{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:38:52Z","timestamp":1773074332783,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Am Coll Clin Pharm"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid overdose deaths increased markedly during the COVID\u201019 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\u2010h supply of methadone for OUD while arranging OTP care, but unclear state\u2010level authorization limited adoption in our California hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe the multidisciplinary process of implementing hospital\u2010based methadone dispensing under the federal 72\u2010h rule at a California acute care hospital. This included legislative advocacy culminating in passage of Assembly Bill 2115, regulatory and legal review, Board of Pharmacy engagement, development of electronic medical record workflows, pharmacy operations redesign, and anti\u2010stigma education. We also evaluated baseline utilization and costs associated with delayed discharges and ED return visits related to methadone access and reported early post\u2010implementation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prior to implementation, methadone\u2010related barriers accounted for 33 excess inpatient days and 15 ED visits in a 7\u2010month period, with an estimated cost of $415\u2009970 annually. In the first 8\u2009months after implementation, 25 patients received dispensed methadone, avoiding at least 40 inpatient days and 12 ED visits, with estimated cost savings of $269\u2009164. Nine patients were newly initiated on methadone during hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospital\u2010based methadone dispensing under the 72\u2010h rule is feasible, legally permissible in California following AB 2115, and associated with reductions in length of stay, ED utilization, and healthcare costs. This program improves continuity of care, reduces stigma, and expands access to lifesaving MOUD, offering a framework for other institutions and states.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70187","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T03:15:27Z","timestamp":1770866127000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Overcoming Legislative and Institutional Barriers to Implementing Methadone Dispensing in a California Health System"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6665-2190","authenticated-orcid":false,"given":"Sarah","family":"Cummins","sequence":"first","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaron","family":"Lopez","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Dakwa","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Nguyen","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Weng","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Eberhardt","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee","family":"Moulin","sequence":"additional","affiliation":[{"name":"University of California Davis Health  Sacramento California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Provisional Drug Overdose Death Counts","author":"Ahmad F. B.","year":"2025"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-3107"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.0976"},{"issue":"2","key":"e_1_2_14_5_1","first-page":"1","article-title":"The American Society of Addiction Medicine (ASAM) National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update","volume":"14","year":"2020","journal-title":"Journal of Addiction Medicine"},{"key":"e_1_2_14_6_1","unstructured":"\u201c21 CFR \u00a71306.07\u2014Administering or Dispensing of Narcotic Drugs \u201daccessed March 24 2025 https:\/\/www.ecfr.gov\/current\/title\u201021\/chapter\u2010II\/part\u20101306\/subjectgroup\u2010ECFR1eb5bb3a23fddd0\/section\u20101306.07#p\u20101306.07(b)."},{"key":"e_1_2_14_7_1","unstructured":"H.R.2281\u2010116th Congress (2019\u20102020) \u201cEasy MAT for Opioid Addiction Act \u201daccessed June 21 2025 https:\/\/www.congress.gov\/bill\/116th\u2010congress\/house\u2010bill\/2281."},{"issue":"151","key":"e_1_2_14_8_1","first-page":"5337","article-title":"Dispensing of Narcotic Drugs to Relieve Acute Withdrawal Symptoms of Opioid Use Disorder","volume":"88","year":"2023","journal-title":"Federal Register"},{"key":"e_1_2_14_9_1","unstructured":"A.B. 2115 \u201c2023\u20132024 Reg. Sess. (Cal. 2024) \u201daccessed June 21 2025 https:\/\/legiscan.com\/CA\/text\/AB2115\/id\/2915478."},{"key":"e_1_2_14_10_1","unstructured":"42 CFR Part 2 \u201cPart 2\u2014Confidentiality of Substance Use Disorder Patient Records \u201daccessed June 21 2025 https:\/\/www.ecfr.gov\/current\/title\u201042\/chapter\u2010I\/subchapter\u2010A\/part\u20102."},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001246"},{"key":"e_1_2_14_12_1","unstructured":"California State Board of Pharmacy \u201cLegislation and Regulation Committee Chair Report: April 11 2024 Committee Meeting \u201dItem IV(d): \u201cAssembly Bill 2115 (Haney) Controlled Substances \u201d accessed January 23 2026 https:\/\/www.pharmacy.ca.gov\/meetings\/agendas\/2024\/24_apr_leg_mat.pdf."},{"key":"e_1_2_14_13_1","unstructured":"CA S.B. 1468. 2023\u20132024 Reg. Sess \u201c(Cal. 2024) \u201daccessed June 21 2025 https:\/\/legiscan.com\/CA\/text\/SB1468\/id\/2999963."},{"key":"e_1_2_14_14_1","unstructured":"A.Anderson \u201cAddiction Medicine Team Dispenses First Three\u2010Day Supply of Methadone at Yale \u201d2023Yale School of Medicine https:\/\/medicine.yale.edu\/news\u2010article\/addiction\u2010medicine\u2010team\u2010dispenses\u2010first\u2010three\u2010day\u2010supply\u2010of\u2010methadone\u2010at\u2010yale\/."},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxad288"},{"issue":"4","key":"e_1_2_14_16_1","first-page":"477","article-title":"A Novel Use of the 3\u2010Day Rule: Post\u2010Discharge Methadone Dosing in the Emergency Department","volume":"25","author":"Nikolaides J. K.","year":"2024","journal-title":"Western Journal of Emergency Medicine"},{"key":"e_1_2_14_17_1","unstructured":"\u201cRequirements for Prescriptions. CA Business and Professional Code \u00a7 4076 \u201daccessed January 23 2026 https:\/\/leginfo.legislature.ca.gov\/faces\/codes_displaySection.xhtml?lawCode=BPC&sectionNum=4076."},{"key":"e_1_2_14_18_1","unstructured":"\u201cPatient\u2010Centered Labels for Prescription Drug Containers; Requirements. CA Code Regulations (California State Board of Pharmacy) \u201dhttps:\/\/www.law.cornell.edu\/regulations\/california\/16\u2010CCR\u20101707.5."},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hsr.2024.100195"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2022.2.54681"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/29767342241262115"}],"container-title":["JACCP:  JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jac5.70187","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jac5.70187","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jac5.70187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:00:57Z","timestamp":1773032457000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/jac5.70187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/jac5.70187"],"URL":"https:\/\/doi.org\/10.1002\/jac5.70187","archive":["Portico"],"relation":{},"ISSN":["2574-9870","2574-9870"],"issn-type":[{"value":"2574-9870","type":"print"},{"value":"2574-9870","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"assertion":[{"value":"2025-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70187"}}