An Act to Authorize Certain Health Care Professionals to Prescribe Methadone
Maine Legislature, Session 131, LD 1146
Committee: Health Coverage, Insurance and Financial Services
Sponsors: BRAKEY, BOYER
Amends: 5 MRSA §20056

Legislative Document
No. 1146
S.P. 473
In Senate, March 13, 2023
An Act to Authorize Certain Health Care Professionals to Prescribe 
Methadone
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BRAKEY of Androscoggin.
Cosponsored by Representative: BOYER of Poland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  5 MRSA §20056 is enacted to read:
§20056.  Prescribing of methadone for substance use disorder treatment
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "Controlled substance" means a controlled substance included in schedule II, III or 
IV of 21 United States Code, Section 812 or in 21 Code of Federal Regulations, Section 
1308.
B.  "Prescriber" means a health care professional licensed under Title 32, chapter 36 or 
with authority to prescribe controlled substances in this State.
2. Authority to prescribe.  A prescriber may prescribe methadone to a person with 
substance use disorder for unsupervised use as long as the following requirements are met:
A. The prescriber determines that the person with substance use disorder is sufficiently 
responsible in handling methadone for unsupervised use, as established in subsection 
3;
B.  The number of days of methadone prescribed to the person with substance use 
disorder for unsupervised use does not exceed the guidelines established in subsection 
4; and
C.  The person with substance use disorder is participating in clinically appropriate 
counseling activities provided by a licensed behavioral health organization or 
community service provider that is the equivalent to the counseling required for those 
receiving substance use disorder treatment at a certified opioid treatment program.
3. Sufficiently responsible for unsupervised use.  A prescriber shall determine if a 
person with substance use disorder is sufficiently responsible for unsupervised use before 
prescribing methadone.  The prescriber must consider the following:
A. Regularity of counseling attendance;
B. Absence of serious behavioral problems at the prescriber's practice;
C. Absence of known recent criminal activity;
D. Stability of the home environment and social relationships;
E. Length of time in substance use disorder treatment;
F. Assurance that methadone medication can be safely stored within the home of the 
person with substance use disorder; and
G. Whether the benefit of the person with substance use disorder derived from 
decreasing the frequency of methadone clinic attendance or presence at the prescriber's 
practice outweighs the potential risks of diversion.
4. Number of days of methadone authorized for prescription.  If a person with 
substance use disorder is determined by a prescriber to be sufficiently responsible for 
unsupervised use, the following limits apply to the supply of methadone.
A. During the first 45 days of treatment, the supply is limited to a single dose each 
week and the person with substance use disorder shall ingest all other doses under 
supervision of the prescriber or at a licensed methadone clinic.
B. In the 2nd 45 days of treatment, the supply is 2 doses per week and the person with 
substance use disorder shall ingest all other doses under supervision of the prescriber 
or at a licensed methadone clinic.
C. In the 3rd 45 days of treatment, the supply is 3 doses per week and the person with 
substance use disorder shall ingest all other doses under supervision of the prescriber 
or at a licensed methadone clinic.
D. In the remaining days of the first 6 months of treatment, a person with substance 
use disorder may be given a maximum 6-day supply of medication and shall ingest the 
dose for the 7th day under supervision of the prescriber or at a licensed methadone 
clinic.
E. After 6 months of continuous treatment, a person with substance use disorder may 
be given a maximum of a 2-week supply of medication.
F. After one year of continuous treatment, a person with substance use disorder may 
be given a maximum one-month supply of medication, but must make monthly visits 
to the prescriber.
Nothing in this subsection limits a prescriber to a specific dosage level of methadone.
5. Proper packaging and storage.  The prescriber must ensure that methadone is 
appropriately stored and packaged as required by 42 Code of Federal Regulations, Section 
8.12(i)(5).
6.  Rules.  The department is authorized to adopt or amend rules to implement this 
section.  Licensing boards of prescribers are authorized to adopt or amend rules to 
implement this section.  Rules adopted pursuant to this subsection are routine technical 
rules as defined in chapter 375, subchapter 2-A.
SUMMARY
This bill allows a health care professional licensed under the Board of Osteopathic 
Licensure or the Board of Licensure in Medicine with authority to prescribe controlled 
substances to prescribe methadone to a person with substance use disorder.  It requires the 
person receiving treatment to participate in appropriate counseling activities that are 
equivalent to those required of individuals receiving methadone treatment at a methadone 
clinic.  It requires prescribers to establish that the person with substance use disorder 
receiving methadone prescriptions are considered sufficiently responsible for unsupervised 
use and the days the prescription is for.  These requirements are based on 42 Code of 
Federal Regulations, Section 8.12 and the changes proposed to those requirements in S. 
3629 introduced to the United States Congress in 2022.