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Press Release: National Alliance of Methadone Advocates
Date: September 4, 2005

Contact: Joycelyn Woods, President

[email protected]

Contact Phone: 1.212.595.nama

NAMA to Provide Information to States Affected by Hurricane Katrina

On behalf of the Board of Directors and the Chapters and International Affiliates of NAMA, we request all possible assistance in enabling patients from New Orleans and other affected areas of the Gulf Coast, to continue treatment in some form and avoid excruciating rapid withdrawals in addition to everything else they are going through.

The situation for patients is unprecedented, and calls for a pro-active and aggressive response on the part of providers and regulators is required.

Specifically, we request that:

1. CSAT expand and make maximum use of procedures including those for Interim Treatment for rapid transfer and hardship Exceptions for take-home doses, including publicizing the availability of new procedures to SMAs and providers in the region.
2. Publicize the ability of licensed MDs to prescribe methadone for up to 28 days for addiction, through state medical societies and similar bodies who may be in contact with general physicians.
3. Commend the Louisiana SMA for their efforts so far.
4. CSAT should create emergency guidelines for accepting patients from the affected areas. For example, instructions for medicating patients that may not have identification or be able to validate their dose. Many patients will be exhibiting classic withdrawal and professionals should be able to access this and provide adequate medication.
5. CSAT staff contact every clinic in the states that are affected and adjacent states that will see evacuated patients (especially Texas, but also Alabama, Florida, Tennessee, Georgia, the Carolinas, Mississippi, etc.), and notify these states of any emergency procedures adopted, to reassure them of the legality of procedures and encourage a pro-active response. AATOD can coordinate with provider associations.
6. CSAT expedite the creation of a few “emergency dosing” stations through existing emergency medical providers based in areas (especially the Houston Astrodome and other major reception shelters in Texas) where we might expect a relatively larger concentration of patients without any means of transport to other facilities.
7. CSAT set up a help line for providers and patients to ask questions.
8. Allow pain patients who may be taking methadone and cannot access their medication to receive assistance until they can be transferred to other medical services.
9. Notify NAMA what measures are being taken, we will attempt to publicize them as much as we can.

The NAMA website will try to provide accurate information for patients affected by the emergency. Any organizations providing services may contact us with the information for posting on the website.

Basic Things for Patients to Know and Do

1. Methadone has been donated so that patients in the affected areas should not have to pay. Go to the closest program where you will get medicated. You should not have to pay for now.
2. Bring any bottles or information to the program with you.
3. Take Home Medication:  Right now unless you were a patient on that particular program no take outs are being given until your status can be confirmed. Bottles can be used to help confirm your take home status. It will still be up to the doctor to decide to give you take home. If you can not get any take home medication at that moment have a counselor document your bottles, the number, dates and any other pertinent data that can be used to help confirm your take home status. When clinics begin to give take home medication this can help you get it quicker.
4. If you are not in the affected area and have traveled elsewhere (i.e. to stay with your family) and you need medication go to the nearest emergency room hospital and you will be able to get 3 days of medication. You will not be able to get take home medication unless the doctor decides to give it to you. From this point you need to look for the closest program in your area and go there. Programs across the US are being instructed to take patients from the hurricaine affected areas. If there is any problem or you can not find a program near by contact CSAT immediately and they will help to arrange something.
5. Buprenorphrine Patients if you can not contact your doctor go to the closest emergency room and follow the ame directions given for methadone patients. If you need help in finding a doctor contact CSAT.

As we discussed over the telephone last night, we have been hard at work the past week coordinating disaster relief activities with the affected states and Opioid treatment programs (OTPs) in the region. Now that we know people from the region are being evacuated throughout the United States it is no longer a regional issue. Here are some of the specific things we’ve done.

OTPs. We are in touch with many OTPs in the Gulf states region. Nick Reuter and I were in Texas and Alabama very recently and know many of the providers in the region. The state methadone provider associations have been in contact with us and with the exception of the closed programs in the New Orleans area seem to be handling the added workload. We have spoken with methadone drug manufacturers on efforts to Supply additional opioid medications to shelters in Baton Rouge and Houston. They are being very generous.

Here is a breakdown of activities in the Gulf States:

Alabama – I was told by the President of the Alabama providers association that a few patients were being treated in Huntsville, Muscle Shoals and elsewhere and that the Mobile programs are operational.

Florida – Gary Wenner of Operation PAR told us that “In most cases we are seeing folks in withdrawal, and rather than guest dosing them we are actually admitting them to our programs. We are giving them a months free treatment, and trying to get them established in jobs ASAP so if they need to stay longer they will be able to support their treatment and themselves.”

Louisiana – We were contacted by one OTP in downtown New Orleans (Vernon Short, Desire Rehabilitation Center) that is now open in a Mobile unit adjacent to program on Gentilly Road. We are working with him to ensure he has a Supply of methadone. CRC in Baton Rouge has brought in staff from other sites and is being provided additional methadone at no cost. One of our medical officers has been deployed to work with the state of Louisiana with a focus on methadone treatment.

Texas – We are working with the Texas Department of Health (TDH) regarding methadone treatment at the Houston Astrodome. The TDH SMA reports that methadone patients at the Astrodome are transported to publicly funded treatment programs in Houston on a daily basis for dosing.

