Since the 1980s, mobile methadone vans have been used to treat opioid addicts in under-served rural areas and inner city neighborhoods.
But the U.S. Drug Enforcement Administration, which regulates dispensing of the addiction medicine, has declined to license any new methadone vans since 2007, due to concerns about potential misuse of the medication.
Officials in some states and cities are asking the DEA to lift its moratorium to expand the use of the vans to help fight the opiate epidemic.
In Seattle and surrounding King County, federal grant money has been allocated to provide four new mobile methadone vans to provide treatment on demand. But the project is on hold due to the DEA ban.
“Mobile treatment vans are critical to addressing the opioid epidemic,” King County behavioral health official Brad Finegood told the Pew Charitable Trusts’ Stateline blog.
“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,” Finegood said.
Another federal agency which provides grants for medication-assisted treatment, the Substance Abuse and Mental Health Services Administration, is also urging the DEA to lift its ban.
Currently, treatment facilities in six states and Puerto Rico use mobile methadone vans to extend access to opioid addiction treatment in under-served areas. New Jersey has four vans, California three, Puerto Rico has three, and Maryland, Illinois, Massachusetts and Washington each have one.
The DEA is considering new regulations that would allow new methadone vans, but it won’t happen right away, DEA official James Arnold said at a recent gathering of the methadone industry’s professional organization, the American Association for the Treatment of Opioid Dependence. It will be months before the new rules will be ready to go, Arnold said.
Association President Mark Parrino said no security breach in any of the mobile vans licensed before the moratorium has ever been reported – causing some to wonder why the ban is in place. He said the most critical need for mobile methadone is in Puerto Rico, still trying to recover from the damage done last year by Hurricane Maria.
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.
In Washington state, Seattle-based Evergreen Treatment Services, which operates the only methadone van in the state, just received an $11 million grant from SAMHSA, part of which has been set aside to buy four new customized vans for about $200,000 each.
The vans will be used daily in Seattle neighborhoods with the greatest need, along with inner-city neighborhoods in the cities of Renton, Olympia and Hoquiam. Along with methadone dispensing, they will also provide counseling, and urine drug screens.
Evergreen director Molly Carney said Washington state’s substance abuse agency is working with SAMHSA to get DEA permission to purchase and outfit the vans. “We’re told they’re actively working on it,” she told Stateline, “but there’s no timeline and no promise of when it will get released.”