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Leaders Are Embracing Multiple Roads to Recovery


As policy-makers and the public have come to appreciate the importance of addressing the addiction crisis head-on, the dollars that have flowed into the industry have ushered in new leaders with new ideas. Sometimes these ideas diverge with mainstream thinking, but that can be welcomed in a field that is striving to raise the bar on access to treatment and quality of care.


Even among the staunchest supporters of one approach or another to treatment and recovery, there appears to be a growing understanding that the industry should embrace all potential roads to wellness. “Meeting clients where they are” has become much more than just a catchy slogan on a treatment center’s webpage.


As we move into 2024, leaders will be looking to several possible developments that could broaden service delivery nationally and in the states. On the federal level, for example, legislation that is now moving through Congress would at least in theory expand access to life-saving medication treatment for opioid use disorder (OUD).


The Modernizing Opioid Treatment Access Act (MOTAA) would allow individual physicians who register with the federal government to prescribe methadone. This would give patients with OUD an option to receive methadone at a pharmacy as an alternative to making daily visits to a clinic setting for their medication.


This proposal has generated strong debate, and that certainly will continue if the legislation advances in Congress. Some leaders legitimately worry that proper safeguards won’t be in place for an additional and previously untested way of delivering methadone treatment. Others wonder if individual physicians would have enough interest in prescribing methadone at all. They point to a still slower-than-expected physician response to the office-based prescribing of buprenorphine for OUD, even after federal regulators lifted many of the restrictions on buprenorphine treatment.


At the close of 2023, the proposed legislation had cleared the Senate’s Health, Education, Labor and Pensions (HELP) Committee. This will be a closely watched initiative as members of Congress return to work in the new year.


At the state level, all eyes will be on California in the first quarter of 2024, as voters there will decide in March on a proposed transformation of behavioral health service delivery in the state. The Proposition 1 ballot initiative, if approved, would broaden the reach of the state’s existing Mental Health Services Act and also would authorize more than $6 billion in general obligation bonds to develop treatment beds and supportive housing units. A major focus of the initiative is to offer viable solutions for individuals with behavioral health disorders who have experienced homelessness.


As with the federal legislation on treatment for OUD, there are concerns about the details of implementing a transformation of California’s service delivery system. Some mental health-focused provider agencies, while supporting the proposal’s goals in principle, wonder if the dollars and workforce capacity will be there to support the mission of including substance use treatment under the Mental Health Services Act. There is also concern that an initiative with a primary focus on housing could weaken the safety net in human services.


These two examples, and many others nationally, reflect a desire to reach more people in need with more sustainable solutions. Groups that find themselves with differing opinions on some of the details are still finding common ground in the desire to offer individuals “no wrong door” to the treatment and support services that can bring about a meaningful and lasting recovery.


As we begin a new year, we at Sigmund Software remain committed to giving our customers the tools to broaden their own mission, individualizing the care they deliver to improve patient outcomes. Our solutions will enhance the performance of your clinical team as they help patients reach their full potential. Best wishes for great success in 2024.