Introduction of the Modernizing Opioid Treatment Access Act

March 6, 2023

WASHINGTON, DC – Today, U.S. Congressmen Donald Norcross (D-NJ-01) and Don Bacon (R-NE-02) unveiled the Modernizing Opioid Treatment Access (MOTA) Act (H.R. 1359). This evidence-based legislation would increase access to care for people experiencing opioid use disorder (OUD) by reforming the outdated regulations governing the prescription and dispensing of methadone. Methadone is one of the most effective medicines used for the treatment of OUD and is considered an “essential medicine” by the World Health Organization. U.S. Representatives Annie Kuster (D-NH-02), David Trone (D-MD-06), Brain Fitzpatrick (R-PA-01), Paul Tonko (D-NY-20), Brittany Pettersen (D-CO-07), and Andy Kim (D-NJ-03) are original cosponsors of the bill.

“Improving access to treatment saves lives, period,” said Congressman Norcross. “This legislation lowers barriers to care at a time when we are still suffering staggering losses due to the ongoing opioid epidemic. We must end the monopoly on this life-saving medicine that only serves to enrich a cartel of for-profit clinics and stigmatize patients.”

“There are only six certified methadone clinics in Nebraska, making it a significant obstacle for those seeking treatment to overcome their opioid addiction,” said Congressman Bacon. “The current law requires patients to visit a clinic daily, which is not physically possible outside of the Omaha/Lincoln metro areas. It’s time make the treatment for opioid addiction more accessible than opioids themselves.”

The legislation makes two crucial changes to FDA regulations that have governed methadone since the 1970s and are not supported by modern medical science:

• Allowing board-certified addiction physicians and addiction psychiatrists to prescribe methadone.

• Allowing pharmacies to dispense methadone.

Currently, the prescribing and dispensing authority of methadone is strictly controlled by Opioid Treatment Programs (OTPs), commonly referred to as methadone clinics. To prescribe methadone, a provider must be associated with an OTP. To pick up a methadone prescription, patients must travel—often every single day—to an OTP to receive their medication under observation by OTP staff. Crucially, 70% of America’s counties lack an OTP, and daily travel can create unnecessary barriers to care for patients who are required to travel long distances, those with mobility issues, or those who lack access to reliable transportation. This is acutely true for residents of rural America.

“The devastating opioid epidemic hitting our nation demands modernization in the way patients receive opioid-related care,” said Congressman Brian Fitzpatrick, co-founder and co-chair of the Bipartisan Mental Health and Substance Use Disorder Task Force. “I’m proud to co-sponsor this important, bipartisan legislation that will make meaningful progress toward combatting the opioid epidemic by expanding access to treatment.”

“We need to make it easier for those experiencing substance use disorder to access treatment and begin recovery,” said Congresswoman Annie Kuster, co-founder and co-chair of the Bipartisan Mental Health and Substance Use Disorder Task Force. “I am proud to help reintroduce this legislation to end the stigma around addiction recovery and eliminate barriers to life-saving treatment and medicines. I will continue working to address the substance use crisis across our country.”

“In order to best fight the opioid epidemic in America, we have to meet folks where they are and ensure treatment is both affordable and accessible,” said Congressman David Trone, co-founder and co-chair of the Bipartisan Mental Health and Substance Use Disorder Task Force. “The Modernizing Opioid Treatment Act does just that by expanding treatment options for those suffering from substance use disorder. With so many lives hanging in the balance, we must continue working together to develop innovative solutions to this crisis.”

Countries including Canada, the United Kingdom, and Australia do not have these same restrictions and have lower opioid overdose death rates than the United States. All three allow prescribing in primary care settings and pharmacy dispensing.

In 2019, the National Academies of Sciences, Engineering, and Medicine concluded that methadone is “not being deployed to maximum impact” and should be available in all treatment settings.

“NJHA applauds Representative Norcross’s leadership in eliminating outdated barriers to recovery by ensuring that prescribers can use their clinical judgement to provide stable patients with take-home methadone,” said Cathy Bennett, the president and CEO of the New Jersey Hospital Association. “The pandemic-era flexibilities provided evidence that patient-focused efficiencies increased access and improved patients’ quality of life without introducing new harms.”

“The Overdose Prevention Initiative commends Congressman Norcross and the other cosponsors of the Modernizing Opioid Treatment Access Act for championing this important legislation, which would make meaningful improvements to the way people access methadone,” said Libby Jones, the program director of the Overdose Prevention Initiative. “With more than 100,000 Americans dying from overdoses yearly, we need to make sure all Americans with opioid use disorder can get effective treatment where and when they need it to aid their recovery.”

“The treatment of opioid use disorder with methadone has a long history and robust scientific evidence supporting its effectiveness, but U.S. federal law limits its availability to heavily regulated and commonly inaccessible opioid treatment programs – a structure that has implications for access to, and quality of, care,” said William F. Haning, MD, DLFAPA, DFASAM, the president of the American Society of Addiction Medicine. “The Modernizing Opioid Treatment Access Act represents a thoughtful expansion of access to a life-saving, effective medication for many Americans with opioid use disorder.”

Senators Ed Markey (D-MA) and Rand Paul (R-KY) introduced a companion bill with the same name in the U.S. Senate.

The introduction of MOTA comes on the heels of a successful push in the 117^th Congress, also led by Congressman Norcross and Senator Markey, to improve methadone access via the Opioid Treatment Access Act of 2022.