Senators Ed Markey and Rand Paul have introduced the Modernizing Opioid Treatment Access Act 2.0, which seeks to expand the availability of methadone by permitting certified addiction specialists to prescribe the medication for pharmacy retrieval.

參議員 Ed Markey 與 Rand Paul 提出了《現代化鴉片類藥物治療獲取法案 2.0》，旨在透過允許認證的成癮專科醫生開立處方由藥局領取，以擴大美沙酮的供應。

The proposed legislation addresses the current restrictive distribution framework, wherein methadone is accessible exclusively through approximately 2,000 specialized opioid treatment programs (OTPs). While 2024 federal reforms introduced limited operational flexibility for these facilities, the proposed Act would facilitate a systemic shift by allowing board-certified addiction physicians to bypass clinic-based administration. Furthermore, the bill empowers the Department of Health and Human Services to designate additional eligible prescribers without further legislative intervention.

擬議的立法旨在解決目前嚴格的分發框架，目前美沙酮僅能透過約 2,000 個專門的鴉片類藥物治療計劃 (OTP) 獲取。雖然 2024 年的聯邦改革為這些設施提供了有限的運作靈活性，但擬議的法案將允許持有委員會認證的成癮科醫生繞過診所管理，從而促成系統性的轉型。此外，該法案授權衛生及公共服務部在無需進一步立法干預的情況下，指定更多合資格的開方醫師。

Historical and institutional tensions characterize the debate over this transition. The American Association for the Treatment of Opioid Dependence and various private equity firms—which hold interests in one-third of all methadone clinics—have opposed the measure. These stakeholders argue that the OTP model provides a necessary comprehensive service suite, integrating medication with counseling. Conversely, patient advocates contend that the current clinic model imposes undue burdens, citing mandatory daily attendance, invasive drug testing, and unpredictable 'call-back' requirements as impediments to care.

這次轉型的爭論具有歷史與體制性的緊張特點。美國鴉片依賴治療協會以及多家私募股權公司（其持有三分之一美沙酮診所的權益）均反對此項措施。這些利益相關者認為，OTP 模式提供了必要的全面服務組合，將藥物治療與諮詢相結合。相反，患者倡導者認為目前的診所模式造成了過重負擔，並指出強制每日出席、侵入性藥物檢測以及不可預測的「回電」要求是治療的障礙。

This legislative effort occurs amidst a shifting executive posture toward medication-assisted treatment. The current administration has cautioned against the utilization of such medications as a permanent default, and certain legislative attempts have been made to rescind the 2024 flexibilities. Despite these headwinds, the proposal has secured endorsements from a broad coalition of medical and policy organizations, including the American Society of Addiction Medicine and the Drug Policy Alliance.

這次立法努力發生在行政部門對藥物輔助治療態度轉變的背景下。現任政府警告不應將此類藥物作為永久的預設選擇，且某些立法嘗試試圖撤銷 2024 年的靈活性措施。儘管面臨這些阻力，該提案已獲得廣泛的醫療與政策組織支持，包括美國成癮醫學會與藥物政策聯盟。

The legislation currently seeks to transition methadone from a clinic-restricted model to a pharmacy-accessible one, pending congressional approval.

該立法目前尋求將美沙酮從診所限制模式轉型為藥局可獲取模式，尚待國會批准。