II 

117TH CONGRESS 

1ST SESSION S. 445 

To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) 

to eliminate the separate registration requirement for dispensing narcotic 

drugs in schedule III, IV, or V, such as buprenorphine, for maintenance 

or detoxification treatment, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 25, 2021 

Ms. HASSAN (for herself and Ms. MURKOWSKI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend section 303(g) of the Controlled Substances Act 

(21 U.S.C. 823(g)) to eliminate the separate registration 

requirement for dispensing narcotic drugs in schedule 

III, IV, or V, such as buprenorphine, for maintenance 

or detoxification treatment, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Mainstreaming Addic5 tion Treatment Act of 2021’’. 


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•S 445 IS

1 SEC. 2. ELIMINATING SEPARATE REGISTRATION REQUIRE2 MENT FOR DISPENSING NARCOTIC DRUGS IN 

3 SCHEDULES III, IV, AND V FOR MAINTENANCE 

4 OR DETOXIFICATION TREATMENT. 

5 (a) IN GENERAL.—Section 303(g) of the Controlled 

6 Substances Act (21 U.S.C. 823(g)) is amended— 

7 (1) by striking paragraph (2); 

8 (2) by striking ‘‘(g)(1) Except as provided in 

9 paragraph (2), practitioners who dispense narcotic 

10 drugs to individuals for maintenance treatment or 

11 detoxification treatment’’ and inserting ‘‘(g) Practi12 tioners who dispense narcotic drugs (other than nar13 cotic drugs in schedule III, IV, or V) to individuals 

14 for maintenance treatment or detoxification treat15 ment’’; 

16 (3) by redesignating subparagraphs (A), (B), 

17 and (C) as paragraphs (1), (2), and (3), respectively; 

18 and 

19 (4) in paragraph (2), as so redesignated, by re20 designating clauses (i) and (ii) as subparagraphs (A) 

21 and (B), respectively. 

22 (b) TECHNICAL AND CONFORMING EDITS.— 

23 (1) Section 304 of the Controlled Substances 

24 Act (21 U.S.C. 824) is amended— 


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1 (A) in subsection (a), by striking 

2 ‘‘303(g)(1)’’ each place it appears and inserting 

3 ‘‘303(g)’’; and 

4 (B) in subsection (d)(1), by striking 

5 ‘‘303(g)(1)’’ and inserting ‘‘303(g)’’. 

6 (2) Section 309A(a) of the Controlled Sub7 stances Act (21 U.S.C. 829a(a)) is amended by 

8 striking paragraph (2) and inserting the following: 

9 ‘‘(2) the controlled substance— 

10 ‘‘(A) is a narcotic drug in schedule III, IV, 

11 or V to be administered for the purpose of 

12 maintenance or detoxification treatment; and 

13 ‘‘(B) is to be administered by injection or 

14 implantation;’’. 

15 (3) Section 520E–4(c) of the Public Health 

16 Service Act (42 U.S.C. 290bb–36d(c)) is amended, 

17 in the matter preceding paragraph (1), by striking 

18 ‘‘information on any qualified practitioner that is 

19 certified to prescribe medication for opioid depend20 ency under section 303(g)(2)(B) of the Controlled 

21 Substances Act’’ and inserting ‘‘information on any 

22 practitioner who prescribes narcotic drugs in sched23 ule III, IV, or V of section 202(c) of the Controlled 

24 Substances Act (21 U.S.C. 812(c)) for the purpose 

25 of maintenance or detoxification treatment’’. 


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1 (4) Section 544(a)(3) of the Public Health 

2 Service Act (42 U.S.C. 290dd–3(a)(3)) is amended 

3 by striking ‘‘any practitioner dispensing narcotic 

4 drugs pursuant to section 303(g) of the Controlled 

5 Substances Act’’ and inserting ‘‘any practitioner dis6 pensing narcotic drugs for the purpose of mainte7 nance or detoxification treatment’’. 

8 (5) Section 1833 of the Social Security Act (42 

9 U.S.C. 1395l) is amended by striking subsection 

10 (bb). 

11 (6) Section 1834(o) of the Social Security Act 

12 (42 U.S.C. 1395m(o)) is amended by striking para13 graph (3). 

