House Bill Would Move Methadone Prescribing Into Local Pharmacies

Three House members introduced legislation Monday that would let board-certified addiction physicians and psychiatrists prescribe methadone for opioid use disorder and have it filled at a neighborhood pharmacy, ending a half-century arrangement under which the medication can be dispensed only inside a federally certified clinic. Those clinics do not exist in roughly 80 percent of American counties, according to a one-pager from the American Society of Addiction Medicine that the bill's sponsors cite.

H.R. 9790, the Modernizing Opioid Treatment Access Act 2.0 of 2026, was filed by Rep. Donald Norcross (D-N.J.) with Reps. Mike Lawler (R-N.Y.) and Paul Tonko (D-N.Y.), and referred to the Energy and Commerce Committee and, for portions within its jurisdiction, to the Judiciary Committee. More than 50 medical and recovery organizations have endorsed it, including the American Medical Association, the American Pharmacists Association, the National Rural Health Association and the American Society of Addiction Medicine.

The change is one paragraph of the Controlled Substances Act

The mechanism is narrow. The bill amends Section 303(h) of the Controlled Substances Act, which requires a practitioner to hold a separate registration tied to an opioid treatment program in order to dispense narcotics for addiction treatment. For methadone prescribed for opioid use disorder, that requirement would be waived, and the attorney general — in consultation with the secretary of Health and Human Services — would instead register qualifying practitioners directly.

Who qualifies is spelled out: physicians and psychiatrists holding subspecialty certification in addiction medicine or addiction psychiatry from the American Board of Preventive Medicine, the American Board of Addiction Medicine, the American Board of Psychiatry and Neurology, or the American Osteopathic Association. A second clause lets the HHS secretary designate additional qualified prescribers under standards the department sets — the provision sponsors describe as giving the agency room to expand the pool without Congress passing another law.

Pharmacies would not need a new registration of their own to fill those prescriptions.

Guardrails the sponsors added after 2023

Norcross led an earlier version of the bill in 2023 that never reached a floor vote. The current text carries restrictions the earlier one lacked, and they are worth reading closely, because opponents of the concept have argued for years that it amounts to prescribing without supervision.

Prescriptions under the new authority would have to be issued electronically and dispensed only to the patient. They would be limited to liquid or dispersible tablet formulations — not the solid tablets more readily diverted. Prescribers would have to obtain and document informed consent, including specific consent covering how confidentiality protections differ when methadone comes from a pharmacy rather than from a treatment program operating under federal addiction-records rules. Pharmacy dispensing would supplement, not replace, a patient's access to the broader services an opioid treatment program provides.

States retain a veto. At a state's request, the attorney general must stop registering practitioners there, revoke registrations already issued, and deny pending applications. The Drug Enforcement Administration would owe Congress a report within 180 days of enactment and every year after, listing registered prescribers by state, which states opted out, how many registrations were revoked or suspended for prescribing violations, and how many pharmacies ordered methadone in the permitted formulations. The act itself would take effect 180 days after enactment.

Treatment provided under the new authority could be delivered through telemedicine, which matters most in the rural counties where the nearest clinic can be an hour's drive each way.

Sponsors put private equity at the center of the argument

Norcross framed the current system less as a safety regime than as a protected market. Nearly a third of opioid treatment programs are owned by private equity firms, a higher share than in practically any other field of medicine, according to research published in Health Affairs and cited in the sponsors' announcement.

"The fact that only a fraction of people can access the most effective, readily-available treatment for opioid addiction is simply a policy choice. And it's a bad choice that's needlessly costing lives," Norcross said. "It's beyond time that our rules catch up with the science — and that we put the needs of Americans over the private-equity monopolies who profit from addiction services."

Lawler, the Republican co-lead, kept to the access argument. The bill "gives qualified addiction specialists the ability to prescribe methadone for opioid addiction through local pharmacies, helping patients access care closer to home safely," he said. Tonko called methadone "a safe, proven, and effective treatment" and said Congress "must do all in its power" to make evidence-based options reachable.

Methadone is one of two primary medications the World Health Organization recommends for opioid use disorder, and ASAM puts its effect on all-cause mortality at a reduction of more than 50 percent.

The clinics are not persuaded

The American Association for the Treatment of Opioid Dependence, which represents opioid treatment programs, has opposed pharmacy prescribing across every version of the bill, arguing it would lead to misuse of methadone. Its objection is not merely institutional posturing, and neither is it disinterested — the programs stand to lose their exclusive hold on a patient population.

Recent research suggests the resistance runs down to the staff level. A survey of opioid treatment program employees in North Carolina, published in July in the Journal of Substance Use and Addiction Treatment, drew responses from 56 of 77 people contacted. Nearly two-thirds viewed pharmacy-based expansion under the bill negatively, and more than a quarter said they saw no potential benefit to pharmacy dispensing at all. The barriers they named most often were a lack of methadone-specific training among community pharmacists and pharmacist stigma toward patients in treatment; the consequence they feared most was the loss of counseling and care coordination that clinics bundle with the dose. The authors noted that respondents may carry a financial interest in the status quo, a conflict their own clinical advisers raised.

Those are implementation problems rather than arguments against the concept, but they are the ones that would determine whether a law like this works in practice.

What happens next

Sens. Ed Markey (D-Mass.) and Rand Paul (R-Ky.) reintroduced the Senate companion in late June, giving the effort bills in both chambers for the first time since 2023. Neither has been scheduled for a markup, and Congress is heading into its August recess. The 2023 predecessor died in committee without a hearing.