Notice for Proposed Rule Making – Change in Federal Oversight for Methadone Treatment

General Barry R. McCaffrey, Director of the Office for National Drug Control Policy (ONDCP), released the Notice of Proposed Rule Making (NPRM) on July 22, 1999, in conjunction with Dr. Westley Clark, Director, Center for Substance Abuse Treatment/SAMHSA. This document provides notice to providers and regulatory agencies throughout the United States of the federal government’s intent to transition authority from FDA oversight of methadone treatment to a CSAT/SAMHSA managed accreditation system. This system will operate under the aegis of CSAT and draft accreditation guidelines are being pilot tested in approximately 180 programs in 15 states by both JCAHO and CARF.

The Association forwarded two survey documents to methadone treatment providers (Board of Directors of the Association) and all of the State Methadone Authorities, soliciting information which was included in the Association’s testimony on November 1, 1999 when the federal interagency hearing convened to receive guidance from the field.

The survey to the Board solicited information about the direct and indirect costs, which are associated with accrediting methadone treatment programs. These programs have already been accredited in a number of states. The second survey was forwarded to the State Methadone Authorities, attempting to understand how the states view the needs of methadone treatment programs, including the number of programs that are deficient according to state’s monitoring practices in addition to programs that are in need of programmatic technical assistance and physical plant improvements.

The results of these surveys were included in the Association’s formal response to the NPRM, which were presented during the hearing of November 1, 1999.

Six states have indicated that 21 treatment programs are currently in violation of FDA regulations. Ten states have reported that 45 programs are in violation of current state regulations. Five states have indicated that 5 programs are in danger of closing. Twenty-nine states have indicated that 155 programs need programmatic technical assistance. Sixteen states have indicated that 25 programs need physical plant improvements. Twenty-one states rated 172 programs as excellent. Thirty states rated 209 programs as good. Twenty-five states rated 145 programs as fair and 11 states rated 36 programs as poor.

The Association’s support for the development of standardized outcome measures and evaluating the efficacy of methadone maintenance treatment can be traced back to the development of the State Methadone Treatment Guidelines. These Guidelines were published in 1993 by CSAT following the release of several critical reports concerning the effectiveness of methadone treatment programs in the United States.

The Association’s support for accreditation is also rooted in the fact that a major segment of the healthcare system in the United States is being reviewed through such accreditation standards. We believe that accrediting methadone treatment will offer the potential of embracing such treatment as part of mainstream medicine in the United States.

It appears that the direct cost of accrediting a methadone treatment program ranges from $7,500.00 – $11,000.00 including the cost of an application (CARF only) and the cost of the on-site survey. Our Association is urging the federal government to develop a multi-year, multipurpose fund to ensure that methadone treatment programs and patients will not be adversely affected by the implementation of accreditation standards, ultimately decreasing access to care through program closure.

Such a fund would be implemented on a needs based model, which would pay for the cost of the survey. The fund would also provide financial and technical support in implementing improvements as a result of the accreditation survey.

Such improvements could be the training of personnel, implementing new information management systems and executing physical plant improvements.

The Association is aware that individual states have promulgated regulations, governing the practices of methadone programs in their respective jurisdictions. In certain states, the specific interests of elected and appointed officials have driven the complexity of particular state regulations. Eight states still do not have any methadone maintenance treatment programs, however, we have been informed that New Hampshire has recently opened an outpatient methadone to abstinence program (180 days).

We have recommended that the federal agencies, which will take primary responsibility for implementing accreditation, work in conjunction with the State Methadone Authorities to maximize the use of one accreditation standard. The Association is hopeful that individual states will adopt accreditation body findings once it is determined that the accreditation surveys are responding to the needs of the States in ensuring that good quality care is being provided within the methadone treatment programs.

The NPRM also raises questions about office based methadone treatment in private practice settings. Our Association has recommended that methadone treatment be offered in office based medical practices through the vehicle of expanding access to “Medical Maintenance Treatment” as a first stage effort. These recommendations have been listed in the text of this News Report. The recommendations include criteria for the participating treatment program, physicians and patient referrals.

The Association believes that stable patients should be given treatment options, including a referral from a methadone treatment program to an office-based practice. It is recognized that some patients may not choose such an option, however, we believe that such alternatives should be made available. Medical Maintenance operations currently exist in New York State and Maryland.

