American Society of Addiciton Medicine

Individualized Pathways

National Advocacy

Individualized Pathways

We champion policies that empower the addiction specialty workforce and their patients to make personalized treatment decisions that are right for them.

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Make Methadone Treatment Accessible

Of the three approved medications to treat opioid use disorder (OUD), methadone may be the best option for certain patients due to it being the only full-agonist opioid, and therefore uniquely positioned to treat individuals with high-potency synthetic opioid use. However, with few exceptions, outdated law restricts outpatient access to just over 2,000 federally certified opioid treatment programs (OTPs), making it difficult, if not impossible, for patients to access. This is especially concerning in rural areas with limited OTPs; Wyoming, for example, has zero. 

 

ASAM supports efforts that would permit board-certified addiction specialist physicians and other trained physicians to prescribe methadone for OUD treatment that can be picked up at a local pharmacy. Such practice would be subject to federal and/or state rules and guidance on supply of methadone for unsupervised use and would require a special registration from the DEA.  


 

Expanded access would empower qualified physicians and their patients to make the healthcare decisions that are right for them when seeking methadone treatment for OUD. 

Optimize Telemedicine for Addiction Care

The ability to receive critical and urgent addiction care via telemedicine has become a lifeline for patients, particularly in rural, remote, and underserved geographic areas. Specifically, telemedicine initiation of prescriptions for lifesaving addiction medications, such as buprenorphine, can help patients who find themselves in crisis situations and unable to physically reach a clinic.

On December 31, 2025, the DEA issued a new rule, titled "Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications," finalizing a December 31, 2025 effective date for rules published on January 17, 2025, titled (1) "Expansion of Buprenorphine Treatment via Telemedicine Encounter" and (2) "Continuity of Care via Telemedicine for Veterans Affairs Patients" (collectively, the "Two Final Rules"). The Two Final Rules create separate, unique pathways for prescribing controlled medications through telemedicine.

Specifically, the buprenorphine-specific final rule allows clinicians to prescribe buprenorphine via telemedicine, including audio-only visits, without requiring a special telemedicine registration. Importantly, this rule reflects meaningful improvements from the original proposal, including:

  • Extending the initial prescription period from 30 days to six months; 
  • Incorporating reasonable safeguards like the review of state prescription drug monitoring program data; and
  • Avoiding unnecessary and burdensome recordkeeping requirements.

Finally, the Fourth Temporary Extension rule ensures that clinicians can continue using the more flexible COVID-era telemedicine authorities for buprenorphine for OUD through December 31, 2026, even when prescribing could also occur under one of the Two Final Rules.

 

ASAM calls upon the DEA and DOJ to adopt two key recommendations to improve the proposed rule on Special Registrations for Telemedicine and Limited State Telemedicine Registrations. This includes recommending that the DEA add another prescribing eligibility category for practitioners who are addiction medicine physicians or board certified in the treatment of addiction. Read ASAM's comment letter and recommendations here. 

 

 

 

Improve Treatment Engagement and Retention for Nonabstinent Patients

In a patient’s journey to overcome addiction, periods of nonabstinence are common.  

To support all patients on their path to recovery, ASAM advocates for policies that allow addiction treatment professionals and addiction treatment programs to provide quality care for this population.  


This includes reconsidering how to appropriately reimburse clinicians for their efforts to re-engage and retain patients, reducing barriers to telehealth services, and re-evaluating policies that limit treatment access for nonabstinent patients.  

Eliminate Pharmacy Access Barriers

Pharmacists play a crucial role in a patient’s addiction care, helping to ensure the safe and effective use of medications for opioid use disorder (MOUDs), such as buprenorphine. Despite buprenorphine being the most common medication treatment for OUD, patients still face difficulties accessing this medication at pharmacies. This is due to multiple reasons, such as pharmacies failing to sufficiently stock this medication out of fear of triggering a suspicious order report (SOR). 

ASAM calls for Congress to exempt controlled medications approved by the FDA for the treatment of SUD from federal SOR requirements. ASAM has also urged the DEA and HHS to not enforce SOR requirements for buprenorphine in order to ensure timely patient access to this lifesaving treatment.  


Promote Access to Quality Recovery Residences

Recovery residences, sometimes referred to as “sober homes” or “recovery homes,” are community programs operated in home-like settings that give people the opportunity to practice interpersonal and life skills in a structured environment. This may be recommended for some people with addiction as an addition to outpatient level of care.  

The structure and community support provided by recovery residences can be immensely beneficial for certain people with addiction. However, there are several barriers that limit patient access to these residences and subsequently hinder their potential impact. These challenges include:  

  • Inconsistent regulation, which have led to issues with safety, quality of care, fraud, and abuse 

  • Failure of clinical recovery residences to assess residents’ need for FDA-approved addiction medications 

  • Rejection of residents who are treated with FDA-approved addiction medications such as buprenorphine and methadone 

 

To overcome these access barriers, ASAM supports policies that would: 

  • Require appropriate quality measures for and credentialing of recovery residences, including mandating that clinical recovery residences meet ASAM Level 3.1 program standards 

  • Increase funding for recovery residences and recovery support services at these residences 

  • Promote research to understand which services within recovery residences maximally reduce harms of substance use and overdose risk and what determinants best match patients with the most appropriate type of recovery residence 

  • Make locating recovery residences easier  

 

 

 

 

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