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BHN’s Patient-Centered Approach to Methadone Access is a Model for the Nation

Ji8¸£ÀûÊÓƵ’s (BHN) submitted comments to federal regulations have all been incorporated in new final rules by the Substance Abuse and Mental Health Services Administration (SAMHSA), announced on February 2, 2024. BHN has played a significant role in shaping national and state policies and is regarded as a leading model for opioid treatment in the United States. 

The new rule announced by SAMHSA marks the first substantial changes to opioid treatment regulations since 2001 and will go into effect in April 2024. The revised federal regulations take historic steps to increase access to lifesaving, evidence-based medications for opioid use disorder (MOUD) and to advance retention in care through promoting patient-centered interventions. These rules aim to help more people recover in a supportive and empowering environment. 

The implementation of these rules in October provides time for Opioid Treatment Programs (OTPs) to prepare and for states to review their regulations that impact how the new rules are implemented. 

The final rule expands access, promotes practitioner autonomy, removes stigmatizing or outdated language, supports a patient-centered approach, and reduces barriers to receiving care that made it difficult for some people to enter or remain in treatment in the past. Practitioners are no longer required to follow rigid criteria to determine the number of take-home methadone doses for a given patient. Instead, they are now guided by harm reduction approaches, shared decision-making with the individual, and considerations of safety and unique circumstances. That helps balance the benefits and risks of methadone take-home doses. These elements were identified as being essential to promoting effective treatment in OTPs and reflect an OTP accreditation and treatment environment that has evolved over the past 20 years. 

BHN opened four Opioid Treatment Program clinics between 2019 and 2021 in Holyoke, Springfield, Orange, and Greenfield. The clinics opened as the fentanyl crisis worsened and overdose deaths climbed. The Orange clinic, opened at the end of 2021, was the first rural methadone clinic in the state. Prior to opening, patients in North Quabbin had to travel 45 minutes to Worcester or Leominster to access medication. 

BHN’s Opioid Treatment Program serves over 2,000 people through its four locations and provides methadone treatment for individuals 18 and older in combination with counseling and behavioral therapies to provide a holistic approach to the treatment of substance use disorders. 

BHN surpasses the standards of its credentialing agencies in many ways, including: 

• All doctors are board-certified in Addiction Medicine 
• Walk-in admissions, without any wait lists 
• Provide more progressive take-home bottle policy, in keeping with federal policy 
• Strong community collaboration with direct admissions from hospitals, primary care, and carceral facilities 
• Scientific dosing strategies in the fentanyl era 

In 2024, BHN will launch a Mobile Methadone Program in Ware, which will be the first of its kind in Western Massachusetts, providing access to methadone from a 35-foot mobile treatment unit. 

Methadone is a medication that has been prescribed for 60 years to treat opioid use disorder. When taken as prescribed, methadone is safe and effective and helps individuals achieve and sustain recovery and reclaim active and meaningful lives. 

BHN clinical and medical leadership have been asked to present the organization’s approach to treatment in multiple forums, including the American Society of Addiction Medicine, the Massachusetts Society of Addiction Medicine, and the MADPH Bureau of Substance Addiction Services. BHN’s Medical Director, Dr. Ruth Potee, was also asked to give a Congressional briefing on methadone on Capitol Hill on February 6, 2024.  

According to Dr. Potee, “Practitioners in the recovery field are increasingly turning to BHN’s approach, along with the sharing of the policies and procedures nationwide to help other methadone clinics provide more patient-centered care. Our clinics have led the way in terms of clinical management in the state and the nation.” 

BHN offers a full continuum of care and services for those in addiction recovery. Programs include inpatient acute treatment services, clinical stabilization services, residential recovery homes, transitional support services, outpatient treatment, recovery coaching, and driver alcohol education services through the Massachusetts Impaired Driver Program.