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Montana News: Methadone and Suboxone
Reprinted from the October 2007 Montana Board of Pharmacy Newsletter.
The Board receives many calls about the administration and dispensing of methadone and Suboxone® (buprenorphine and naloxone). Methadone may be used for the treatment of pain, and any pharmacy may dispense methadone for such an indication. This would include using methadone as part of a formal pain management program in which a patient is switched from other licit drugs to methadone to control or gradually reduce dosage.
Methadone may only be used to maintain treatment of addiction or to detoxify a patient when the prescriber is working
for a narcotic treatment facility (NTF) registered by DEA, Department of Public Health and Human Services, and the Board. In such cases, the drug may only be administered at the NTF. If an addicted patient is admitted to a hospital for a condition other than addiction, methadone can be administered in the same amount as provided by the patient’s NTF or an amount sufficient to keep the patient from going into withdrawal. You cannot continue therapy when the patient is discharged from
the hospital.
You also cannot provide the patient with a discharge prescription of this drug. Outside of the NTF, methadone cannot be prescribed or administered to addicted patients. However, DEA regulations 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 treatment by allowing qualified physicians to dispense or prescribe specifically approved Schedule III, IV, and V medications in settings other than an NTF. At the present time Suboxone and Subutex® (buprenorphine) are the only two Schedule III, IV, or V medications that have been approved by Food and Drug Administration for this medication for treatment of opioid addiction.
In order to prescribe this medication for maintenance therapy, a qualified physician must receive training and a registration
number. Any pharmacy can fill a Suboxone or Subutex prescription. You can verify participation in this program by consulting http://buprenorphine.samhsa.gov and clicking on Buprenorphine Locator. There is also a frequently asked questions
link on the site, which is extremely useful. Please contact the Board office for additional information.
