Montana: A Trailblazer in Eliminating Regulatory Barriers for Opioid Use Disorder Treatment, According to Community Medical Services

HELENA, Mont., Oct. 24, 2024 /PRNewswire/ — When the Substance Abuse and Mental Health Services Administration (SAMHSA) updated their recommendations governing Opioid Treatment Programs (OTPs) in April 2024, Montana was among the first to implement significant changes for OTPs in the state. Community Medical Services (CMS) currently provides care to Montana residents at 4 clinics, (Billings, Bozeman, Kalispell and Missoula), and has been working to adjust their clinical guidance to institute these changes aimed at improving patient safety and retention in treatment programs. This is a crucial step forward in addressing the opioid epidemic, providing more effective care for individuals struggling with opioid use disorder.

Extended Take-Home Doses
Under the new rules, patients are no longer required to come to a clinic at the same frequency as they have historically needed to. Medical providers can determine the appropriate number of take-home doses based on individual patient needs and criteria, including:

• Absence of active substance use disorders or other health conditions that increase the risk of patient harm
• Regular attendance for supervised medication administration
• Absence of serious behavioral problems
• Absence of known recent diversion activity
• Safe transportation and storage of take-home medication

Higher Initial Dosing
The initial dose of methadone, which was historically capped on the first day, can now be titrated more quickly at the medical provider’s discretion, allowing patients with higher opioid tolerance to get to a therapeutic dose more quickly. This change acknowledges the varying levels of opioid tolerance among patients, exacerbated by the increased presence of fentanyl in the illicit drug supply, and enables medical providers to tailor treatment to individual needs.

Drug Screens
The presence of unprescribed amphetamine or cocaine on drug screen results will no longer be the sole limiting factor to requiring patients to not have to come into clinics daily, unless it increases the risk of overdose. This change recognizes that patients with opioid use disorder may also struggle with other substance use disorders and requires medical providers to assess each patient’s unique situation.

Conclusion
The SAMHSA Final Rule changes mark a crucial step forward in enhancing Opioid Treatment Programs in Montana. By providing more flexible and individualized treatment options, these changes aim to improve patient safety and retention, decrease daily patient volumes at clinics, and ultimately support individuals in their journey towards recovery.

How CMS is Implementing SAMHSA’s Changes
At its 4 clinics in Montana, CMS has proactively implemented the SAMHSA Final Rule changes. Our approach focuses on balancing patient safety with reducing barriers to treatment, ensuring that any changes benefit our patients and their recovery outcomes.

Triweekly dosing—allowing patients to come to the clinic only three times per week—has become the new standard. This means that most patients, even those who might test positive for stimulants or miss some clinic days, are not required to visit the clinic more than three times a week. For patients who meet certain stability criteria, the option to advance to weekly clinic visits is available after just two weeks of triweekly dosing. This provides immense relief to patients who previously struggled to balance daily trips to the clinic with their other responsibilities, such as work or family.

Visit the CMS blog on our website for a complete review by our Chief Science Officer, Dr. Robert Sherrick, of how we are taking an active step toward implementing these changes and seeing early positive results https://communitymedicalservices.org/samhsa-final-rule-changes/

Media Contact:
John Koch– Director Public Relations
John.Koch@CMSGivesHope.com

2827 Fort Missoula Rd, Missoula, MT 59804

8707 Jackrabbit Ln Suite D, Belgrade, MT 59714

2415 S Catlin St, Missoula, MT 59801

795 Sunset Blvd F, Kalispell, MT 59901

2040 Rosebud Dr, Billings, MT 59102

2827 Fort Missoula Rd, Missoula, MT 59804

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SOURCE Community Medical Services