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SAMHSA PUBLISHES FINAL RULE THAT EXPANDS ACCESS TO TREATMENT FOR OPIOID USE DISORDER

On February 2, 2024, the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of the Department of Health and Human Services (HHS), adopted a final rule that updates regulations related to Opioid Treatment Program (OTP) accreditation, certification, and standards for the treatment of Opioid Use Disorder (OUD) with Medications for Opioid Use Disorder (MOUD) in OTPs.

WHAT THE RULE DOES

The rule focuses on reducing barriers to receiving care, promoting practitioner autonomy and individualized care, and modernizing accreditation and certification standards to reflect current practices.

The rule reduces barriers to receiving care:

• Expands the definition of “practitioner” by adding pharmacists to the list of providers who are able to prescribe or dispense MOUD, which allows communities without OTPs to access MOUD, such as methadone.
• Includes new definitions to expand access to evidence-based practices such as split dosing, telehealth and harm reduction activities.

The rule promotes practitioner autonomy and individualized care:

• Provides criteria for unsupervised doses of methadone, including removal from sole consideration the length of time an individual has been in treatment and requirements for rigid reliance on toxicology testing results that demonstrate complete and sustained abstinence from all substances prone to misuse.
• Patients may be eligible for unsupervised, take-home doses of methadone upon entry into treatment, based on the clinical judgment of a patient’s provider.

Accreditation and certification standards have been updated:

• Permits the use of online/electronic forms to reflect a modern treatment environment.
• Part 8 has also been updated to facilitate information sharing between Accreditation Bodies and SAMHSA, particularly in those circumstances where there have been changes or violations in accreditation.
• The rule removes requirements for practitioners to dispense certain types of MOUD with a waiver.

LOOKING FORWARD

The effective date of the final rule is April 2, 2024, and the compliance date is October 2, 2024.