[ad_1]
cnn
—
Some people receiving treatment for opioid use disorders will soon be able to take home doses of their methadone medications or schedule telehealth appointments in ways they haven’t always been able to do before.
For the first time in more than two decades, the U.S. Department of Health and Human Services is making major updates to the regulations governing Opioid Treatment Programs, or OTPs. certified and accredited programs that provide medications such as methadone or buprenorphine for people diagnosed with an opioid use disorder. These are the only certified programs through which people can access methadone treatment, a medication approved to treat opioid use disorder reducing cravings and withdrawal and mitigating or blocking the effects of opioids.
TO final rule, scheduled for publication on Friday, will update the OTP regulations. The updates include expanding eligibility for patients to take home doses of their methadone treatment, allowing them to begin treatment via telehealth, and allowing nurse practitioners and physician assistants to order medications.
These updates aim to “reach people where they are,” HHS Secretary Xavier Becerra said, and make treatments more accessible.
“If you’re trying to take care of your family, get a new job, maybe go back to school and stay in recovery, being able to access treatment through telemedicine, that’s just a basic thing that makes a difference in someone’s life. to help you. stay well,” said Rachel Pryor, counselor to the secretary.
“Being able to take doses of methadone home so you don’t have to go back and forth to a methadone clinic every day, that helps you keep your job and get your life back,” he said. “We’re just trying to help people keep their lives together.”
Becerra has heard firsthand how quickly a life can spiral out of control. On Wednesday, he met with four young peoplethrough drug abuse prevention organization CADCAwho have been affected by the current substance use crisis in the country.
LaDarrick Smith, Morehouse College student in Atlanta, told Becerra about a friend who started vaping at a young age and then started using drugs and is now in prison. They still keep in touch, Smith said, and his friend never intended for his life to take that spiral.
“We have to do more to catch people before they get out of control, and out of control could be, in this case, prison for your friend, or it could be an overdose and maybe death,” Becerra said. “To do that, we have to know how to better reach people.”
During the Covid-19 pandemic, regulations on the use of telemedicine for the treatment of opioid use disorders were relaxed, Pryor said, and the latest updates to OTP regulations make these telemedicine options permanent.
“This final rule represents a historic modernization of OTP regulations to help connect more Americans to effective treatment for opioid use disorders,” said Dr. Miriam Delphin-Rittmon, Under Secretary for Mental Health and Substance Use. of HHS and leader of the Division of Substance Abuse and Mental Health. Health Services Administration or SAMHSA, by written statement.
“While this rule change will help anyone who needs treatment, it will have a particular impact for those living in rural or low-income areas for whom reliable transportation can be challenging, if not impossible,” he said. “In short, this update will help those most in need.”
Access to medications for opioid use disorder has been an ongoing problem for people in the United States, said Dr. Noa Krawczyk, an assistant professor in the Department of Population Health at the University’s Grossman School of Medicine. of New York and member of the Center for Epidemiology and Opioid Policywho is not involved with HHS.
Officials’ latest efforts to expand access to treatment are “excellent,” Krawczyk said, but there is still work to be done to ensure that both harm reduction tools and medications are accessible to those who need them most. For example, not all US counties They have an opioid treatment program, he said, and these geographic disparities affect access.
“Historically, the way opioid use disorder medications have been regulated has made it very difficult for them to proliferate. For example, methadone, which is the most evidence-based treatment we’ve had since the ’70s, is very restricted. In the United States, right now you can only get it through an Opioid Treatment Program, a special clinic that has very different licenses and is not available in most counties,” Krawczyk said.
“There is a lot of stigma against these medications,” he said. “People have a negative idea about methadone. “They think that if you are taking one of these drugs, you are replacing one drug with another, which is a big myth, because they are extremely effective and help people achieve many different goals, including staying alive.”
The final rule updating the OTP regulations is the latest in a series of actions the Biden-Harris administration has recently taken to combat the ongoing overdose epidemic in the country.
HHS also announced Thursday that certain federal grant funds can now be used to purchase test strips for xylazine, an animal sedative commonly known as tranq. This means that grant recipients, such as local health departments, first responders or health systems, can use the funds to purchase xylazine test strips as tools to help prevent overdoses and other drug-related harm.
“We want communities to be able to have resources to purchase these test strips so people know what’s happening with their drug supply,” said Capt. Christopher Jones, director of SAMHSA’s Center for Substance Abuse Prevention.
Test strips are commonly used to detect whether fentanyl is present in recreational drugs, and xylazine test strips They are increasingly available. Fentanyl is a powerful synthetic opioid that’s about 100 times more potent than morphine and 50 times more potent than heroin. Xylazine is not an opioid but rather a sedative that is commonly used in veterinary medicine.
“In 2021, we made clear that fentanyl test strips were a permitted use for these beneficiaries. What we are making public is that xylazine test strips are also a permitted use for these beneficiaries,” Pryor said. “Xylazine is a very scary thing that is on the streets today along with fentanyl.”
When xylazine is added to fentanyl products or other drugs, it may increase the risk of overdose.
“Xylazine, because it adds a sedative effect, adds to what opioids already do in terms of slowing breathing and having a risk of overdose. It can lengthen or strengthen that effect, making it more dangerous,” Krawczyk said. “This is definitely an emerging issue that we need to learn about and do a lot more in terms of trying to get test strips out there and educate people about how to address xylazine in drug delivery and medically.”
The White House has declared that fentanyl mixed with xylazine is a emerging threat 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 proportion of fentanyl overdose deaths in which xylazine was detected increased from about 3%. from deaths in January 2019 to almost 11% in June 2022. representing an almost four-fold increase.
Overall, the number of overdose deaths associated with any drug continues to increase each month in the United States, although the pace appears to be slowing. Deaths hit a record high in May and have changed little in the following months, through August.
View this interactive content on CNN.com
According provisional data According to the CDC’s National Center for Health Statistics, more than 112,000 people died from drug overdoses in the 12-month period ending in August.
“Drug overdoses reach every corner of our society, taking lives and causing immeasurable pain to families and communities. That’s exactly why President Biden made it a key priority of his Unity 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, the evidence-based strategies and the shared commitment across our nation to confront the overdose epidemic,” he said. “HHS is focused on the full range of solutions needed to address substance use. We will continue to use every lever available to address this and save lives. That includes focusing on prevention, as well as expanding treatment and engagement for those struggling with substance use disorder.”
Get the weekly CNN Health newsletter
Earlier this week, HHS, through SAMHSA, released an updated toolkit on how to prevent and respond to overdoses. The latest version of Overdose Prevention and Response Toolkit has appendices for specific audiences, including people who use drugs, people who take prescription opioids, first responders, and health professionals.
The hope is that these latest actions by HHS, including the final rule for opioid treatment programs, will reduce overdose death rates, Jones said.
“When we look at more than 110,000 overdose deaths, we have to pull every lever we have to reduce overdoses, and medication treatment for opioid use disorder is one of the strongest evidence-based practices we have,” he said . “We know that it can reduce the risk of dying by 50%. “So this rule modernizes the way we provide medication treatment in opioid treatment programs so more people can have access.”