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Washington News: Methadone/Suboxone Rules: A Primer
Published in the July 2006 Washington State Board of Pharmacy Newsletter
The Board receives many calls about the administration and dispensing of methadone and Suboxone® (buprenorphine/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 narcotic addiction or to detoxify a patient when the prescriber is registered by Drug Enforcement Administration (DEA), Department of Social and Health Services, and the Board as a narcotic treatment facility (NTF). In such cases, the drug may only be administered by 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 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 NTP. At the present time, Suboxone (buprenorphine/naloxone) and Subutex® (buprenorphine) are the only two CIII, IV, or V medications that have been approved by Food and Drug Administration for 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/Subutex prescription. You can verify participation in this program by consulting http://buprenorphine.samhsa.gov and clicking on Physician Locator. There is also a Frequently Asked Questions link on this site, which is extremely useful. Please contact the Board office for additional information.
