This regulation governs the provision of Medications for Substance Use Disorder (MSUD), including medications for opioid use disorder (OUD), by licensed providers in the District of Columbia. It establishes eligibility criteria for clients, informed consent requirements, permissible delivery methods (in-office, mobile unit, or take-home), required therapeutic guidance content, documentation standards, and qualified practitioner designations. Opioid Treatment Programs (OTPs) are explicitly named and must not deny MSUD to clients who decline SUD counseling. All providers must comply with applicable federal regulations governing medication-assisted treatment.
View official source6346 MEDICATIONS FOR SUBSTANCE USE DISORDER 6346.1 MSUD is the use of FDA-approved medications in accordance with the client’s Plan of Care for the treatment of SUD, including OUD. OTPs shall not preclude clients who refuse SUD Counseling/Therapy from receiving MSUD. Providers shall administer MSUD in accordance with all governing Federal regulations. 6346.2 Clients receiving MSUD must meet diagnostic criteria for: Active moderate to severe SUD; Being in SUD remission; or Being at high risk for recurrence or overdose. 6346.3 Providers shall ensure that clients receiving MSUD understand and provide written or verbal informed consent and document the informed consent in the client’s medical record. 6346.4 Providers may deliver MSUD in-office, through a mobile unit, or as a take-home regimen in accordance with all governing Federal regulations. Providers shall ensure that all MSUD administrations include the unit of medication and therapeutic guidance in accordance with § 6346.5 and all governing Federal regulations. For clients receiving a take-home regimen, therapeutic guidance shall include guidance related to storage and self-administration. 6346.5 Therapeutic guidance provided during MSUD shall include: Safeguarding medications; Possible side-effects and interaction with other medications; Impact of missing doses; Monitoring for withdrawal symptoms and other adverse reactions; Appearance of medication and method of ingestion; and For clients receiving a take-home regimen, therapeutic guidance shall include additional guidance related to storage and self-administration. 6346.6 The provision of MSUD shall be accompanied by SUD treatment services in accordance with the client’s Plan of Care. 6346.7 Providers shall document MSUD services through medication log updates and an encounter note for each visit, including therapeutic guidance. 6346.8 Qualified Practitioners of MSUD are: (a) Physicians; and (b) APRNs. 6346.9 The following may deliver MSUD under the direction of a Qualified Practitioner: (a) PAs. (b) RNs; or (c) LPNs. SOURCE: Final Rulemaking published at 62 DCR 12056 (September 4, 2015); as amended by Final Rulemaking published at 67 DCR 011585 (October 9, 2020); as amended by Final Rulemaking published at 72 DCR 008497 (August 1, 2025). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 6346