Is This Methadone’s Moment?

IS IT TOO LATE? –

Oct. 31, 2024 – “It’s absolutely atrocious that methadone policies have not kept up with the evidence. If you look at other countries that have expanded their access to methadone, their overdose rates have fallen dramatically,” said Leslie Suen, MD. “Methadone is a very good medication that’s been shown over and over to be very effective and safe,” Alan Leshner, PhD.

Methadone has been shown to be highly effective for opioid use disorder (OUD). So why is it still so difficult to prescribe in the United States and is that about to change?

A recent study from Canada adds to the growing body of evidence supporting methadone’s effectiveness in treating OUD and bolsters efforts to expand access in the United States by removing restrictive barriers.

This paper included more than 30,000 patients with OUD and showed those on methadone were almost 60% significantly less likely to stop treatment at 24 months than their peers assigned to buprenorphine/naloxone (adjusted hazard ratio [aHR], 1.58), with no difference in mortality risk (aHR, 0.57).

“In Canada, unlike the US, methadone and buprenorphine/naloxone are both available in office-based settings. Methadone really outperforms buprenorphine/naloxone in being able to retain people in treatment, which is our main goal and comes with a host of benefits,” Bohdan Nosyk, PhD, with Simon Fraser University in Burnaby, British Columbia, Canada, who worked on the study, told Medscape Medical News.