SUPPORT Program Update: Some Beneficial Changes for Prescribers

The Drug Enforcement Administration (DEA) recently published a final rule to the SUPPORT* Act of 2018 that applies to healthcare providers who dispense and administer controlled substances for Medication-Assisted Treatment for Opioid Use Disorder (OUD).

This rule update includes the following beneficial changes to prescribers:

1. Patient Limits Removed – There is no longer a federal limit on the number of patients a practitioner can treat for maintenance or detoxification treatment without being separately registered as a Narcotic Treatment Program (NTP). This significantly expands the number of practitioners authorized to treat OUD.
2. Elimination of DATA-Waiver Program – The previous Drug Addiction Treatment Act (DATA)-waiver program, which required practitioners to obtain a waiver to prescribe certain controlled substances for OUD, has been removed.
3. Increased Time Limit for Administering Controlled Substances Delivered by Pharmacy – The time frame for practitioners to administer controlled substances to the named patient has been extended from 14 days to 45 days from the date of receipt by the practitioner.

Other Key Changes for Healthcare Providers

1. New Training Requirements for DEA Registration – All "qualified practitioners" — those licensed to prescribe controlled substances and not solely veterinarians — seeking a DEA registration or renewal to dispense controlled substances (Schedules II-V) must meet a one-time training requirement.
   1. This requirement applies to any registration or renewal application submitted on or after June 27, 2023.
   2. Physicians must meet one of the following, as specified by the final rule:
      1. Hold a board certification
      2. Complete at least eight hours of training
      3. Graduate in good standing
   3. Non-physicians must be legally authorized by the state to dispense controlled substances and meet one of the following:
      1. Complete at least eight hours of training
      2. Graduate in good standing
   4. DEA forms 224 and 224a have been modified for practitioners to self-attest to meeting these training requirements.
2. NTP Registration Requirement – Practitioners dispensing Schedule II narcotic drugs for maintenance or detoxification treatment must still obtain a separate annual registration as an NTP.

*SUPPORT is an acronym for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018: Dispensing and Administering Controlled Substances for Medication-Assisted Treatment.