Moratorium on methadone vans seen as barrier to help

WASHINGTON — From California to Vermont, mobile methadone vans have served people with opioid addiction in rural towns and underserved inner-city neighborhoods for nearly three decades.

But the U.S. Drug Enforcement Administration, which regulates dispensing of the Fda-approved addiction medicine, has refused to license any new methadone vans since 2007 over concerns about potential diversion of the medication.

Now, in an unrelenting opioid epidemic that is killing more than a hundred Americans every day, some state and local addiction agencies are asking the federal government to lift its moratorium as quickly as possible.

In Seattle and surrounding King County, for example, federal grant money has been set aside to deploy four new mobile methadone vans to provide treatment on demand in addiction hotspots around the city and county. But the project is on hold until the DEA lifts the ban.

“Mobile treatment vans are critical to addressing the opioid epidemic,” said King County behavioral health official Brad Finegood. “As this epidemic grows and changes, concentrations of people who are affected by it can be found in shifting locations within the city and county. If we’re going to be effective, we need to be nimble and bring the medication to them instead of asking everybody to trudge across town to get their daily dose at a fixed facility.”

Joining the chorus of state and local behavioral health agencies is another federal agency, the Substance Abuse and Mental Health Services Administration, which provides grants to King County and other locations to make it easier for people with dangerous opioid addictions to receive treatment with methadone and other evidence-based medications.

According to a spokesperson at SAMHSA, agency officials are urging the DEA to remove the ban.

At a recent New York City gathering of the methadone industry’s professional organization, the American Association for the Treatment of Opioid Dependence, DEA official James Arnold said a proposal for a new set of regulations that would permit new methadone vans to be licensed was months away from completion.

Mark Parrino, who heads the industry group, said no security breach in any of the mobile vans licensed before the moratorium has ever been reported, leading industry experts to question why the ban persists.

Treatment officials in Connecticut, Maryland, New Jersey, New York and Washington state have expressed interest in deploying new methadone vans to fight the epidemic but have been stymied by the DEA moratorium, Parrino said. The most urgent need for mobile methadone, he said, is in Puerto Rico, where Hurricane Maria destroyed much of the territory’s transportation infrastructure and medical facilities last year.