Resources
An online library of the Board's various forms, publications, brochures, alerts, statistics, and medical resources.
Dispensing Opioid Treatments to Initiate Maintenance or Detoxification Treatment Under the Federal Three Day Rule
Under federal and state law (21 CFR §1306.07(b) and Health & Safety Code §11158), authorized practitioners who are not specifically registered with the federal Drug Enforcement Administration (DEA) to conduct a narcotic treatment program (NTP) may dispense on an emergency basis Schedule II narcotic medication (e.g., methadone) to patients for the purpose of initiating maintenance treatment or detoxification treatment (or both).
Key Requirements of the Rule
- Practitioners may dispense up to a three-day supply of Schedule II narcotic medication while referral to opioid treatment is being arranged.
- Not more than a three-day supply may be dispensed to one person for one person's use. This emergency treatment may not be renewed or extended.
- The rule is intended as a short-term emergency bridge until the patient can be admitted to a licensed NTP.
The Three Day Rule represents one pathway for practitioners to dispense Schedule II medications to initiate treatment for opioid use disorder (OUD). For more information about the Three Day Rule and other pathways to treat OUD, see the Additional Resources at the bottom of this webpage.
For more information about licensed narcotic treatment programs, review the online provider directory or contact the California Department of Health Care Services (DHCS), Licensing and Certification Division, Counselor and Medication Assisted Treatment Section at:
Website: DHCS Licensing and Certification
Email: Send a message to the DCHS Narcotic Treatment Program
Phone: (916) 322-6682
Additional Resources
- DEA Guidance on Development of Revised Three Day Rule (Jan. 12, 2023)
- DEA Notice of Final Rule, Dispensing of Narcotic Drugs to Relieve Acute Withdrawal Symptoms of Opioid Use Disorder (Aug. 8, 2023)
- DEA Practitioner’s Manual, An Informational Outline of the Controlled Substances Act (Rev. 2023)
- Substance Abuse and Mental Health Services Administration, Federal Guidelines for Opioid Treatment Programs (Fall 2024)
- California Department of Public Health, Substance and Addiction Prevention Branch, Resources: Health Care Providers
- Medical Board of California, Guidelines for Prescribing Controlled Substances for Pain (July 2023)