Using methadone to detox from other opioids can come with stigma. One program is hoping to ease that.
WSHU’s Ebong Udoma spoke with CT Mirror’s Calista Oetama to discuss her article, “CT’s first state-funded methadone vans expand access to treatment,” as part of the collaborative podcast Long Story Short. Read the story here.
WSHU: Hello, Calista. You say you decided to look into this as a follow-up to a story published two years ago by your colleague at the Connecticut Mirror, Andrew Brown. What was Andrew's story about, and what was your follow-up here?
CO: So, my colleague Andrew Brown spent years covering the opioid crisis in Connecticut. In 2024, he published a story about the travel burdens faced by clients seeking methadone, which is considered the most effective medication for treating opioid use disorder. It's a really tightly regulated substance, so people who seek it for opioid use disorder can only get it by going to a certified clinic in person. A couple of researchers from Yale and Virginia Tech found that a Connecticut resident traveling by car might have to drive 45 minutes one way to reach a clinic, while taking public transport might take three hours for some people. So if you work a nine-to-five or you've got to drop your kids off at school in the morning, it's just not feasible. Even though this care is considered life-saving by many people. So Andy's story was about that, and he mentioned at the end that Connecticut was planning to use $4 million taken from opioid settlement funds to develop these two big mobile units that can go to places with high overdose rates and less public transport to dispense methadone to people who might need it. Two years later, I was kind of wondering what happened to those vans, and I decided to reach out to a bunch of providers. They pointed me to the two organizations that were running the units, and it turns out the timing was great because one van launched last month, and the other, which I visited, will officially hit the road tomorrow.
WSHU: And that's one that's dedicated to the southeastern corner of Connecticut, correct?
CO: The one that just launched in July was dedicated to the southeast. The one I visited is dedicated to the northeast.
WSHU: Okay. Now let's talk about the northeast. It's a pretty rural area of the state, so transportation is a big issue. How have they been able to help out by having these vans out there?
CO: Well, my colleague and I visited the van over there. It took us an hour to get there from Hartford, and it was mostly like one straight road with a lot of forests and fields. It's definitely hard to get around on a bus, and I could immediately see how hard it would be for people to travel there. So these vans, they'll go to places like in northeastern Connecticut that have had like historically high rates of overdoses. They'll park at a known location, and then people can come to receive their dose one by one. They just line up with the van in the front.
WSHU: So they put out a notice that they're coming to the area, and how does that work?
CO: They advertise it through word of mouth, which is how they get most of their clients, and then they'll put out a notice saying we're going to be parked here. Please come if you need to.
WSHU: Okay, could you just tell us about the process itself? They try to explain that to you, right?
CO: So they basically kind of gave us a tour of the vans as we got there. So a client will enter from the back of the van. They'll climb up a couple of steps to the receptionist's office. They sign in with the nurse over there and then get their dose. They'll take their dose and then they'll move through the next part of the van. And if they need case management or counseling sessions, they can talk to people there and receive them if needed. It's all pretty private. There are partitions everywhere, and there's going to be noise machines so that people can't eavesdrop on these conversations. And once everything's done, they exit through a door on the side of the van. No worries about making contact with any other person other than the people staffing the van.
WSHU: And how often will the vans be out in these areas?
CO: They'll be out Mondays through Fridays from 7 a.m. to 11 a.m. This is usually when people, you know, wake up, start working, or right before then.
WSHU: Okay. The other thing that I'm really curious about is the funding structure for this. How is it being funded, and can that be sustained?
CO: That's a really good question. So Connecticut has received more than $185 million in opioid settlement funds, and the Department of Mental Health and Addiction Services has pledged about $4 million of those to outfit these two vans. So that's like $2 million per van, which is quite expensive. The reason why they're so expensive is that methadone is so tightly regulated. These units need to comply with a bunch of guidelines set by different state and federal agencies. There's maintenance, gas, salaries, so it's quite hefty in terms of both the size of these vans and the cost it takes to run them. I've talked to some of the providers, and they said that they definitely want this van to continue long-term, even when these opiate settlement funds stop funding the vans in 2027. They say they've accounted for this expense in their budgets, and they're hoping that there will be enough people seeking these services to continue getting funding from other sources as well.
WSHU: Now, there's also been some legislation that is pushing back against methadone treatment centers like these. Could you just tell us a little bit about the legislation that's been in the works and some that have been passed that might affect the future of methadone clinics?
CO: One calls for the reversal of updated guidelines that initially expanded access during COVID, which was a time when I think lawmakers on both sides of the political spectrum realized just how deadly the opioid crisis was. This bill wants to reverse this expansion of treatment, and providers and advocates I spoke to said it's unlikely to pass since bipartisan support for maintaining this current level of access- that you can get methadone prescribed to you if you go to a clinic or a methadone van- seems to remain quite strong.
But there's another bill, also a bipartisan one, that wants to pull access in the opposite direction, making it even easier to get methadone. Right now, because methadone is a Schedule II controlled substance, you can prescribe methadone for pickup at a pharmacy, unlike other opioid use disorder medications like Buprenorphine or Naltrexone. But this bill wants to make direct pickup possible. Advocates I spoke to are quite in favor of this. They're saying it's going to normalize it even more and reduce stigma. But I think it is quite a big step to deregulate Methadone further, and providers seem a bit skeptical about how much support it will receive. So I'm really interested to see where that goes. It just seems like these two bills, despite being in their early stages, it's clear that the issue of access is still getting a lot of attention.
WSHU: In the meantime, the methadone vans are trying to destigmatize the use of methadone.
CO: Absolutely.
