DOH releases updates to Medication-Assisted Treatment and Regulated Drug rules

The Department of Health has released updates to two Department Rules: the Medication-Assisted Treatment Rule and the Regulated Drug Rule. 

The Medication Assisted Treatment Rule establishes the requirements for authorized office based opioid treatment providers to prescribe and dispense buprenorphine.  The proposed changes expand capacity for the treatment of opioid dependence by allowing advanced practice registered nurses and physician's assistants to prescribe buprenorphine to individuals requiring and seeking treatment for opioid dependence. The rule also increases the number of patients a physician may treat from 100 to 275.  

These changes implement at the state level changes authorized by Congress last year in the Comprehensive Addiction and Recovery Act (CARA).  

The Regulated Drug Rule adds new drugs and other chemical substances that are illegal or judged to be potentially fatal or harmful for human consumption unless prescribed and dispensed by a professional licensed to prescribe or dispense them. Examples include acetylfentanyl, a lethal opioid, and newly emerged synthetic recreational drugs. The rule also establishes benchmark dosages for certain drugs to provide a baseline for use by prosecutors to seek enhanced penalties for possession of higher quantities of the drug.  These Benchmarks are set by the Board of Medical Practice and are not intended as clinical guidelines but rather establish by statute a level over which increased penalties are available. 

The changes would add the following drugs and benchmarks for the first time:

  • Buprenorphine: 36mg
  • Clonazepam: 20mg
  • Trazodone: 600mg
  • Tramadol: 300mg
  • Zolpidem: 12.5mg
  • Oxymorphone:120mg
  • Gabapentin: 2400mg
  • Cyclobenzaprine: 30mg
  • Buspirone: 90mg
  • Bupropion: 450mg
  • Fentanyl: 3.2 mg

Both proposed rules can be found here.


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