What Does the SAMHSA Final Rule on Medications for the Treatment of Opioid Use Disorder Mean for OTPs?
Updated Dec. 30, 2024
At the start of 2024, SAMHSA issued its final rule on “Medications for the Treatment of Opioid Use Disorder,” introducing a large update to OTP treatment standards. These updates represented the most significant revision to OTP treatment standards in over 50 years and marked a critical shift toward patient-centered care.
At Sonara Health, we know the importance of these updates as they not only improve patient outcomes but also empower providers to make informed decisions for meeting their individual patients’ needs. We know it has been a significant transition, and we will continue to provide OTPs with the support they need.
In this article, we’ll reflect upon the most significant changes in SAMHSA guidelines (including the clarifying language published in December 2024), explain why they’re so important, and share practical steps you can take to navigate this transition.
What Has Changed with the Final Rule?
The final rule included a variety of updates focused on removing stigmatizing language, supporting a more patient-centered approach, and decreasing barriers to accessing care.
Some of the most notable changes included:
Making the COVID-19 take-home flexibilities permanent
Allowing providers to issue take-homes during the first week of treatment (under certain conditions)
Eliminating the requirement of one year of opioid addiction before entering treatment
Prioritizing treatment for pregnant individuals and reducing treatment barriers for people under 18
Encouraging shared decision making between patients and providers
For a more in-depth examination of the changes included in the final rule, review this chart from SAMHSA.
The Importance of Clinical Decision-Making and Practitioner Discretion
The revised rule emphasizes the importance of clinical decision-making and practitioner discretion in delivering effective, individualized care within OTPs. This approach prioritizes tailoring treatment plans to each patient based on their unique needs.
In SAMHSA’s own words,
“The revised rule also recognizes the importance of practitioner discretion in determining and recommending the appropriate level of care and support for each patient… Rather than imposing rigid, one-size-fits-all dosing schedules, the rule gives practitioners the authority and responsibility to work with patients to determine the appropriate level of patient medication visits based on each patient's individual needs, progress, and stability.”
We’re encouraged to see SAMHSA’s policies align with what we’ve long believed: OTPs will see greater treatment success when they’re able to individualize care based on the patient in front of them.
Supporting OTPs through the Final Rule Changes
At Sonara Health, we’re thrilled to see SAMHSA take this important step toward increasing access to care and promoting a whole-person approach to treatment.
We also know that increasing take-home flexibilities does not guarantee that more take-homes will be issued. In one study, half of all prescribers chose not to increase take-home flexibilities when they had the ability to do so.
We’ve found that this hesitancy is rooted in a lack of trust between providers and patients, and we’re here to change that.
Sonara’s solution strengthens the provider-patient relationship by giving providers a window into their patients’ at-home dosing. Our web-based application allows patients to remotely record their methadone doses for their care teams to review.
And with this increased visibility, providers can feel confident issuing more take-homes, making it easier for their patients to succeed at treatment and reducing the need for daily trips to the clinic.
Why it Matters
When considering the impact of these changes, we think SAMHSA said it best:
“These changes are about respect, trust, understanding, and compassion. Trusting that you understand what you need, while highly skilled OTP practitioners respect your values, needs, and preferences. The revised rules allow them to provide you with the best care available. They balance the need for responsive patient care with responsible ways to make sure you’re getting good care, all while providing you with consistency, humanity, support, and empowerment through your recovery journey.”
Our team at Sonara is perfectly aligned with this mission, and we’re committed to giving OTPs the tools they need to put this into practice.
To learn more about our solution, or to discuss how remote observation can support your OTP’s strategy for implementing the final rule, reach out to our team here.