14 (7) Section 1866F(c)(3) of the Social Security 

15 Act (42 U.S.C. 1395cc–6(c)(3)) is amended— 

16 (A) in subparagraph (A), by inserting 

17 ‘‘and’’ at the end; 

18 (B) in subparagraph (B), by striking ‘‘; 

19 and’’ and inserting a period; and 

20 (C) by striking subparagraph (C). 

21 (8) Section 1903(aa)(2)(C) of the Social Secu22 rity Act (42 U.S.C. 1396b(aa)(2)(C)) is amended— 

23 (A) in clause (i), by inserting ‘‘and’’ at the 

24 end; 

25 (B) by striking clause (ii); and 


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1 (C) by redesignating clause (iii) as clause 

2 (ii). 

3 SEC. 3. NATIONAL EDUCATION CAMPAIGN. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services, acting through the Assistant Secretary 

6 for Mental Health and Substance Use, shall conduct a na7 tional campaign to educate practitioners with respect to 

8 the elimination of the separate registration requirement 

9 under section 303(g) of the Controlled Substances Act (21 

10 U.S.C. 823(g)), as in effect on the day before the date 

11 of enactment of this Act, for dispensing narcotic drugs in 

12 schedule III, IV, and V for maintenance or detoxification 

13 treatment. 

14 (b) REQUIRED COMPONENTS.—The national edu15 cation campaign under subsection (a) shall— 

16 (1) encourage practitioners to integrate sub17 stance use treatment into their practices; and 

18 (2) include education on publicly available edu19 cational resources and training modules that can as20 sist practitioners in treating patients with a sub21 stance use disorder. 


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1 SEC. 4. COMMUNITY HEALTH AIDES AND COMMUNITY 

2 HEALTH PRACTITIONERS. 

3 (a) PRACTICE OF TELEMEDICINE.—Section 102 of 

4 the Controlled Substances Act (21 U.S.C. 802) is amend5 ed— 

6 (1) in paragraph (54)(A), by striking clause (i) 

7 and inserting the following: 

8 ‘‘(i) while the patient is— 

9 ‘‘(I) being treated by, and physically 

10 located in, a hospital or clinic registered 

11 under section 303(f); or 

12 ‘‘(II) for purposes of section 302(h), 

13 being treated by a community health aide 

14 or community health practitioner; and’’; 

15 (2) by redesignating paragraph (58) as para16 graph (59); 

17 (3) by redesignating the second paragraph des18 ignated as paragraph (57) (relating to the definition 

19 of ‘‘serious drug felony’’) as paragraph (58); 

20 (4) by moving paragraphs (57), (58) (as so re21 designated), and (59) (as so redesignated) 2 ems to 

22 the left; and 

23 (5) by adding at the end the following: 

24 ‘‘(60) The terms ‘community health aide’ and ‘com25 munity health practitioner’ have the meanings within the 


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1 meaning of section 119 of the Indian Health Care Im2 provement Act (25 U.S.C. 1616l).’’. 

3 (b) DISPENSATION OF NARCOTIC DRUGS IN SCHED4 ULE III, IV, OR V.—Section 302 of the Controlled Sub5 stances Act (21 U.S.C. 822) is amended by adding at the 

6 end the following: 

7 ‘‘(h) DISPENSATION OF NARCOTIC DRUGS IN SCHED8 ULE III, IV, OR V BY CERTAIN PRACTITIONERS.— 

9 ‘‘(1) IN GENERAL.—Notwithstanding subsection 

10 (a)(2), a community health aide or community 

11 health practitioner may dispense a narcotic drug in 

12 schedule III, IV, or V, such as buprenorphine, or a 

13 combination of such drugs, to an individual for 

14 maintenance treatment or detoxification treatment 

15 (or both) without being registered under this title if 

16 the drug is prescribed by a practitioner through the 

17 practice of telemedicine. 

18 ‘‘(2) PREEMPTION.—Notwithstanding section 

19 708, a State may not require a community health 

20 aide or community health practitioner to be licensed 

21 by the State in order to dispense narcotic drugs in 

22 accordance with paragraph (1) of this subsection.’’. 

Æ 


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