Two years after federal regulations permanently adopted greater flexibility for medications for opioid use disorder (MOUD), New York experts convened to discuss the benefits and challenges of take-home medications.

The annual COMPA Symposium, which was also livestreamed, was hosted by the Coalition of Medication-Assisted Treatment Providers and Advocates, a nonprofit membership organization in New York. State officials also discussed how to prevent interruptions to OUD services amid coming Medicaid eligibility and work requirement changes as part of H.R. 1.

Chinazo Cunningham, M.D., a commissioner of New York’s Office of Addiction Services and Supports (OASAS), presented on the successes the state has had thus far in expanding OUD treatment access.

“People of color in the state of New York are dying [at] the highest levels,” Cunningham began, adding that the good news is that Black New Yorkers had the largest reduction in overdose deaths from 2023 to 2025. Part of that is thanks to flexible dosing, first introduced during COVID-19 and made permanent by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2024.

This flexibility has both pros and cons, highlighted by a separate clinical panel. Allowing patients to take vital MOUD home acknowledges various social determinants that present barriers to arriving in-person on a regular basis for treatment, speakers agreed. At the same time, some cases call for extra caution, like if a patient is unstable and may be using while in treatment.

-C, an outpatient physician assistant, said during the clinical panel. There is real risk of diversion, which patients sometimes even own up to, he said.

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