Beyond Methadone – Improving Health and Empowering Patients in Opioid Treatment Programs (OTPs): Hepatitis C, Overdose Prevention, Syringe Exchange, Buprenorphine, & Other Opportunities to Make Programs Work for Patients.
New York has increasingly recognized that drug use is more effectively addressed through health and rights-based approaches, rather than through the criminal justice system. One important example is Opioid Treatment Programs (OTPs), which offer methadone and buprenorphine to people who are dependent on heroin and other opioids (e.g. painkillers).
But methadone treatment programs are not perfect, and we have found they miss a lot of opportunities to address unmet health needs among their patients, while failing to ensure basic rights are upheld.
VOCAL-NY members who are current or former methadone patients worked with the Urban Justice Center’s Community Development Project to develop a community–led research report that would document the challenges faced by methadone patients in OTPs and develop recommendations to make these programs more patient-centered.
Our new report, Beyond Methadone – Improving Health and Empowering Patients in Opioid Treatment Programs (OTPs): Hepatitis C, Overdose Prevention, Syringe Exchange, Buprenorphine, & Other Opportunities to Make Programs Work for Patients is the result.
Our research findings cover topics as diverse as hepatitis C, overdose prevention, syringe access, alternatives to methadone (burprenorphine), treatment interruptions, patient rights and involvement, and harassment by security and police.
Highlights of findings include:
- Hepatitis C: About one-quarter of patients we surveyed did not know their hepatitis C status and did not recall ever being offered a test, and more than half of those who did test positive were offered no viral testing or further care.
- Overdose Prevention: One in ten patients surveyed had experienced an overodse in the past two years and one in five had been with someone else who had overdosed, but most reported that there was no education or services to prevent overdose at their program.
- Syringe Access: Three in four patients surveyed said they supported allowing syringe exchange services onsite to prevent the spread of HIV and hepatitis C.
- Treatment Interruptions: More than half of survey respondents had missed a methadone dose, which can trigger severe withdraw symptoms and cause someone to use illicit drugs, which were caused by limited clinic hours, Medicaid case closures, and delays with transportation assistance.
Recommendations include onsite hepatitis C testing and care coordination, naloxone distribution and education about the new “911 Good Samaritan” law to prevent overdose deaths, onsite syringe exchange, and administrative reforms to prevent treatment interruptions.
We released the report during a briefing at 250 Broadway on October 6th, 2011. The briefing began with welcoming remarks by Assembly Committee on Health Chair Richard N. Gottfried and Assembly Committee on Alcoholism and Substance Abuse Chair Steven Cymbrowitz. After a presentation of the report findings by VOCAL-NY leaders, an expert panel followed with Dr. Daliah Heller (Assistant Commissioner, Bureau of Alcohol and Drug Use Prevention, Care and Treatment in the NYC Department of Health & Mental Hygiene), Dr. Steven Kipnes (Medical Director for the NYS Office of Alcoholism and Substance Abuse Services), and Dr. Sharon Stancliff (Medical Director for the Harm Reduction Coalition and medical consultant for the AIDS Institute in the NYS Department of Health).