The Health Department and the New York State Office of Addiction Services and Supports (OASAS) launched a program to deliver methadone to patients with COVID-19, COVID-like illness, or at high risk of COVID-19. In a first for New York City, 20 Health Department staff, working in teams of two, are making curbside deliveries of methadone to patients’ homes and to City-run isolation hotels. The program can make approximately 1,300 deliveries per month. To reduce the risk of COVID-19, staff are equipped with masks, hand sanitizer and wipes and have undergone safety training, including best practices for maintaining social distancing.
“Methadone is a life-saving medication,” said Health Commissioner Dr. Oxiris Barbot. “New Yorkers who take methadone and get sick from COVID-19 should not have to choose between getting their medication and protecting their health or the health of others. No other medication is as strictly regulated as methadone, and I urge my federal colleagues to consider making these changes permanent after the pandemic is over.”
OASAS Commissioner Arlene González-Sánchez said, “Amid the COVID-19 pandemic, we have made numerous adjustments to continue providing services, while at the same time protecting the safety of staff, patients, and the public. With this new delivery program, people can still receive their life-saving medication, while also staying safe from dangers presented by COVID-19. This program will be a great benefit for people throughout New York City who are affected by COVID-19, or are at high risk of complications from this disease if they were to contract it.”
Expanding methadone home delivery
After a soft launch in mid-April at select isolation hotels, the methadone home delivery program now accepts patients from isolation hotels run by NYC Health + Hospitals, NYC Emergency Management, and the Mayor’s Office of Criminal Justice.
In addition, the Health Department expanded the eligibility criteria of patients who can receive home delivery of methadone, lowering the age minimum from 65 to 50 years and lowering the minimum take-home dose from 14 days to 7 days.
Anyone who takes methadone can be referred for methadone delivery at the discretion of the medical director of their opioid treatment program.
Emergency regulations allowing for home delivery
Methadone is an effective and safe treatment for opioid use disorder and reduces the risk of overdose, yet it remains the most heavily regulated medication in the country. Under federal regulations, people who take methadone must go to an opioid treatment program regularly – ranging from every day to once a month – to pick up their medication.
In response to the COVID-19 pandemic, the federal government has loosened the regulations around methadone, allowing local governments to coordinate methadone delivery to high-risk patients. In addition, clinics are now able to provide up to 28 doses of methadone for patients to take home, depending on their stability in treatment. Furthermore, patients may assign a family member or member of their household to pick up their methadone for them. Currently, 40% of New York City residents who take methadone have someone else pick up their medication on their behalf.
Guidance for referrals
In order to receive methadone delivery, patients need to be referred to the program by either the medical director of their opioid treatment program or staff at the isolation hotel where they currently reside. The Health Department suggests the following guidance for patient referrals, but any patient can be referred at the discretion of the medical director:
- Diagnosis or symptoms of COVID-19.
- A take-home dose of methadone for a minimum of 7 days; age 50 or older; AND an underlying health condition:
- Lung disease
- Moderate to severe asthma
- Heart disease
- A weakened immune system
- Kidney disease
- Liver disease
“Methadone is a lifesaving maintenance medication that helps people to lead safe and healthy lives. It is vital that those who are particularly vulnerable to COVID-19 are not forced to risk their lives by braving to access methadone. I am pleased that the City of New York, in partnership with OTPs and advocates, has devised a solution that ensures that people continue to have access to methadone while they shelter safely at home,” said Assemblymember Linda B. Rosenthal, Chair of the Committee on Alcoholism and Drug Abuse (D/WF-Manhattan).
“Housing Works applauds this important effort from DOHMH and OASAS to provide methadone to people who are in isolation shelters coping with the COVID-19 pandemic,” said Charles King, CEO, Housing Works. “We should also ensure that these folks have access to additional harm reduction resources, such as clean syringes.”
Allegra Schorr, President of the Coalition of Medication-Assisted Treatment Providers and Advocates of New York State (COMPA), stated, “COMPA commends our city and state partners NYC DOHMH and OASAS for their rapid response and mobilization on this crucially timed methadone delivery system designed to help patients in treatment with opioid use disorder through the coronavirus crisis – and at the same time help fight the spread of COVID-19.
During these unprecedented times, Opioid Treatment Programs (OTPs) across New York City will now have the vital support needed to have methadone delivered, within protocols and guidelines, to both New Yorkers in New York City’s Isolation Hotels and patients at risk or isolated at home due to the coronavirus. We believe this will help our OTPs continue to battle the crisis of opioid addiction and overdose while simultaneously acting to protect personal and public health during the COVID threat.”
Opioid treatment programs have been dispensing methadone in New York City since the late 1970s. There are currently 68 opioid treatment programs in the city that serve an estimated 28,500 New Yorkers who take methadone. Unlike other jurisdictions nationwide, there is no wait to start taking methadone in New York City. A 2017 report on methadone treatment found that more than half (55%) of New Yorkers who take methadone are over 45 years old.
New Yorkers can find more information about substance use and their health here. Individuals seeking support or treatment for substance use issues for themselves or their loved ones can contact NYC Well by calling 1-888-NYC-WELL, texting “WELL” to 65173, or going to nyc.gov/nycwell. Free, confidential support is available at any hour of the day in over 200 languages.