SAMHSA Proposed Rule on Medications for the Treatment of Opioid Use Disorder

February 14, 2023

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The Lancet: Volume 8, ISSUE 3, e238-e246, March 2023. Synthesising evidence of the effects of COVID-19 regulatory changes on methadone treatment for opioid use disorder: implications for policy


In response to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) made several significant changes to long-standing policy to accommodate social distancing while supporting patient care for treatment of opioid use disorder (OUD). The first set of changes applied to patients receiving methadone to treat OUD. Methadone is regulated very strictly and pre-pandemic most patients needed to visit their opioid treatment program (OTP) every day the clinic was open to receive their daily dose. If the clinic was closed, or if patients had special approval, they could take their dose home in advance. For patients, the logistical challenges of getting to the clinic every day can create an extreme burden even without the stress and risk of a deadly pandemic. In March 2020, SAMHSA acted boldly to permit additional take-home supplies, up to 14 days or 28 days, of methadone for patients receiving care in an OTP.

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