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Montana News: A Review of Rules for Methadone and Suboxone for the Treatment of Pain and Addiction
Reprinted from the July 2007 Montana Board of Pharmacy Newsletter.
Used with permission from the Washington State Board of Pharmacy.
The Board receives many calls about the administration and dispensing of methadone and Suboxone® (buprenorphine/naloxone). Methadone and buprenorphine may be used for the treatment of pain, and any pharmacy may dispense these drugs for that indication. . . .
Methadone may only be used to manage narcotic addiction or to detoxify a patient when the prescriber is registered by the Drug Enforcement Administration (DEA) and the federal Department of Health and Human Services as a narcotic treatment facility (NTF). In such cases, methadone may only be administered by the NTF. [There are no registered physicians and/or NTFs in the state of Montana.]
If an addicted patient is admitted to a hospital for a condition other than addiction, methadone can be administered in the same amount as the patient’s NTF or an amount sufficient to keep the patient from going into withdrawal. Therapy can not be continued when the patient is discharged from the hospital, and the patient can not be given a discharge prescription for methadone.
Outside of the NTF, methadone can not be prescribed or administered to addicted patients. However, DEA regulations do allow a physician to personally administer, not prescribe, daily methadone doses for a period of up to three days.
The Drug Addiction Treatment Act of 2000 expanded the clinical context of medication assisted opioid addiction treatment by allowing qualified physicians to dispense, prescribe, and administer specifically approved Schedule III, IV, and V medications in settings other than NTFs. At the present time, Suboxone (buprenorphine/naloxone) and Subutex® (buprenorphine) are the only two Schedule III-V medications that have been approved by the FDA for treatment of opioid addiction. In order to prescribe these medications for maintenance of addiction, a physician must receive training and a special registration number from the DEA. An “X” preceding the first letter of a DEA registration number indicates that the registrant has received the required training to prescribe Suboxone or Subutex. Any pharmacy may fill a Suboxone or Subutex prescription written by a qualified prescriber. A list of qualified physicians [by state] is available at www.buprenorphine.samhsa.gov by clicking on Physician Locator.
[Currently there are qualified physicians located in Montana.]
