LIFE SAVER –
April 23, 2025 – Dr. Edwin Salsitz is a methadone OG. He was one of a coterie of New York City doctors who pioneered its use to treat opioid use disorder back in the 1980s. “God almighty. So many people could have been saved from HIV if they’d either gotten on methadone or stayed on methadone.” It started in 1985. He would prescribe in his clinic and patients would pick up a 28-day supply from an on-site pharmacy. It was liberatory not to have to attend a clinic six days a week. To participate, patients had to be “stable,” which meant no positive urine screens usually for a couple of years, be employed and not need counseling. In other words, they had to be, “model methadone patients.” Recruited from clinics around the city and beyond, 70 percent were white and 30 percent were Black or Latino.
A tiny handful of OBOT programs remain around the country, a legacy of a bygone era. To open a new one requires an exemption from the Substance Abuse and Mental Health Services Administration (SAMHSA). Amid the ongoing overdose crisis, it’s urgent to reboot the model that Dr. Salsitz helped pioneer and make the medication available to all who need it.
