"Three Day Rule" for Opioid Use Disorder Treatment

Under federal and state law (Title 21 CFR section 1306.07(b) and Health and Safety Code section 11158), authorized practitioners who are not specifically registered with the federal Drug Enforcement Administration to conduct a narcotic treatment program (NTP) may dispense on an emergency basis Schedule II narcotic medication (e.g., methadone) to patients for the purpose of initiating maintenance treatment or detoxification treatment (or both).

Key Requirements of the Rule:

Practitioners may dispense up to a three-day supply of Schedule II narcotic medication while referral to opioid treatment is being arranged.
Not more than a three-day supply may be dispensed to one person for one person’s use. This emergency treatment may not be renewed or extended.
The rule is intended as a short-term emergency bridge until the patient can be admitted to a licensed NTP.

The Three Day Rule represents one pathway for practitioners to dispense Schedule II medications to initiate treatment for OUD. For more information about the Three Day Rule and other pathways to treat OUD, see Additional Resources.

For more information about licensed narcotic treatment programs, review the online provider directory or contact the California Department of Health Care Services (DHCS), Licensing and Certification Division, Counselor and Medication Assisted Treatment Section at:

Website: DHCS Licensing and Certification
Email: DHCSNTP@dhcs.ca.gov
Phone: (916) 322-6682