S. 4941: Modernizing Opioid Treatment Access Act 2.0 of 2026

This bill would change federal rules so that certain qualified doctors and other prescribers could write prescriptions for methadone to treat opioid use disorder, and pharmacies could dispense it to patients. Under current law, methadone for opioid treatment is generally limited to opioid treatment programs (often called methadone clinics). The bill would create a new pathway for methadone to be prescribed and filled through pharmacies for supervised or unsupervised use.

What would change

• The Attorney General, working with the Secretary of Health and Human Services, would register certain practitioners to prescribe methadone for opioid use disorder outside the usual clinic system.
• Eligible prescribers would include:
  • licensed practitioners who are already allowed to prescribe controlled substances; and
  • either addiction medicine/addiction psychiatry specialists with certain board certifications, or other practitioners the Secretary determines are qualified under federal standards.
• Methadone prescribed under this new system would have to be:
  • prescribed electronically only;
  • dispensed according to applicable federal and state limits on quantity; and
  • provided only in liquid or dispersible tablet form.
• Patients getting methadone through this pharmacy-based pathway would still have access to other care through an opioid treatment program if they are enrolled in one.
• Prescribers would have to document informed consent, including explaining that confidentiality rules may differ when methadone is dispensed through a pharmacy instead of a treatment program.
• States could opt out of the new registration system. If a state asks, the Attorney General would have to stop registering prescribers in that state, revoke existing registrations there, and deny pending applications.
• Maintenance treatment or detoxification treatment under this system could be provided through telemedicine.
• Pharmacies would not need a separate federal registration just to dispense methadone that was prescribed under this new pathway.

Reporting requirements

The DEA would have to report to Congress within 180 days after enactment, and then every year, on:

• how many practitioners are registered in each state;
• which states asked to opt out;
• how many registrations were revoked or suspended for violations related to these prescriptions; and
• how many pharmacies ordered methadone in liquid or dispersible tablet form.

When it would take effect

The bill would take effect 180 days after it is enacted.

Relevant Companies

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