WASHINGTON, D.C. — Senators Ed Markey and Rand Paul introduced an updated version of legislation on June 25, 2026, aimed at expanding access to methadone treatment for opioid addiction. The proposed bill, titled the "Modernizing Opioid Treatment Access Act 2.0," would allow doctors board-certified in addiction medicine to prescribe methadone for pharmacy pickup.

The legislation would also permit the Department of Health and Human Services (HHS) to designate other providers who could directly prescribe methadone without additional congressional action. Currently, methadone is available for addiction treatment only through approximately 2,000 specialized facilities known as opioid treatment programs (OTPs). Many of these programs require patients to attend the clinic daily for their methadone dose.

Senator Markey emphasized the need for broader access to the medication. "For too long, we have kept methadone — an evidence-based, life-saving medication — locked away, far from many of the people who need it," Markey said in a statement. He added, "The 'Modernizing Opioid Treatment Access Act 2.0' would take a carefully considered step forward in expanding access to this medication by allowing the most highly trained addiction physicians in the country to prescribe methadone for their patients to pick up at a pharmacy."

Markey first introduced similar legislation in 2023. The Senate Committee on Health, Education, Labor, and Pensions approved that bill in December 2023 on a bipartisan basis. However, the bill did not receive a full Senate vote and did not advance in the House of Representatives during 2023. Federal reforms enacted in 2024 provided OTPs with more flexibility regarding patient protocols.

Methadone is one of three medications approved by the Food and Drug Administration for treating opioid addiction; it works by binding with the same brain receptors as heroin or fentanyl to prevent cravings and withdrawal symptoms. In 2024, an investigation revealed that private equity firms had acquired stakes in nearly one-third of all methadone clinics nationwide.

Private equity-backed clinic chains and the American Association for the Treatment of Opioid Dependence initiated a lobbying and public relations campaign in 2024 to oppose the legislation. This campaign, titled "Program, Not a Pill," argued that OTPs offer comprehensive services, including counseling, beyond just medication. Some methadone clinics conduct "call-backs," requiring patients to return take-home doses on short notice to verify proper use.

In April 2026, the Trump administration issued an open letter to addiction treatment providers, warning against the use of medications "as a default sentence to life-long medication use." Organizations endorsing the updated legislation include Faces & Voices of Recovery, the American Society of Addiction Medicine, the Drug Policy Alliance, the R Street Institute, and the Legal Action Center.