For Pharmacists: Integrating Medications for Opioid Use Disorder (MOUD) into Community and Clinical Pharmacy Settings
Pharmacists are often the most accessible healthcare practitioners, making you a vital point in the continuum of care for patients with substance use disorders (SUD). Your ability to educate, monitor, and manage medications, to improve a patient’s health, including the availability of Food and Drug Administration (FDA)-approved medications for opioid use disorder (MOUD), makes you uniquely suited to help patients.
There are various pathways to recovery. The use of MOUD including buprenorphine, methadone, and naltrexone, is just one component of an evidence-based care plan that includes additional patient-centered supports such as counseling and behavioral therapies, and medical and social services to best meet the needs of the individual with an opioid use disorder (OUD).
It is beneficial for all when pharmacists and other practitioners collaborate in their communities to ensure that the needed medications are available to patients. By working with practitioners in your area, you can help ensure the appropriate treatment for new patients is available, as well as the continuity of services for patients who are already utilizing these lifesaving medications for OUD and SUD.
Pharmacy Safety
The Drug Enforcement Administration (DEA) provides resources to the pharmacy community on their Pharmacy News web page to prevent the diversion of pharmaceutical controlled substances and scheduled listed chemical products into the illicit market.
The web page features topics such a prescription fraud and important regulatory information. In addition, the web page hosts a safety alert video, which includes a comprehensive set of resources aimed at guiding pharmacists on strategies to prevent theft, such as improving security measures and reporting suspicious activities. This is part of a broader effort to raise awareness and protect pharmacies from being targeted by criminals. These burglaries involve the theft of controlled substances, which are then sold illegally, impacting both public safety and patient care.
These DEA resources emphasize the critical role pharmacists play in ensuring medications are dispensed safely while preventing misuse in the community. Access the full suite of resources available on the DEA Pharmacy News web page:
- Pharmacist’s Guide to Prescription Fraud outlines prevention techniques, controls, and the responsibilities of pharmacists. Pharmacy professionals are in a unique position and play an important role in detecting suspicious and fraudulent activity.
- Pharmacist’s Manual provides important regulatory information for pharmacists. Compliance with the Controlled Substances Act (CSA) and its objectives is a powerful resource for protecting the public health, ensuring patient safety, and preventing the diversion of controlled substances and drug products containing listed chemicals.
Policy Changes and Your Role
With the elimination of the DATA-Waiver (X-Waiver), pharmacists, where state laws allow, can now prescribe buprenorphine for the treatment of OUD without a special waiver. This important policy change makes your role in the continuum of care even more significant, ensuring the safe and effective dispensing of buprenorphine and providing essential medication counseling to support patients in their recovery.
The National Association of Boards of Pharmacy (NABP) includes information on the Requirement for Pharmacists Prescribing Buprenorphine. The NAPB states that while the SUPPORT Act and MAT Act cleared the federal path pharmacist’s ability to prescribe buprenorphine independently rests on a “triple-lock” requirement including these three steps:
- State Authorization: The pharmacist’s practice state must specifically recognize “prescriptive authority” or “independent initiation” for buprenorphine within the pharmacist’s scope of practice.
- DEA Registration: The pharmacist must hold an active DEA registration. Under the MATE Act, all DEA-registered practitioners must complete a one-time, 8-hour training on treating and managing patients with opioid or other substance use disorders.
- Specialized CPE (The SUPPORT Act Path): For states that choose to implement the specific pathways laid out in 2025, pharmacists may be required to complete an additional, targeted ACPE-accredited training focused specifically on buprenorphine.
Please review the information on the NAPB web site for additional information on the Requirement for Pharmacists Prescribing Buprenorphine.
Integrating MOUD into Pharmacy Practice
Explore these resources to identify MOUD protocols and processes that best suit your setting and your patients, and tailor them to your needs.
Education and Awareness
- Review the Drug Enforcement Administration's Pharmacist's Guide to Prescription Fraud Trifold Brochure 2024 (PDF | 1.1 MB)
- SAMHSA Advisory: Expanding Access to Medications for Opioid Use Disorder: The Role of Pharmacists and the Settings in Which They Work outlines how pharmacists can support expanded access to MOUD
- Dear Colleague Letter on Expanding Access to Medications for Opioid Use Disorder Through Pharmacist State Scope-of-Practice Flexibility
Plan for Success
- Involve stakeholders in your organization: Engage stakeholders at all levels of your organization in the planning process to develop best practices and protocols for integrating MOUD into your pharmacy practice.
- Connect with other practitioners:
- Partner with other healthcare practitioners to create coordinated care plans.
- Visit PCSS–MOUD to find additional information, training, and mentoring.
- Use ORN to find locally meaningful guidance, education, and training resources.
- Explore the National Council for Mental Wellbeing’s Center of Excellence for Integrated Health Solutions for the newest evidence-based resources, tools, and support for practitioners working to integrate primary and behavioral healthcare.
Continuing Education Resources
In addition to PCSS-MOUD, there are numerous resources available to pharmacists to explore continuing education opportunities in SUD, OUD, and MOUD: