Pharmaceutical capitalism and the criminalization of addiction puts evidence-based treatment for opioid addiction out of reach for many people. Profit motives and punishment are not perspectives that lend themselves to healing and/or safe communities.
This "Issue Brief" from PEW Charitable Trust, explains "Opioid treatment programs (OTPs) are the only health care facilities that can offer patients all three forms of FDA-approved medication for opioid use disorder (OUD): methadone, buprenorphine, and injectable extended-release naltrexone. But Pew found that nearly all states have rules governing OTPs that are not based in evidence and, in turn limit access to care or worsen patient experience."
As Helen Redmond writes in Filter Magazine, "The problem begins with the lack of OTPs in many communities. As of 2018, 80 percent of US counties, representing nearly a quarter of the population, had none. The reasons behind this number are state restrictions on the opening of new clinics, moratoriums, capping of their numbers, and requirements for a "certificate of need."
In these seventeen maps, "Pew examines regulations from 49 states and the District of Columbia. The state of Wyoming, whose motto is "Equal Rights," has zero methadone clinics. The chart book focuses on regulation that "worsens patient experiences" and "limits access to care." In the midst of an opioid-involved overdose crisis, it's vital to understand why OTPs, the only setting where methadone is available to treat addiction, are failing so spectacularly."
These visual representations of "Opioid Treatment Program Regulations by State" represent the most comprehensive study on access to care and patient experiences. These "maps illustrate how hobbled methadone clinics are by a web of federal and state regulations that are not based in evidence, reinforce stigma and significantly limit access."
Redmond concludes, "Other clinic-generated barriers the maps illustrate include: Discouraging long-term treatment, capping medication dosages, inflexible counseling requirements, and difficulty guest dosing…. Given these facts, opening more OTPs is not the answer. That many states want OTPs to be regulated like a pharmacy, replete with a pharmacist on staff, is curious. Instead, close clinics and let patients pick up methadone at a real pharmacy."
Check out these two documentaries, Liquid Handcuffs: A documentary to Free Methodone, by Helen Redmond, and the trailer to Swallow This: Methadone and Covid-19, by Helen Redmond and Marilena Marchetti. For a historical discussion on the Black Panther Party and methadone, check out the Atlantic Monthly article, "How racism gave rise to acupuncture for addiction treatment." Dope is Death, a short film by Vice News, tells"The story of a radical movement that sought to end heroin addiction in communities of color with acupuncture, led by Dr. Mutulu Shakur, the stepfather of Tupac Shakur."
Incarcerated since 1986, "Dr. Shakur participated in civil rights, Black liberation and acupuncture healthcare all as part of movements of the late 1960s to the 1980s. For over twenty-five years, Dr. Shakur has been a leading voice in the Black community calling for peace, reconciliation and healing for the countless lives lost in pursuit of basic justice and human rights. Dr. Shakur received his ninth parole denial in January 2021. After being diagnosed with life-threatening bone cancer yet denied compassionate release, his lawsuit against the US Parole Commission and the Bureau of Prisons for unjust denials was expedited." For more on Dr. Mutulu Shakur's case, click here.
