名媛直播

WASHINGTON -- Using mobile vans to deliver medication-assisted treatment (MAT) such as methadone would become easier for substance abuse treatment centers under a by the Drug Enforcement Administration (DEA).

The regulation eliminates a requirement that the treatment centers, also known as narcotic treatment programs (NTPs), have a separate registration for their mobile vans. "This final rule waives the requirement of a separate registration at each principal place of business or professional practice where controlled substances are dispensed for those NTPs with mobile components that fully comply with the requirements of this rule," according to the notice published in the Federal Register. "These revisions to the regulations are intended to make maintenance or detoxification treatments more widely available, while ensuring that safeguards are in place to reduce the likelihood of diversion."

"Actions like this evidence-based treatment in underserved communities are urgently needed," said Regina LaBelle, Acting Director of National Drug Control Policy, on a Monday morning phone call with reporters. "The Centers for Disease Control and Prevention estimate more than 92,000 Americans died from drug overdose in the 12-month period ending in November 2020. For millions of families and communities across the country, as well as for President Biden, Vice President Harris, myself, and all of us on this call, this issue is personal and requires immediate action."

"Today's rule change meets several of our top priorities by expanding access to treatment ... to ensure greater access to treatment for all communities," she continued. "Barriers to treatment have had an especially pronounced effect on communities of color, resulting in health disparities and health inequity. All Americans, regardless of their race, color, or zip code should have access to the treatment they need." She noted that the effectiveness of mobile vans has already been proven in six states in Puerto Rico, "and the DEA action today means the services can reach more people, especially the most vulnerable in our community."

Thomas Prevoznik, deputy assistant administrator of the DEA's Diversion Control Division, also spoke during the call. "We're currently losing nearly 70,000 souls per year to opioid-involved overdoses," said Prevoznik. "We know we can't arrest our way out of this problem." Instead, the DEA and other federal agencies recognize they need to "focus on efforts to improve use of MAT and help opioid-addicted Americans recover."

He noted that although there are more than 1,900 treatment programs registered with the DEA, "not every opioid-addicted American has access to these brick-and-mortar locations, especially in rural areas." This is due to a variety of factors including long distances and a lack of transportation options, he added. "The rule finalized today offers more flexibility for MPTs that wish to operate a mobile component ... This action cuts some of the red tape involved and streamlines the registration process."

Tom Coderre, acting assistant secretary for mental health and substance use at the Substance Abuse and Mental Health Services Administration (SAMHSA), said that "no American should have to drive or ride a bus for 2 hours every day to receive the life-saving, evidence-based treatment they need to survive ... As a person in recovery myself, I understand first-hand the need to remove as many barriers as possible, squash negative public attitudes associated with medication-based treatment, and meet people where they are."

Prevoznik said that "with this action, DEA is sending a very important message -- that we support use of MATs for opioid use disorder, and we're using all of the tools at our disposal to make treatment options available to anyone who needs it anywhere in the country," Prevoznik said. During a question-and-answer session, a senior policy adviser to the Office of National Drug Control Policy said that the administration "doesn't have an idea of what percentage" of the 1,900 NTPs will set up the mobile vans, but "we know anecdotally that a lot of opioid treatment programs are very excited about this rule" and are gearing up their budgets to set up the vans.

Asked whether federal funding would be available to help treatment centers pay for the vans, a senior adviser to SAMHSA said that "this is an allowable use for SAMHSA funding and we'll work with states to address any questions they have regarding how to access SAMHSA funds for these purposes."

The DEA received a number of comments on the final rule, including suggestions regarding how far the vans should be allowed to travel to dispense treatment. "DEA will not define an exact distance that the mobile component can travel from its registered location," the agency said in its response.

"DEA has concluded that mobile NTPs must be required to return to their registered locations upon the completion of their operations each day and that such a requirement can be met while still increasing access to maintenance or detoxification treatment in rural and underserved areas. A specified mileage limit, however, is not necessary ... NTPs are better positioned than DEA to determine how far from their registered location the mobile components can travel while still allowing adequate time to return to their registered location at the end of the day."

Comment