The R Street Institute called on Virginia Governor Abigail Spanberger on March 12 to sign Senate Bill 421, which would allow remote pharmacy dispensing at opioid treatment programs (OTPs) in the state. Stacey McKenna, resident senior fellow and associate director in Healthier Communities at the R Street Institute, outlined the organization’s support for the bill in a letter addressed to the governor.
The issue is significant as opioid use disorder (OUD) continues to affect thousands of Virginians each year. According to McKenna, more than 450 Virginians died from opioid overdoses in 2025 and about 150,000 are estimated to be living with OUD. She said that while Virginia has made progress by expanding access to drug checking tools and improving resources for pregnant women who use opioids, barriers remain—particularly regarding access to methadone treatment.
McKenna said methadone is considered the gold standard for treating OUD but is heavily regulated and only available through restrictive OTPs. These clinics often require patients to travel long distances daily for supervised dosing, which can discourage people from starting or continuing treatment. “Among those individuals who do manage to visit the clinic regularly, many find it disrupts their broader attempts at recovery and rebuilding their lives, making it difficult to hold a job, care for family, or work on relationships with friends and loved ones,” McKenna said.
SB 421 proposes allowing pharmacists to remotely supervise dosing and provide counseling at OTPs. McKenna argued this change would reduce operational costs for clinics and expand access without increasing risk: “Remote dosing of methadone has been shown to be safe and effective in the home, absent of health professionals, and this bill would allow remote dosing and oversight but in the presence of clinic care staff.” She added that such reforms could save lives, improve quality of life, increase community wellbeing and safety, and reduce costs related to overdose and OUD.
In her conclusion, McKenna urged Governor Spanberger to sign SB 421 into law: “Expanding and reducing barriers to evidence-based treatment for OUD would save Virginians’ lives… SB 421 is an important step toward doing just that. Therefore, we urge you to sign into law SB 421.”
