SAMHSA Implements Major Revisions to Opioid Treatment Program Regulations

A doctors prescription pad with stethoscope sitting above it and a writing  pen sitting on top of it.

Final Rule

The Substance Abuse and Mental Health Services Administration (SAMHSA) issued a final rule updating regulations for Opioid Treatment Programs (OTPs) and standards for treating opioid use disorder (OUD). The rule, effective April 2, 2024, with a compliance deadline of October 2, 2024, makes several COVID-19-related flexibilities permanent.

The changes include allowing take-home doses of methadone, prescribing medication for OUD via telehealth without an initial in-person evaluation and simplifying some admission requirements to better reflect evidence-based practices. These modifications could help enhance access to treatment and improve patient outcomes.


In this update SAMHSA has approved the use of telehealth for initial evaluations of opioid treatment programs (OTPs) for methadone and buprenorphine. Patients must complete In-person examinations within the first two weeks of starting an OTP program to help ensure comprehensive care.

Take-Home Flexibilities

Historically, OTP patients faced daily in-person visits to receive their medication, with limited take-home doses. SAMHSA’s updated regulations permanently adopt flexible take-home dose policies introduced during the pandemic. Patients in OTPs  can now receive up to 28 days of take-home doses of methadone based on certain criteria including  their stability and clinical assessment. This individualized approach aims to promote continuity of care, reduce stigma and remove barriers to treatment access.

Updated OTP Admission Criteria

The final rule replaces certain admission requirements. Now, qualified healthcare professionals can assess patients’ eligibility based on diagnostic criteria for OUD that include severity, remission status or risk of recurrence or overdose. This shift offers a more subjective approach.

Other Changes

Several additional changes aim to improve access to treatment and reduce stigma within OTPs. For more information please refer to the official Federal Register document.


SAMHSA’s finalization of the updated regulations governing OTPs aim to enhance patient care and promote more individualized treatment. It is essential for medical professionals to monitor the implementation of these regulations and other regulatory updates.

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