AOAT submits statement for the record on critical importance of preserving SAMHSA OTP treatment flexibilities

House Energy & Commerce Health Subcommittee

Hearing on Policies to Protect Our Communities from Illicit Drug Threats

March 26, 2026

The Advocates for Opioid Addiction Treatment (AOAT) commends the Subcommittee for holding a hearing to examine policies addressing the addiction and overdose crisis in our country. However, AOAT strongly opposes H.R. 5629, as it would reverse the significant progress made in our shared fight against the opioid overdose epidemic. This legislation would likely lead to higher rates of opioid-related deaths and overdoses by restricting access to evidence-based treatment and eliminating patient-centered protocols that have proven effective.

AOAT represents more than 700 opioid treatment program (OTP) facilities and office-based opioid treatment (OBOT) providers across 46 states. Our health care teams provide lifesaving Medication-Assisted Treatment (MAT) to approximately 215,000 patients daily. Our facilities employ interdisciplinary teams—including physicians, pharmacists, nurses, counselors, peer support/recovery coaches, administrators, and clerical staff—to deliver comprehensive, evidence-based care to individuals living with opioid use disorder (OUD).

OTPs are highly regulated, structured, and comprehensive treatment facilities. We operate under strict federal, state, and local oversight—including the Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Enforcement Administration (DEA), state regulatory and Medicaid authorities, and pharmacy boards. Each facility must maintain continuous accreditation from a SAMHSA-approved body.

We support this rigorous regulatory framework and the patient and public safety protections it ensures. Most of our patients receive methadone, a Schedule II narcotic, as part of MAT. Methadone is highly effective when administered under physician supervision and diversion-control protocols. Without these safety measures, the risk of overdose is extremely high, as evidenced in the early 2000s, when physician-prescribed methadone for pain led to widespread overdoses, deaths, and diversion. Importantly, medication alone is not OUD treatment—it stabilizes patients by mitigating cravings and withdrawal symptoms, enabling engagement in the behavioral health therapies essential to recovery.