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Comment & Response
Health Care Policy and Law
April 2020

Additional Barriers to Methadone Use in Hospitals and Skilled Nursing Facilities—Reply

Author Affiliations
  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 3Institutes for Behavior Resources, Inc, REACH Health Services, Baltimore, Maryland
JAMA Intern Med. 2020;180(4):615. doi:10.1001/jamainternmed.2020.0117

In Reply Starting January 1, 2020, as a result of the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, Medicare Part B has provided a bundled payment for opioid addiction treatment in an opioid treatment program.1

This advance, however, does not address the concerns of Gifford and colleagues about the inability of long-term care facilities to obtain methadone from community pharmacies to treat opioid use disorder. As discussed in our Viewpoint,2 current Drug Enforcement Administration regulations only allow pharmacies to supply these facilities with methadone for short-term withdrawal management, known as detoxification, of patients with opioid use disorder. This clinical use is associated with poor outcomes.

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