How OTPs Can Benefit Their Communities
The opioid crisis has continued to claim thousands of lives each year, rising to an all-time high of 81,806 deaths in 2022.
And although 2023 saw an overall decline in overdoses for the first time, overdose deaths continue to rise for certain demographics, including non-Hispanic Black men, and for populations in certain states, including Alaska and Oregon.
In the midst of this ongoing crisis, opioid treatment programs have a unique opportunity to support individuals with addiction and help prevent overdose deaths through medication assisted treatment, counseling, and other life-saving services. OTPs are also the only facilities that can legally administer methadone, a proven and effective treatment for Opioid Use Disorder.
Despite their positive impact, there are only around 1,900 OTPs in the U.S., and stigma around opioid addiction and its treatment mean that many OTPs face resistance from people in their communities.
In this article, we’ll examine the different ways OTPs benefit their communities at large, along with some key improvements that will help OTPs increase their impact in the future.
4 Ways OTPs Benefit Communities
1. Access to Life-Saving Care
In a recent study from JAMA Network, 32% of adults said they knew someone who had died of a drug overdose. Substance abuse is far more prevalent than it may appear — even if you don’t realize it, you likely know someone in your community who’s experiencing opioid addiction — and many individuals don’t have access to the care they need.
This is partially due to the stigmatization of life-saving medications like methadone and buprenorphine. Though proven to be the most effective methods in treatment of opioid addiction, many people still see these medicines as an alternative to getting high.
In reality, methadone and buprenorphine are safe when prescribed and used correctly. In fact, methadone reduces the risk of dying from an opioid overdose by 50% or more. Methadone is a synthetic opioid agonist, which means it attaches to the opioid receptors in the body. This prevents withdrawal symptoms, but it also doesn’t create a euphoric sensation. Methadone has been successfully used in OTPs for more than 40 years.
Buprenorphine works similarly, but it’s a partial opioid agonist, meaning it activates opioid receptors less strongly than methadone. This can produce the same life-saving effects.
In order to give patients the access to live-saving care they deserve, we must reduce both the stigmatization around methadone and buprenorphine and the barriers that make it challenging for patients to access these medications.
OTPs should also consider strategies for implementing a low-barrier care model, such as collaborating with patients to build more personalized treatment plans, and using a remote dosing solution like Sonara Health to safely issue more take-home methadone doses.
2. Improved Employment
Patients with OUD often experience withdrawal symptoms that take a toll on their mental and physical health, making it difficult to find or continue employment.
Methadone and buprenorphine, two medications provided by OTPs, prevent withdrawal symptoms so patients can participate in daily life sooner. But stigmas surrounding long-term treatment reduce OTPs’ abilities to continue medicating their patients.
In fact, research from The National Academies shows that the period after discontinuing long-term treatment is when a patient is at the highest risk for overdose. Long-term, uninterrupted treatments have been shown to increase employment rates and mental health.
The longer these patients are receiving treatment, the more likely they are to participate as active, engaged members of their local communities and workforce.
Employment for OTP patients can be difficult with the need to visit their treatment center daily for a number of weeks. Sonara has partnered with OTPs to support responsible take-home medication earlier, which in turn can make it easier for patients to gain and maintain employment.
3. Reduce Localized Crime
One common stigma surrounding OTPs is the belief that they lead to increased crime and drug use in local neighborhoods. This misconception is not only false, but it’s rooted in the outdated practices of the 1970s when OTPs were first introduced.
When OTPs were established, they were often used as part of the Nixon administration’s “war on drugs,” which disproportionately affected people of color. At that time, OTPs were seen as tools to reduce crime and prevent methadone diversion rather than as healthcare facilities.
Today, OTPs focus on improving substance addiction treatment through patient-centered healthcare. They’re designed to help individuals recover from addiction and do not serve as control mechanisms for the communities they inhabit.
There are no studies to suggest that OTPs increase criminal or drug related activities in their local neighborhoods. On the contrary, expanding OTPs across the U.S. is crucial in the mission to reduce opioid-related deaths and abuse.
In our work at Sonara, we’ve found that even take-home doses — when issued responsibly and monitored by a remote dosing solution like Sonara — do not significantly increase risks for communities. Sonara data shows 85% of patients enrolled are properly administering their take-home medication. And by partnering with Sonara, OTPs can identify the small percentage of patients that may require additional support.
4. Access to Community Resources
OTPs don’t just provide medical resources to help their patients physically recover—they often partner with community resources to increase mental and social recovery, too.
Here are a few resources OTPs may offer along with medication assisted treatment:
Counseling Services — OTPs offer counseling services to help patients recover psychologically, and to provide additional support in behavior changes and relapse-prevention.
Case Management — Some OTPs provide legal services on a case-by-case basis for their patients.
Housing — OTPs can provide temporary living solutions to patients through partnering with local housing agencies, homeless shelters, or supportive housing programs.
Employment — OTPs often partner with local businesses to provide transitional employment solutions for patients. Additionally, they may facilitate skill development, peer support or mentoring.
Additionally, OTPs may offer peer support, education services, medical care, and transportation support. The mission for many OTPs goes beyond just treating opioid addiction — they specialize in helping patients rebuild their lives, too.
The Road Ahead for Opioid Treatment Programs
Even though all research shows that OTPs are an effective tool for treating OUD and don’t negatively impact their communities, stigmas around opioid addiction are still powerful and pervasive.
Furthermore, rules governing the establishment, operation, and provision of care at OTPs exist at both the federal and state levels, with many states adding more restrictive requirements than the federal government. Government policies that reflect these stigmas have historically made it challenging for OTPs to maximize their impact. In order to give OTPs the full reign they need to properly help their patients, we need to destigmatize opioid recovery but also take a closer look at the regulations that are rooted in NIMBYism (“Not in My Back Yard-ism”) and other prejudice.
One strategy for overcoming these limitations is building partnerships with Federally Qualified Health Centers and Certified Community Behavioral Health Clinics to support an integrated care model that leverages co-located medication units. For more on this approach, watch the replay of Sonara’s recent webinar with the National Council for Mental Wellbeing.
And if you’re interested in learning how Sonara can help you expand access to take-home methadone, please contact us today.
