<p>Methadone is an essential tool for addressing opioid use disorder, especially with the prevalence of high-potency synthetic opioids in the drug supply. The current care delivery model in the United States with siloed methadone clinics has many limitations. Legislation has been proposed to expand access to methadone to office-based settings with pharmacy dispensing. Even with legal and regulatory changes, there are many practical barriers to implementation which include insurance coverage and patient cost, prior authorizations, and stocking of methadone. Practical steps for clinicians and policymakers to take to overcome these barriers include ensuring insurance coverage for methadone, removing methadone from the algorithms that limit the amount of controlled substances pharmacies can order, and obtaining concentrated methadone formulations.</p>