Mobile But Still Tied Down: Challenges to Scaling Mobile Methadone Through a Regulatory Thicket

Using New York’s early rollout as a case study, the authors describe how mobile methadone units remain hamstrung by security rules, high costs, requirements to return daily to a home clinic and stay within state lines, and community opposition. The authors argue that without a broader shift away from “methadone exceptionalism,” mobile units will remain a modest convenience rather than a transformative way to close treatment gaps.