The importance of responsibly expanding access to methadone treatment for opioid use disorder (OUD) is crucial. Methadone, a long-lasting opioid agonist, is a well-studied and effective medical treatment for OUD, which is associated with a significantly higher risk of early death. While there is support for liberalizing access to methadone from opioid treatment programs (OTPs), concerns have been raised about allowing addiction specialist physicians to prescribe methadone for OUD that can be dispensed from retail pharmacies. However, these concerns are misleading and put more patients at risk. The modernizing opioid treatment access act (M-OTAA) aims to address these issues by providing federal safeguards and improved patient safety while expanding access to methadone treatment. Several stakeholder organizations have endorsed this legislation. The opposition’s arguments against M-OTAA lack evidence and fail to acknowledge the training and expertise of addiction specialist physicians. The current restrictions on methadone treatment for OUD in OTPs are recognized as a vulnerability in addressing the opioid overdose crisis, and expanding access to methadone through alternative settings can help evaluate its effectiveness and identify gaps in access.