Substance Abuse and Mental Health Services Administration

Press Release

Contact: Ivette Torres/Leah Young
May 18, 2001
Phone: (301) 443-5052

Training Begins for Accreditation of Methadone Programs

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) is beginning a series of eight training sessions around the country for substance abuse treatment programs that use methadone and other medications to treat heroin and similar addictions. The sessions will teach treatment centers how to meet accreditation standards designed to improve treatment practices. The new standards replace a 30-year-old inspection program conducted by the Food and Drug Administration (FDA). The first seminar is today in Baltimore.

The new accreditation standards follow the recommendations that have been made over the last decade by several groups, such as the Institute of Medicine, the Congressional General Accounting Office, and the National Institutes of Health. The new standards emphasize individualized treatment and improving the quality of care through increased medical supervision and assessment of patient outcomes. Substance abuse treatment programs will be accredited by non-federal agencies or state governments, following criteria established by CSAT.

"With these new standards treatment of heroin addiction will move from a system dominated by documentation and detailed Federal regulation to one focused on accreditation and accountability," said acting SAMHSA Administrator, Joseph H. Autry III, M.D. "Clinical decision making will be where it belongs - in the hands of treating professionals working with opiate-addicted patients. After all, methadone alone is not the answer. It is just one part of a many-faceted, personalized treatment approach that embraces psychosocial and supportive community-based services as well as medication."

H. Westley Clark, M.D., J.D., M.P.H., Director of CSAT, explained that "the accreditation system will set a higher standard of care for those receiving methadone treatment. It should improve the quality of treatment programs overall by allowing for more clinical judgment in treatment, help mainstream the medical treatment of opioid dependence, and continue a federal role, managed by SAMHSA's Center for Substance Abuse Treatment."

While the White House Office of National Drug Control Policy (ONDCP) estimates that there are approximately 980,000 heroin addicts in the United States, only about 20 percent currently receive methadone or LAAM, as part of an addiction treatment program. There are approximately 1200 methadone treatment programs in the U.S., including programs approved for LAAM treatment.

Accreditation has been proven over the years to produce effective outcomes and is a widely adopted external quality assessment system used by the federal government, states, managed care firms, insurers, and others to ensure accountability for quality treatment. Accreditation should give assurances to communities that the highest quality medicine is being practiced.

The move to accreditation follows recommendations made by a 1997 National Institutes of Health consensus panel. The panel concluded that existing federal and state regulations limit the ability of physicians and other health care professionals to provide methadone maintenance services to patients and recommended accreditation in lieu of regulations to improve the quality of care. The changes are also consistent with a 1995 report by the Institute of Medicine that stressed the need to readjust the balance among regulations, clinical practice guidelines and quality assurance systems.

The new standards consider both patient benefits and community concerns. Oversight of substance abuse treatment facilities is transferred from the Food and Drug Administration (FDA) to SAMHSA's Center for Substance Abuse Treatment. The regulations of the Drug Enforcement Administration regarding diversion of methadone remain in place.

Following the Baltimore workshop, training will be conducted in New York on May 21, and Dallas on May 30. Training will be held in Lowell, MA on June 5, Chicago on June 12, Atlanta on June 19, Los Angeles on June 26 and Seattle on June 28.

The new standards go into effect on May 18, 2001 as part of the Code of Federal Regulations 42 part 8, "Certification of Opioid Treatment Programs." This final rule includes a transition plan that allows existing treatment programs approximately 2 years to achieve accreditation under the new system.

The Center for Substance abuse Treatment (CSAT) is a component of the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA, a public health agency within the U.S. Department of Health and Human Services, is the lead federal agency for improving the quality and availability of substance abuse prevention, addiction treatment and mental health services in the U.S. Copies of CSAT documents are usually available at www.samhsa.gov or ncadi.samhsa.gov.