In Reply Starting January 1, 2020, as a result of the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, Medicare Part B has provided a bundled payment for opioid addiction treatment in an opioid treatment program.¹

This advance, however, does not address the concerns of Gifford and colleagues about the inability of long-term care facilities to obtain methadone from community pharmacies to treat opioid use disorder. As discussed in our Viewpoint,² current Drug Enforcement Administration regulations only allow pharmacies to supply these facilities with methadone for short-term withdrawal management, known as detoxification, of patients with opioid use disorder. This clinical use is associated with poor outcomes.

在2020年1月1日开始的答复中，由于2018年《促进阿片类药物康复和患者和社区治疗的物质使用失调预防法》的结果，Medicare B部分在阿片类药物治疗计划中提供了捆绑付款，用于阿片类药物成瘾治疗。^1个

但是，这一进展并未解决Gifford及其同事对长期护理机构无法从社区药房获得美沙酮治疗阿片类药物使用障碍的担忧。正如我们观点中所讨论的那样，现行的《药物管制署》²法规仅允许药房向这些设施提供美沙酮，用于阿片类药物使用障碍患者的短期停药管理（即所谓的排毒）。这种临床使用与不良预后相关。