The White House Office of National Drug Control Policy recently announced it is lifting a moratorium on mobile methadone vans to increase access to medication for opioid use disorder, but a local addiction treatment specialist feels the move is unlikely to have a local impact.
A statement from the explains lifting the moratorium on mobile methadone vans is expected to “particularly” help “individuals in underserved communities.”
“The new rule, effective July 28, will streamline registration requirements on mobile methadone vans and make it easier for treatment providers to obtain a license to operate treatment vans,” the statement continues.
At a recent press briefing held by the Office of National Drug Control Policy, the newspaper inquired if the new policy will benefit rural communities like those in and around the North Quabbin region.
“Certainly,” a senior advisor with the office replied. “There’s some uptake that’s going to happen in urban and suburban areas. But I think the big boon is — because we’re going beyond the anchorage of opioid treatment programs — we’re actually able to use these vans to hit rural areas that are just geographically harder to get to. I think the rural piece is really, really key to serving those communities.”
However, Dr. Ruth Potee, an addiction treatment specialist with Behavioral Health Network, feels the move is unlikely to have much of an impact locally. Potee, who has offices in Springfield and Greenfield, is opening a methadone clinic serving Athol and Orange later this year.
“The finances of a methadone van are really tricky,” she said, “because they’re expensive. The vans themselves, they have to get outfitted with a locked safe and travel with security; my guess is you’re talking a quarter-million dollars. I have investigated for real, but it’s my understanding that’s sort of the price point.
“Now, I work for a not-for-profit methadone clinic, so our job is to basically break even and provide excellent medical care. Having said that, it’s going to be hard for me to argue for a methadone van because we can’t afford it. The safes themselves are like $20,000.”
She also pointed out that methadone vans in the North Quabbin region would be redundant, given that a methadone clinic is slated to open in the Aubuchon Plaza by sometime this summer or fall.
“At least in Athol and Orange we’re going to have a clinic open. People are going to have access,” Potee said. “Really what (the van) would be is for towns like Royalston, and Colrain, and Hubbardston, the Brookfields — places that actually are far away from the nearest methadone clinic, places where there’s no public transportation. Those are the areas where people struggle.
“But per capita, how many people need methadone in those small rural towns?” she continued. “They’re small numbers. So, the math of it just doesn’t work.”
While saying this latest move by the Drug Enforcement Administration is, overall, a positive step, Potee argues more needs to be done.
“I think nationwide it is a positive move to get more availability of methadone, particularly in rural areas or areas where public transportation is limited,” she said. “Having said that, this is a workaround for a really broken system. The whole system of how methadone is regulated is profoundly broken, it’s antiquated and it’s not evidence-based. It was put in place 49 years ago. What we were doing for medical care in 1972, we don’t do almost any of that stuff anymore. Methadone we do because it’s codified in the federal regulations.
“Again, it’s a workaround. So, I guess I’m not going to spend tons of time patting the federal government on the back for doing this move because we need a lot bigger moves to happen.”
Greg Vine can be reached at gvineadn@gmail.com.