The Substance Abuse and Mental Health Services Administration (SAMHSA) issued a proposed rule on Dec. 13 that would expand access to treatments for opioid use disorder by updating opioid treatment program (OTP) standards and admission criteria.
During the COVID-19 public health emergency, SAMHSA has allowed flexibility for providers to use telehealth (via audio-only or video-enabled) to prescribe buprenorphine to patients without an in-person visit. This proposed rule would make that change permanent. While the rule would not allow providers to prescribe methadone virtually, it would permit providers to offer take-home doses of methadone to patients. The rule would also expand the definition of OTP practitioner to include any provider appropriately licensed to dispense and/or prescribe approved medications and possesses a waiver to do so.
The proposed rule would remove a requirement that an OTP only admit people with at least one year of an opioid addiction. It also proposed to eliminate the requirement that a practitioner who has a waiver to prescribe buprenorphine for up to 275 patients report to SAMHSA on an annual basis.
Public comments in response to the rule may be submitted to SAMHSA by Feb. 14, 2023.
While these SAMHSA regulations are a positive step, the Drug Enforcement Agency also needs to make changes to enable better access to buprenorphine. The AAMC has endorsed related legislation, the Mainstreaming Addiction Treatment Act of 2021 (H.R. 1384, S. 445), which would remove the requirement that health care providers apply for and receive a waiver from the Drug Enforcement Administration to prescribe buprenorphine for the treatment of a substance use disorder [refer to Washington Highlights, April 30, 2021].