Frequently Asked Questions for Pharmacists on Methadone, Suboxone®, or Subutex®?
A: 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) as a narcotic treatment facility (NTF). In such cases, the drug may only be administered by the NTF.
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. To prescribe this medication for maintenance therapy, a qualified physician must receive training and a registration number. Prior to dispensing these agents it is recommended that you consult the following website: http://www.suboxone.com/hcp/pharmacists/ .
Pharmacists receiving a prescription for Suboxone® or another approved narcotic to treat opioid addiction should verify that the prescriber has been granted a waiver. The following can be used to verify that the prescriber is approved to prescribe Suboxone® or Subutex® for opioid addiction:
1) Check the prescriber’s Drug Enforcement Administration (DEA) number; physicians granted a waiver under DATA 2000 are issued a special DEA number that always begins with “X”; as of July 2005, physicians are required to include this special DEA number on all prescriptions for Suboxone® or Subutex®;
2) Check the Substance Abuse and Mental Health Services Administration (SAMHSA) physician locator at: http://www.samhsa.gov/;
3) Call SAMHSA at 1-866/287-2728 (physicians can elect not to be listed on the Web site); or
4) Call the prescriber and ask to have the DEA registration certificate faxed to you.
Please Note: Federal regulations require a greater degree of confidentiality regarding patient information pertaining to patients who are being treated for substance abuse; therefore, when verifying a prescriber’s waiver, it is a violation of federal regulations to disclose the identity of the patient for whom the prescription was written, even if you are speaking directly to the prescribing physician.