Services (DAS). She was proud of setting up the Citizens’ Advisory Council (CAC) whose purpose was to involve consumers and families in improving the current system of care.

She served on the board of NAMA Recovery (formerly the National Alliance of Methadone Advocates) three times. As 2nd Vice President she was one of the founding directors of NAMA Recovery from 1992-94. She was part of the Interim Board in 1998-99 and assisted in NAMA Recovery's re-organization. This past fall she joined the board for a third time to provide her legal expertise.

But her greatest contribution and life's work was helping medication assisted treatment (MAT) patients with legal issues. It was mostly Pro Bono. There are hundreds, probably thousands of MAT patients and their families who benefited from these cases because agencies were educated about the benefits of MAT.

In 1993 she was a member of the Committee to Study the Federal Regulation of Methadone Treatment that resulted in the 1995 Institute of Medicine's report, Federal Regulation of Methadone Treatment. From 1998 to 2002 she served on the SAMHSA Center for Substance Abuse Treatment’s National Advisory Council. She served as a founding member and first chairperson of the Faces and Voices of Recovery (FAVOR) and was one of the persons responsible for insuring that persons receiving MAT were considered "in recovery". In 2005, Lisa participated in her third Institute of Medicine of the National Academies Committee Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. This Committee’s findings are published in the 2006 National Academies Press, Improving the Quality of Health Care for Mental and Substance-Use Conditions.

Lisa was the recipient of many national awards for her advocacy work. In 1996, she received the first Public Service Award presented by the National Institute of Drug Abuse (NIDA) for her efforts to educate others about the effectiveness of methadone treatment. In 2006, she received the Johnson Institute's Award, America Honors Recovery. And this past fall, she received the Richard Lane and Robert Holden Patient Advocacy Award at the American Association of Opiate Addiction Treatment Conference (AATOD).

Her most recent work was the article on Recovery Orientated Methadone Maintenance co-authored with William L. White, M.A.

FAVOR will be creating a page on their website to commemorate her life and incredible contributions to our recovery advocacy movement. Please email Whitney O’Neil at woneill@facesandvoicesofrecovery.org with any pictures, stories or remembrances that you would like to share.

You can read William White's interview with Lisa at:
Lisa's Interview

The paper by William White and Lisa Mojer-Torres Recovery Oriented Methadone Maintenance can be downloaded at:
www.williamwhitepapers.com

The family strongly suggests that in lieu of flowers, memorial contributions in Lisa's memory be made to Hospital at the University of the Pennsylvania, Ovarian Cancer Research, 3400 Spruce Street, Philadelphia, PA. 19104.