Welcome to Public Health On Call, a podcast from the Johns Hopkins Bloomberg School of Public Health,

where we bring evidence, experience, and perspective to make sense of today's leading health challenges.

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This is Lindsay Smith Rogers. Today, why methadone, a gold star treatment for opioid use disorder, is so hard to get.

Dr. Brian Hurley, president of the American Society of Addiction Medicine, talks about what the

organization and others are doing to try and change federal regulations around this

life-saving medication. Let's listen. Dr. Brian Hurley, thank you so much today for being on

public health on call. How are you? Very well. Thank you for having me. Sure. So today we're going to

talk about methadone. There are a lot of people that need it, not a lot of people that can get it.

So first of all, let's talk about why methadone? Methadone is a really effective medication to treat opioid use disorder.

It's one of the three medications that are FDA approved, the other two being buprenorphine

and then naltrexone.

Methadone has an advantage being able to start a patient on methadone treatment, even before they're in withdrawal.

Based on their clinical exam, you can start somebody on a lower dose of methadone and then titrate

up over the course of the patient's first few weeks in treatment. And tell me, is it effective?

Yes, methadone is a effective medication to treat opioid use disorder.

It reduces opioid use.

It supports patient retention, or basically, it supports people continuing in treatment.

And for patients that have opioid use disorder with other drugs,

actually the use of other drugs, oftentimes goes down as well as part of their methadone

treatment.

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