Opinion | Methadone access is crucial to curbing fentanyl use

Regarding Sam Quinones’s Feb. 2 Friday Opinion essay, “Supply — not demand — is driving the fentanyl crisis”:

The opioid crisis is too complex to reduce to supply or demand, but we cannot pretend that we are adequately addressing demand for drugs such as fentanyl. One significant gap is patient access to methadone, a “gold standard” treatment for long-term recovery from opioid use disorder.

Virtually unchanged 1970s-era regulations restrict this prescription medication like no other. Patients must travel up to six days a week, sometimes hours each way, to clinics called opioid treatment programs to take methadone. Twenty-four percent of Americans live in a county with no such programs, and only about 400,000 Americans — of an estimated 5.6 million with opioid use disorder — are taking methadone today.

In a nod to demand, Mr. Quinones offered jail as a “blessed refuge” for recovery from opioid use disorder. But overregulation of methadone makes its provision in carceral settings nearly impossible: Though more than half of incarcerated individuals meet the criteria for opioid use disorder, just 12 percent of correctional facilities offer medication to treat them. This disruption of care creates challenges for individuals trying to successfully reenter society once their sentences are complete.

The bipartisan Modernizing Opioid Treatment Access Act would begin to unshackle methadone from its regulatory prison. It would treat opioid use disorder as the medical condition it is by allowing prescribing by addiction doctors, expanding access in and out of carceral settings. And it would take a step toward addressing the demand for opioids that is most certainly part of the problem.

Jessica Shortall, Hopkins, Minn.

The writer leads the Safer From Harm coalition at R Street Institute.