DEA Announces Improvements to Medication Assisted Treatment

Improved access will benefit rural areas with limited treatment options

WASHINGTON – The Drug Enforcement Administration announced on February 26, 2020, an important step to improve access to medication assisted treatment, especially in rural areas where those suffering with opioid use disorder may have limited treatment options.

“Thankfully, prescription opioid overdose deaths have declined more than 13 percent, but thousands of Americans still suffer from addiction and opioid use disorder,” said DEA Acting Administrator Uttam Dhillon. “Today’s proposal is an important step to improve access to medication assisted therapy, a successful evidence-based practice to treat opioid dependence. DEA is committed to ensuring that these tools and resources are available to everyone, especially in rural areas where treatment options may be limited.”

Under the proposal published today, narcotic treatment program registrants authorized to dispense narcotic drugs approved to treat opioid dependence would be authorized to implement a “mobile component” to their registration, eliminating the need for a separate DEA registration. This streamlined registration process will make it easier for providers to offer needed services in remote or underserved areas.

In April 2000, DEA, in association with the American Methadone Treatment Association – now the American Association for the Treatment of Opioid Dependence – developed guidelines for NTPs to ensure more uniform standards throughout the United States. As the opioid crisis evolves, DEA and their partners seek to provide additional tools and resources to further increase accessibility for persons with opioid use disorder. Alternative methods, such as mobile components of NTPs, can be used to bring treatment to those in rural or other underserved areas where NTPs are not accessible, or to allow people who are unable to travel to an NTP to receive care.

According to the Centers for Disease Control and Prevention (CDC), more than 67,000 Americans lost their lives to drugs in 2018, and more than half of those deaths involved opioids. The demand for evidence-based medication-assisted treatment for substance use disorders, including opioid use disorder, has increased over the years, especially for services provided by NTPs. In some areas of the country, this has resulted in long waiting lists and high services fees, especially in rural communities.

The distance to the nearest NTP or the lack of consistent access to transportation in rural and underserved communities may prevent or substantially impede access to these critical services. There are more than 1,700 NTPs registered with DEA, including opioid treatment programs, detoxification treatment services that utilize methadone, and compounders. This proposed rule builds on existing experience and provides additional flexibility for NTPs in operating mobile components, subject to the regulatory restrictions put into place to prevent the diversion of controlled substances.

The proposed rule is available here