There is often confusion about using methadone in the treatment of patients. The history of laws regarding methadone dates back to the Harrison Narcotics Tax Act of 1914, allowed use of opioids for medical conditions (namely, pain) and was interpreted by the courts as a prohibition of prescribing opioids to opioid addicts. Methadone was developed in Germany in 1937 and was marketed in the US in 1947.
The Narcotic Treatment Act of 1974 provided guidlines to allow registered Narcotics Treatment Programs (NTP) to provide methadone treatment for opioid dependence. In general, methadone is dispensed in pill form for treatment of pain, and liquid form for treatment in Narcotic Treatment Programs.
There is no special license to prescribe methadone for pain, other than the regular DEA certification [21 CFR 1306.07(c)]. However, to prescribe methadone for opioid dependence, a facility needs to be a registered Narcotic Treatment Program.
In a hospital setting, patients who are registered in a methadone program may continue to receive methadone maintenance if the NTP transfers the medication to the hospital of long-term care facility (LTCF) with the approval of the state Methadone Authority. In California, you may contact:
Acting Deputy Director
Quality Assurance Division
1700 K Street Sacramento, CA 95814
Phone: (916) 327-7681
Fax: (916) 323-5086
If the patient is NOT enrolled in a methadone program, the law states that a practitioner may administer narcotics to relieve acute withdrawal from opioids, but only a one-day supply may be given at one time, and for no more than three days total. This is done with the understanding that attempts to refer for treatment are done concurrently, and should be documented [21 CFR 1306.07(b)].
For patients needing referral to a Methadone Clinic, Matrix has an excellent program at the Los Angeles Clinic. You may visit: Matrix Narcotic Treatment Program or call (323) 933-9186 for more information.