Research indicates that approximately 7% or 12,530 of the existing methadone maintenance population (179,000) would be eligible for referral to medical maintenance treatment. Our Association does not support the policy of having physicians involved in treating newly admitted patients, which have not been referred through a hub referral site, especially where treatment is available at an established methadone treatment program.

We have also urged the federal agencies to develop a series of technical assistance documents to assist programs with different patient census sizes throughout the country. Such publications would serve as “how to” documents, including model policy procedure manuals, model diversion management plans, model quality assurance packages in addition to other elements of the accreditation system.

The NPRM also raises the issue of lifting the prohibition of LAAM take home dosages. We support removing such a prohibition since we now have more than five years of experience in administering LAAM to patients in methadone treatment programs.

We have also supported the NPRM’s intent to provide greater clinical flexibility in determining take home dosages for patients, who have met the criteria under current federal law, ensuring stability prior to giving any take home medication. The Association has opted to support the second variation, which was proposed in the NPRM, allowing individual methadone treatment programs to dispense take home medication for up to fourteen days following one year of treatment and up to a thirty-one day supply following two years of treatment, providing that the patient has met the criteria as stipulated in the Proposed Rule.

In summary, the Association supports the federal government’s intent to shift regulatory oversight away from process oriented regulations to outcome oriented accreditation standards of care. We have urged the federal government not to create a two tiered system of regulatory oversight holding methadone treatment programs accountable to accreditation standards and individual practitioners to a lesser standard of care. We believe that the development of such a two tiered system would create instability throughout the entire system of treatment and would be counter to the intent of the Proposed Rule.

We are also hopeful that individual states will either adopt accreditation standards or accept the results of accreditation surveys in lieu of their own state regulatory inspections as a means of avoiding duplication of effort and cost.

Finally, we view the Proposed Rule as only one piece of a federal strategy to increase access to care, to improve the quality of care currently offered, to expand new opportunities for patients and to educate the public about the value of methadone treatment. Accrediting methadone treatment programs will not significantly increase access to care. An infusion of funds at the federal and state levels of government is required to improve treatment access and quality.

@aatod1984
  • TREATING OPIOID USE DISORDER: SO MUCH MORE THAN MEDICATION #aatod2024

TODAY is the last day to take advantage of the discounted registration rate. #aatod2024 is the world’s premier training conference event for the treatment of #OUD.

For registration and hotel information ➡️ bit.ly/3Ue57Q6.

We look forward to seeing you in Las Vegas!
  • #aatod2024 Conference Update. Comprehensive Listing/Descriptions of Workshops, Posters, and Hot Topic Roundtable Conference Sessions are now available ➡️ http://bit.ly/3Ue57Q6.

The workshop committee is pleased to present a dynamic workshop lineup that includes extremely rich and diverse educational content for all disciplines. You will hear from experts who will share the latest research and developments relating to opioid use disorders and treatment. The workshop lineup will include state of the art information on diverse areas of focus such as patient care and best practices, building community partnerships and collaborations, public policy and regulatory changes, workforce development, quality assurance, and financial reimbursement. There will be workshops that focus on emerging treatment trends and developments such as the fentanyl epidemic, mobile opioid treatment programs, regulatory changes, expansion of treatment services in rural areas, integrating treatment with the corrections systems, and integrating harm reduction initiatives. For those newer to the field or those who want a refresher on the basics, we have once again included a “Foundations” track which will include selections on the fundamentals of medication assisted treatment.

The conference will continue to be the world’s premier training and education event for the treatment of opioid use disorders.  We hope to see you in Las Vegas!
  • Patient access to OTPs saves lives every day.

AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. 

Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
  • Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. 

“Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA 

Read More ➡️ bit.ly/3tKb1gy
  • Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
  • Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. 

Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. 

Register ➡️ bit.ly/461CkkG
  • Final Opportunity to Submit Proposals for the #aatod2024 Conference. The submission window will close tonight at 12am ET.

To submit a proposal, please follow the on-screen instructions, bit.ly/3KxQSzU. For questions or additional information regarding the Call for Presentations, please send an email to meetings@aatod.org or call 856-423-3091.

