California is the Most Restrictive Methadone State in the Country — A New Bill Will Make it the Most Accessible

SACRAMENTO, CA – Assemblymember Matt Haney (D-San Francisco) has introduced AB 2115 that will radically change California's strategy on the treatment of opioid addiction by transforming California from a state with the most restrictive methadone laws in the country, into a state leading in methadone accessibility. The bill will ensure that people with opioid addiction are able to access this lifesaving treatment by removing outdated laws that were first crafted during the Vietnam War.

Methadone is a highly effective medication that eases the debilitating symptoms of opioid withdrawal for people who have quit drugs like heroin and fentanyl. Unfortunately the state’s many bureaucratic barriers to methadone treatment have left medical professionals hobbled in their fight against the spreading fentanyl crisis, leading to a sharp increase in opioid overdoses since 2019.

“We’ve reached a point where the treatment for opioid addiction is much harder to get than the deadly drugs themselves,” said Haney. “Dealers are much better at getting fentanyl and heroin into people’s hands than we are at getting them addiction medication. We have to reverse that entirely if we want to save people’s lives.”

Currently the state’s stringent regulations far surpass federal guidelines, and require patients to jump through numerous hurdles to access methadone including requiring patients to line up in front of specialized methadone clinics every morning to receive treatment. Drug dealers, aware that people with addiction gather together every morning, often prey on these vulnerable former users as they wait in line.

Additional bureaucratic barriers facing patients seeking methadone treatment include: requiring multiple physical exams, some of which may have already been performed at hospitals before treatment starts; requiring patients to demonstrate at least a year of documented opioid use which ignores the reality of the rapid nature of fentanyl addiction; requiring time consuming mandatory counseling sessions that are often extremely difficult to schedule due to a nationwide shortage of qualified councilors; removing patients from the clinics rolls if they do not seek treatment for more than two weeks, forcing the patient to start over with the lengthy admission process which involves significant paperwork for the patients and the clinic; limiting the amount of methadone that is allowed to be prescribed which does not take into consideration fentanyl and the higher doses of methadone needed to combat it.

Many European countries have made easy access to methadone a cornerstone of their addiction fighting strategy and have been highly successful in reversing their opioid crises. Last year the entire continent of Europe had a total of 6,100 deaths from an opioid overdose, while in comparison, California alone had over 7,300 deaths in 2023.

“It is infuriating and mind boggling that during the worst drug crisis in history, as thousands of Californians die every year, that we would keep one of the most effective treatments for addiction locked away where people can’t access it,” said Haney who chairs the Assembly’s Fentanyl and Opioid Overdose Prevention Committee. “If we are serious about stopping fentanyl, we have to get serious about methadone. Get people off of deadly drugs and into treatment, and get rid of these backwards retrograde barriers to treatment that are still in law.”

“California is one of the most progressive states advancing treatment for opioid use disorder, but when it comes to methadone - the most effective medication preventing overdoses and saving lives is still restricted.” said Dr. Leslie Suen who is an Assistant Professor of Medicine at University of California San Francisco. “By removing unnecessary barriers to care, we can help more Californians receive the life-saving treatment they need to recover from addiction.”

AB 2115 represents a significant shift in how opioid addiction is treated in California by aligning California’s law with updated federal guidelines set by the Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration, making California one of the most accessible states for methadone treatment access.

AB 2115 expands methadone access in the State by:

1. For the first time allowing doctors to prescribe their patients up to 72-hours worth of take-home doses of methadone. Previously only a methadone clinic could prescribe methadone.
2. Increasing the amount of methadone a patient can take home from a clinic, allowing them to avoid lining up for methadone in front of clinics on a daily basis.
3. Allowing for expedited entry into a treatment program, by allowing non-methadone clinic doctors to perform federally required physical exams of the patient, as well as allowing patients to decline non-drug related blood testing and lab work.
4. Remove the requirement that a patient have at least one year of recorded opioid usage before receiving treatment.
5. Remove the requirement that the patient participate in frequent counseling services.
6. Allow the patient to be absent from treatment for up to 30 days before being removed from a program.
7. Allow physicians greater discretion to determine the appropriate dosage of methadone to administer for a patient.

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