Reducing stigma and expanding methadone access in the U.S.: the Modernizing Opioid Treatment Access Act and beyond

(MOTA) Act proposes reforms to methadone regulation by allowing addiction physician specialists to prescribe up to 30-day doses through community pharmacies. This perspective examines the bill's implications, implementation challenges, and future policy directions to improve equitable access to methadone. While opioid treatment programs have played a critical role in methadone delivery, their restrictive model can increase stigma and limit access, particularly in underserved areas. The COVID-19 pandemic demonstrated that 30-day take-home methadone-dispensed through opioid treatment programs-could be implemented safely in the U.S. and international pharmacy-dispensing models further support a less restrictive approach. However, successful implementation requires addressing inadequate prescriber training, pharmacy participation barriers, and insurance coverage limitations. Expanding methadone access through pharmacies is a step toward integrating addiction treatment into mainstream healthcare. If able to effectively increase accessibility, the MOTA Act may also help reduce stigma and improve outcomes for individuals with opioids use disorder.