Regulation on Methadone Use in the ED

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mark heelon
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Regulation on Methadone Use in the ED

Our clinical, regulatory, and legal teams are wrestling with a question that has arisen from some of the complications of COVID. Like many emergency departments, we are holding patients with complex psychiatric needs for placement at other facilities, sometimes for a week or more. Some of these patients also have opioid use disorder and are maintained on methadone. Of note, these patients are NOT admitted to our hospital and are still under the care of our ED providers.

According to the Code of Federal Regulation Title 21 § 1306.07, non-admitted patients are allowed to be managed for a maximum of 3 days on methadone by a provider in this setting. Of course, if the patient is admitted for another reason, we can maintain treatment but that doesn't seem to apply here.

Is anyone else experiencing this situation and are you interpreting this differently? Any strategies you have put in place?

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