Exceptions. We are expediting review and approval of exception requests. We are encouraging OTPs to use our new electronic exception reporting system to save time, costs. There are several patients who are getting extended take-homes to enable them to volunteer in the Gulf States.

States. We held a briefing with the Gulf States last week and are coordinating activities with each SMA. In addition, we are meeting with all the SMA’s by teleconference on the 19th.

AATOD. We are in daily contact with Mark Parrino.

In addition, I’m providing a point by point response to your specific concerns. Please feel free to share this with your membership and other patient advocacy organizations. This will be the basis for Friday’s briefing.

1. CSAT expand and make maximum use of procedures including those for Interim Treatment for rapid transfer and hardship Exceptions for take-home doses, including publicizing the availability of new procedures to SMAs and providers in the region.

   Response. A notification was sent last week (see attached) to affected states and OTPs in the region providing guidance on how to proceed under the emergency. We are planning to make this guidance available nationwide to all States and OTPs shortly. When the guidance is sent out you will receive a copy.

2. Publicize the ability of licensed MDs to prescribe methadone for up to 28 days for addiction, through state medical societies and similar bodies who may be in contact with general physicians.

   Response. Physicians are not permitted under DEA rules to prescribe methadone for addiction treatment. Section 1306.07 of the DEA’s rules provide that a physician not working in an OTP can administer methadone to a person “for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment. Not more than one day’s medication may be administered to the person or for the person’s use at one time. Such emergency treatment may be carried out for not more than three days and may not be renewed or extended.”

3. Commend the Louisiana SMA for their efforts so far.

   Response. We agree that the Louisiana SMA has done an excellent job to date. Moreover, the other states in the Gulf region, including Texas, Mississippi, and Alabama have similarly performed admirably under the circumstances. Many other states have stepped up to the plate to ensure that patients get medicated with a minimum of disruption.

4. CSAT should create emergency guidelines for accepting patients from the affected areas. For example, instructions for medicating patients that may not have identification or be able to validate their dose. Many patients will be exhibiting classic withdrawal and professionals should be able to access this and provide adequate medication.

   Response. We’ve done that for the affected states and will issue additional guidance for the nation. You will receive a copy as soon as it is available.

5. CSAT staff contact every clinic in the states that are affected and adjacent states that will see evacuated patients (especially Texas, but also Alabama, Florida, Tennessee, Georgia, the Carolinas, Mississippi, etc.), and notify these states of any emergency procedures adopted, to reassure them of the legality of procedures and encourage a pro-active response. AATOD can coordinate with provider associations.

   Response. This has been done. The next step will be to notify every program in the United States. We’re coordinating with AATOD and providers in states that are not a part of AATOD to ensure they are fully informed.

6. CSAT expedite the creation of a few “emergency dosing” stations through existing emergency medical providers based in areas (especially the Houston Astrodome and other major reception shelters in Texas) where we might expect a relatively larger concentration of patients without any means of transport to other facilities.

   Response. There does not appear to be a need for “emergency dosing stations” outside the existing OTP network. The State of Texas has arranged for patients to go from the Houston Astrodome to a publicly funded clinic. I understand the patients do not have to pay for methadone treatment under this arrangement. Patient exceptions are being expedited. If the need arises for additional treatment capacity we are prepared to work with the providers in Texas and elsewhere to ensure patient access to both methadone and buprenorphine.

7. CSAT set up a help line for providers and patients to ask questions.

   Response. We are considering the best manner in which this might be done with SAMHSA officials in the overall of the overall Department of Health and Human Services response to the disaster. We’ll keep you informed as to what direction the Agency determines will be most effective.

8. Allow pain patients who may be taking methadone and cannot access their medication to receive assistance until they can be transferred to other medical services.

   Response. CSAT’s accreditation guidelines provide:

   Patients who are diagnosed with physical dependence and a pain disorder are not prohibited from receiving methadone/buprenorphine therapy for either maintenance or withdrawal in an OTP if such setting provides expertise or is the only source of treatment.

9. Notify NAMA what measures are being taken, we will attempt to publicize them as much as we can.

   Response. We are trying to set up a conference call for a briefing with patient advocacy organizations.*

Robert Lubran

Division of Pharmacologic Therapies

* NAMA and other advocacy organizations were briefed on September 9, 2005. CSAT is keeping all the organizations in the loop so that we can provide information to you.

Information on Katrina

Fax Sent to Programs and SMAs


Download pdf of Fax  pdf format

Katrina Guidance Letter

SAMHSA Letter September 5, 2005


Download pdf of Letter  pdf format

Poster 1


Poster 2


Download pdf of Posters  pdf format

Give Them What They Deserve

Grievance/Compliment Report

https://www.methadone.org/grievance_report.html

Some Are Heros, Others Are &<¿µ&>§”¢<

Disasters bring out the best in some people but for others it is the worst. Is there someone out there — an agency, program, person who has done something above and beyond what is required of them that you would like to thank. Give them a Compliment Report from NAMA. It is investigated just like a Grievance Report except the investigation is about something good.

There are already a number of Grievances that could be filed against an agency, program and I support some people too. Usually these kind of Grievances are the kind of complaints that can be verified without your name being brought up. This is the way to let them know that at least someone was watching them — maybe more because you don’t know who else filed a report and there could be several.

It’s the only way to let them know. And reports about the Katrina Disaster will provide NAMA with information about where the system is failing. We will forward any informatin that we prepared to the concerned parties.