Mobile Methadone Clinics: How Do They Work?

According to the CDC, last year was the deadliest year on record for fatal drug overdose in the United States, with nearly 75 percent of these deaths involving opioids like fentanyl and heroin.

Methadone, a long-acting opioid drug, is one of the oldest and most effective treatments for opioid use disorder (OUD), a life-threatening disease that affects millions of Americans.

Over the last year, and in years prior, experts have been searching for ways to make this treatment more accessible for people struggling with addiction. One of these delivery options, subject to a ban until very recently, is a mobile methadone clinic.

What Are Mobile Methadone Clinics?

Mobile methadone clinics, also known as methadone vans or mobile opioid treatment programs (OTPs), provide the mobile delivery of methadone doses for people with OUD.

Methadone maintenance treatment, also known as medication-assisted treatment with methadone, is a leading treatment for opioid addiction, which is clinically diagnosed as OUD.

Mobile methadone, by way of a methadone van, is one strategy to increase access to this evidence-based treatment for underserved communities—including rural communities and underserved urban communities.

How Do Mobile Methadone Clinics Work?

To operate legally, mobile methadone clinics must be registered with the U.S. Drug Enforcement Administration (DEA), a federal agency, as a mobile opioid treatment program.

Unlike methadone treatment that’s offered at a fixed location, mobile clinics can travel. This renders them effective for getting methadone to people who don’t have easy access to a methadone clinic for daily doses.

Methadone vans serve to address common barriers to treatment for people with opioid use disorder, including lack of transportation and limited OTP options in one’s community.

The Federal Ban On Mobile Methadone Clinics

In 2007, the DEA placed a moratorium on the approval of new mobile methadone clinics. This effectively served as a ban on the creation of new mobile methadone clinic units.

But in June of 2021, the DEA released new rules that essentially lifted this ban, and waived a previous requirement that mobile OTPs obtain a separate DEA registration for each mobile component.

This decision was prompted by the surge in opioid overdose deaths seen in 2020, influenced at least in part by the consequences of the COVID-19 pandemic, which cut off treatment and support options for many.

Why Are Mobile Methadone Clinics Controversial?

One of the reasons methadone vans are so deeply regulated is due to concerns about the use of methadone as a long-term maintenance treatment for OUD.

As an opioid drug, methadone can be misused, diverted, and become addictive if its use by a person with addiction isn’t closely monitored by a licensed medical professional.

Because of these potential risks, methadone for opioid use disorder can only be administered by an OTP that’s certified by the Substance Abuse and Mental Health Services Administration.

Concern About Methadone Diversion With Mobile Clinics

Over the course of the U.S. opioid epidemic, concerns of diversion and methadone abuse have prevented the expansion of methadone treatment options that don’t require daily visits to a clinic.

One primary concern with mobile methadone vans is a risk for diversion, or the act of using prescription drugs in ways other than directed by a healthcare professional.

Last year, however, the DEA stated that allowing DEA-registered mobile clinics to expand the operation of their bans, with appropriate safeguards, would “be consistent with the public health and safety”.

Pros Of Lifting The Federal Ban On Mobile Methadone Clinics

Many addiction treatment advocates and experts see the lifting of this federal ban as a sign of progress, and a critical step towards expanding opioid addiction treatment options.

Advantages of lifting this ban, experts say, include:

Increased Treatment Access

Allowing for the creation of new methadone vans is expected to increase treatment access for people in underserved communities who lack plentiful or accessible OTP options.

Communities expected to benefit from this rule change include:

• rural communities
• underserved urban communities
• Black, indigenous, and people of color (BIPOC) with OUD
• communities that lack reliable public transit options
• people who are incarcerated

Combats Misconceptions About Safety Of Methadone Treatment

Within both medical and patient communities, the safety of methadone treatment is still hotly debated today. For instance, some argue that it is merely trading one addiction for another.

This new change by the DEA, however, signals an acknowledgment of the effectiveness of MAT with methadone, and the need to ensure people with opioid addiction can access evidence-based treatment.

Opens The Discussion To Further Reform

Another potential benefit of this move, some experts say, is that it opens the door to revisiting all rules governing methadone treatment for opioid use disorder.

That is, while new changes from the DEA constitute one step for expanding treatment access, there are other limitations that still serve as barriers to treatment.

Additional recommendations proposed by some health experts include:

• incentivizing the creation of new mobile methadone clinic units
• addressing state regulatory barriers
• revisiting limitations on take-home doses of methadone for OUD
• revisiting rules that limit prescribing and dispensing of methadone

Potential Drawbacks Of Mobile Methadone Clinics

While many perceive the lifting of the federal ban on mobile methadone clinics as a positive step, some health and policy experts share concerns about allowing more mobile clinics to operate.

Concerns and potential drawbacks include:

• the cost of operating new mobile OTPs
• the risk of methadone diversion
• limitations of these new changes

Some advocates of lifting the ban on mobile methadone clinics say that this new change from the DEA is a positive step forward, but that it’s also not going far enough.

That is, even with new rule changes, restrictions on how methadone vans can operate will still be upheld and—some argue—continue to limit the scope and effectiveness of mobile OTPs.

Methadone MAT Options For Opioid Addiction

Mobile methadone vans are not the only option for accessing methadone maintenance treatment.

Traditionally, methadone treatment for opioid abuse and addiction is provided by opioid treatment programs (also known as methadone clinics) and some addiction rehab programs.

What Are The Benefits Of Medication-Assisted Treatment?

Research shows that medication-assisted treatment programs that use FDA-approved medications like methadone or buprenorphine can offer a number of crucial benefits.

Benefits of MAT treatment programs include:

• increased treatment retention
• increased safety in the event of relapse
• reduced risk for fatal opioid overdose
• decreased illicit opiate use (e.g. heroin use)
• improved birth outcomes for people with opioid use disorder who take methadone for addiction while pregnant

According to SAMHSA, medication-assisted treatment can help restore normalcy to a person’s life in the early stages of treatment and recovery.

Like any physical health problem though, such as diabetes, having consistent access to this treatment is often necessary to ensure its long-term effectiveness for helping people maintain recovery.

Where To Find MAT Rehab Programs For Opioid Abuse

Opioid treatment programs that offer methadone are offered by many inpatient rehab centers, residential rehab facilities, and outpatient drug addiction treatment programs.

This includes treatment for people addicted to illicit opioids like heroin and prescription opioid pain relievers like oxycodone (OxyContin/Percocet) and hydrocodone (Vicodin).

Find Medication-Assisted Treatment (MAT) With Methadone Near You

Our treatment referral specialists are dedicated to connecting individuals and families affected by addiction with high-quality drug treatment services.

For more information about methadone treatment, or to find a rehab program that offers methadone treatment near you, call our helpline to find available treatment options today.