We look forward to receiving your submissions and hope to see you at the conference for what will be the premier conference on the treatment of opioid use disorders in 2024! #morethanmedicine #programnotapill #opioids #OUD #OpioidUseDisorder #submitproposal
  • Today is the Final Day to Submit Proposals for the #aatod2024 conference, 9/21 ➡️ bit.ly/3KxQSzU

The Workshop Committee encourages you to submit proposals on innovative initiatives to enhance patient outcomes, improve program development and administration, promote integration across the continuum of care, and the development of collaborations with organizations outside of the traditional opioid treatment system.

Conference Objectives:
1️⃣Conduct a comprehensive review of the latest evidence addressing the opioid epidemic and its implications for patients, clinicians, administrators, and policy makers by identifying the most effective interventions.
2️⃣Discuss peer to peer approaches in treating opioid use disorder in an effort to improve patient outcomes in health systems, organizations, and communities.
3️⃣Evaluate the gaps in current services for opioid use disorder and develop recommendations to improve the delivery of multidisciplinary care in various populations based upon evidence-based practices.
4️⃣Disseminate a comprehensive plan of innovative services designed to treat emerging needs of patients with opioid use disorder and improve patient outcomes by providing examples of effective methods and how to implement them.
5️⃣Identify effective referral pathways to other health services offering treatment for conditions associated with opioid use disorder addiction and/or recovery by developing partnerships within the community.
  • We are pleased to announce that the deadline for submitting presentations for the #aatod2024 Conference has been extended to Thursday, September 21, 2023.

We encourage all interested parties to take advantage of this opportunity and submit their proposals as soon as possible. We look forward to receiving your proposals and to seeing you in Las Vegas in 2024. 

https://conta.cc/3PiV5ck
  • August 31st is International Overdose Awareness Day 
💜 #IOAD2023 
💜 #NaloxoneSavesLives 
💜 #EndOverdoseNow

Please contact your State Opioid Treatment Authority for locations in your community that distribute naloxone kits —> bit.ly/3qVPOPz. 

 Full Video 🎥 bit.ly/3ElzdYD
TREATING OPIOID USE DISORDER: SO MUCH MORE THAN MEDICATION #aatod2024

TODAY is the last day to take advantage of the discounted registration rate. #aatod2024 is the world’s premier training conference event for the treatment of #OUD.

For registration and hotel information ➡️ bit.ly/3Ue57Q6.

We look forward to seeing you in Las Vegas!
TREATING OPIOID USE DISORDER: SO MUCH MORE THAN MEDICATION #aatod2024 TODAY is the last day to take advantage of the discounted registration rate. #aatod2024 is the world’s premier training conference event for the treatment of #OUD. For registration and hotel information ➡️ bit.ly/3Ue57Q6. We look forward to seeing you in Las Vegas!
3 weeks ago
View on Instagram |
1/10
#aatod2024 Conference Update. Comprehensive Listing/Descriptions of Workshops, Posters, and Hot Topic Roundtable Conference Sessions are now available ➡️ http://bit.ly/3Ue57Q6.

The workshop committee is pleased to present a dynamic workshop lineup that includes extremely rich and diverse educational content for all disciplines. You will hear from experts who will share the latest research and developments relating to opioid use disorders and treatment. The workshop lineup will include state of the art information on diverse areas of focus such as patient care and best practices, building community partnerships and collaborations, public policy and regulatory changes, workforce development, quality assurance, and financial reimbursement. There will be workshops that focus on emerging treatment trends and developments such as the fentanyl epidemic, mobile opioid treatment programs, regulatory changes, expansion of treatment services in rural areas, integrating treatment with the corrections systems, and integrating harm reduction initiatives. For those newer to the field or those who want a refresher on the basics, we have once again included a “Foundations” track which will include selections on the fundamentals of medication assisted treatment.

The conference will continue to be the world’s premier training and education event for the treatment of opioid use disorders.  We hope to see you in Las Vegas!
#aatod2024 Conference Update. Comprehensive Listing/Descriptions of Workshops, Posters, and Hot Topic Roundtable Conference Sessions are now available ➡️ http://bit.ly/3Ue57Q6. The workshop committee is pleased to present a dynamic workshop lineup that includes extremely rich and diverse educational content for all disciplines. You will hear from experts who will share the latest research and developments relating to opioid use disorders and treatment. The workshop lineup will include state of the art information on diverse areas of focus such as patient care and best practices, building community partnerships and collaborations, public policy and regulatory changes, workforce development, quality assurance, and financial reimbursement. There will be workshops that focus on emerging treatment trends and developments such as the fentanyl epidemic, mobile opioid treatment programs, regulatory changes, expansion of treatment services in rural areas, integrating treatment with the corrections systems, and integrating harm reduction initiatives. For those newer to the field or those who want a refresher on the basics, we have once again included a “Foundations” track which will include selections on the fundamentals of medication assisted treatment. The conference will continue to be the world’s premier training and education event for the treatment of opioid use disorders. We hope to see you in Las Vegas!
4 weeks ago
View on Instagram |
2/10
Patient access to OTPs saves lives every day.

AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. 

Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
Patient access to OTPs saves lives every day. AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
3 months ago
View on Instagram |
3/10
Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. 

“Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA 

Read More ➡️ bit.ly/3tKb1gy
Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. “Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA Read More ➡️ bit.ly/3tKb1gy
4 months ago
View on Instagram |
4/10
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery. Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1 For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
4 months ago
View on Instagram |
5/10
Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. 

Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. 

Register ➡️ bit.ly/461CkkG
Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. Register ➡️ bit.ly/461CkkG
5 months ago
View on Instagram |
6/10
Final Opportunity to Submit Proposals for the #aatod2024 Conference. The submission window will close tonight at 12am ET. To submit a proposal, please follow the on-screen instructions, bit.ly/3KxQSzU. For questions or additional information regarding the Call for Presentations, please send an email to meetings@aatod.org or call 856-423-3091. We look forward to receiving your submissions and hope to see you at the conference for what will be the premier conference on the treatment of opioid use disorders in 2024! #morethanmedicine #programnotapill #opioids #OUD #OpioidUseDisorder #submitproposal
5 months ago
View on Instagram |
7/10
Today is the Final Day to Submit Proposals for the #aatod2024 conference, 9/21 ➡️ bit.ly/3KxQSzU The Workshop Committee encourages you to submit proposals on innovative initiatives to enhance patient outcomes, improve program development and administration, promote integration across the continuum of care, and the development of collaborations with organizations outside of the traditional opioid treatment system. Conference Objectives: 1️⃣Conduct a comprehensive review of the latest evidence addressing the opioid epidemic and its implications for patients, clinicians, administrators, and policy makers by identifying the most effective interventions. 2️⃣Discuss peer to peer approaches in treating opioid use disorder in an effort to improve patient outcomes in health systems, organizations, and communities. 3️⃣Evaluate the gaps in current services for opioid use disorder and develop recommendations to improve the delivery of multidisciplinary care in various populations based upon evidence-based practices. 4️⃣Disseminate a comprehensive plan of innovative services designed to treat emerging needs of patients with opioid use disorder and improve patient outcomes by providing examples of effective methods and how to implement them. 5️⃣Identify effective referral pathways to other health services offering treatment for conditions associated with opioid use disorder addiction and/or recovery by developing partnerships within the community.
5 months ago
View on Instagram |
8/10
We are pleased to announce that the deadline for submitting presentations for the #aatod2024 Conference has been extended to Thursday, September 21, 2023. We encourage all interested parties to take advantage of this opportunity and submit their proposals as soon as possible. We look forward to receiving your proposals and to seeing you in Las Vegas in 2024. https://conta.cc/3PiV5ck
5 months ago
View on Instagram |
9/10
August 31st is International Overdose Awareness Day 💜 #IOAD2023 💜 #NaloxoneSavesLives 💜 #EndOverdoseNow Please contact your State Opioid Treatment Authority for locations in your community that distribute naloxone kits —> bit.ly/3qVPOPz. Full Video 🎥 bit.ly/3ElzdYD
6 months ago
View on Instagram |
10/10

Announcing groundbreaking updates: HHS/SAMHSA's new regulations mark a significant step forward for opioid treatment programs. Fostering enhanced accessibility, flexibility and patient dignity. Gratitude to @@AATOD1984 for their pivotal role in this progress. #OpioidTreatment

Load More...

2024 Conference Las Vegas

2024 Conference

AATOD, Inc.
225 Varick Street, Suite 402
New York, New York 10014

Contact Us
Phone : 212-566-5555
Email : info@aatod.org

Social Sharing
RSS
Follow by Email
Facebook
Twitter
YouTube
LinkedIn
Instagram

Stay Connected to AATOD