Kaylee Deutsch, PharmD; Welia Health
Opioid use disorder (OUD) has become increasingly prevalent within the past decade, affecting an estimated 16 million people worldwide and over 2.1 million people within the United States according to Dydyk et al. These authors also noted that in the United States, opioid use has resulted in more deaths than any other drug in our history. Considering these statistics, it is important to connect those diagnosed with OUD to treatment and resources to reduce the risk of fatal overdose. This is where mobile methadone clinics come in, such as the R.V. type van operated by the Acacia Network that makes a stop at a men’s homeless shelter in the South Bronx of New York City.
Otterman discusses this new service in a New York Times article. Addiction experts have noted methadone has become increasingly useful in OUD treatment, as widespread use of fentanyl has increased some patient’s opioid tolerance levels so high that other treatments, such as buprenorphine, have become less effective in OUD treatment for these individuals. With the use of this medication, convenience can complicate success of treatment with many states requiring methadone be administered via certified clinics with patients under direct supervision. Mobile methadone clinics are not a completely new concept, with programs existing for thirty years prior to 2007, when the DEA refused to license any new programs due to concerns of drug diversion. However, in an article published by Cureus, it was noted that after pressure from multiple healthcare professionals to relieve these restrictions and lack of data supporting diversion via mobile programs, the DEA issued expanded regulations on July 28, 2021 to allow for continuation of mobile OUD program approvals.
Patients of the mobile methadone clinic in the Bronx have noted this access to be life-changing in reducing the likelihood of relapse by making treatment more accessible to them. There are currently only 42 vans registered nationwide, so there is an unmet need for access to these programs. In the future, this modality of treatment can be expanded in order to address OUD in underserved populations, including those experiencing homelessness or who live in rural areas with minimal programs available. As pharmacists, we can be instrumental in advocating for this change in order to provide better care to our patients.
Resources:
- Dydyk AM, Jain NK, Gupta M. Opioid Use Disorder. StatPearls. Published January 17, 2024. Accessed August 29, 2024. https://www.ncbi.nlm.nih.gov/books/NBK553166/
- Otterman S. Could This Van Help People Quit Fentanyl? The New York Times. Published July 21, 2024. Accessed July 24, 2024 https://www.nytimes.com/2024/07/21/nyregion/mobile-methadone-vans-fentanyl.html.
- Breve F, Batastini L, LeQuang JAK, Marchando G. Mobile Narcotic Treatment Programs: On the Road Again?. Cureus. 2022;14(3):e23221. Published 2022 Mar 16. doi:10.7759/cureus.23221