Overcoming Legislative and Institutional Barriers to Implementing Methadone Dispensing in a California Health System

Opioid overdose deaths increased markedly during the COVID‐19 pandemic, highlighting the need to optimize access to medications for opioid use disorder (MOUD). Hospitalization presents a key opportunity to initiate treatment. However, methadone access is uniquely limited by federal and state regulations requiring dispensing through Opioid Treatment Programs (OTPs). This frequently delays hospital discharge, prolongs inpatient length of stay, or necessitates return emergency department (ED) visits when OTPs are inaccessible. In March 2022, the Drug Enforcement Administration permitted hospitals to dispense up to a 72‐h supply of methadone for OUD while arranging OTP care, but unclear state‐level authorization limited adoption in our California hospital.