S. 445Senate117th Congress (2021-2023)In Committee

Mainstreaming Addiction Treatment Act of 2021

Introduced February 25, 2021

AI-Generated Summary

Updated February 7, 2026 at 11:16 PM UTC

The Mainstreaming Addiction Treatment Act of 2021 removes the special registration that doctors and other practitioners must have to dispense schedule III, IV, or V narcotics such as buprenorphine when used for maintenance or detoxification treatment. By amending the Controlled Substances Act, the bill lets qualified providers prescribe and dispense these medications without the extra registration, and it also permits community health aides and practitioners to dispense them via telemedicine without state licensing requirements. The law also directs the Health and Human Services Secretary to run a national education campaign to inform providers about the new rules.

Key Provisions

  • Eliminates the separate registration requirement for dispensing schedule III‑V narcotics for maintenance or detoxification treatment, amending 21 U.S.C. 823(g).
  • Updates related sections of the Controlled Substances Act and the Public Health Service Act to align with the registration change.
  • Requires HHS to conduct a national education campaign to teach practitioners about the new dispensing rules and encourage integration of substance‑use treatment into practice.
  • Allows community health aides and community health practitioners to dispense schedule III‑V narcotics via telemedicine without being registered under the CSA, and bars states from imposing licensing requirements for that dispensing.

Legislative Activity

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SenateIntro Referral Latest Action

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

February 25, 2021

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SenateIntro Referral

Introduced in Senate

February 25, 2021

SenateIntro Referral

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

February 25, 2021

Bill Text

Latest available legislative text

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Introduced in SenateIssued February 25, 2021

II

117th CONGRESS

1st Session

S. 445

IN THE SENATE OF THE UNITED STATES

February 25, 2021

Ms. Hassan (for herself and Ms. Murkowski) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) to eliminate the separate registration requirement for dispensing narcotic drugs in schedule III, IV, or V, such as buprenorphine, for maintenance or detoxification treatment, and for other purposes.

1.

Short title

This Act may be cited as the Mainstreaming Addiction Treatment Act of 2021.

2.

Eliminating separate registration requirement for dispensing narcotic drugs in schedules III, IV, and V for maintenance or detoxification treatment

(a)

In general

Section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)) is amended—

(1)

by striking paragraph (2);

(2)

by striking (g)(1) Except as provided in paragraph (2), practitioners who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment and inserting (g) Practitioners who dispense narcotic drugs (other than narcotic drugs in schedule III, IV, or V) to individuals for maintenance treatment or detoxification treatment;

(3)

by redesignating subparagraphs (A), (B), and (C) as paragraphs (1), (2), and (3), respectively; and

(4)

in paragraph (2), as so redesignated, by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively.

(b)

Technical and conforming edits

(1)

Section 304 of the Controlled Substances Act (21 U.S.C. 824) is amended—

(A)

in subsection (a), by striking 303(g)(1) each place it appears and inserting 303(g); and

(B)

in subsection (d)(1), by striking 303(g)(1) and inserting 303(g).

(2)

Section 309A(a) of the Controlled Substances Act (21 U.S.C. 829a(a)) is amended by striking paragraph (2) and inserting the following:

(2)

the controlled substance—

(A)

is a narcotic drug in schedule III, IV, or V to be administered for the purpose of maintenance or detoxification treatment; and

(B)

is to be administered by injection or implantation;

.

(3)

Section 520E–4(c) of the Public Health Service Act (42 U.S.C. 290bb–36d(c)) is amended, in the matter preceding paragraph (1), by striking information on any qualified practitioner that is certified to prescribe medication for opioid dependency under section 303(g)(2)(B) of the Controlled Substances Act and inserting information on any practitioner who prescribes narcotic drugs in schedule III, IV, or V of section 202(c) of the Controlled Substances Act (21 U.S.C. 812(c)) for the purpose of maintenance or detoxification treatment.

(4)

Section 544(a)(3) of the Public Health Service Act (42 U.S.C. 290dd–3(a)(3)) is amended by striking any practitioner dispensing narcotic drugs pursuant to section 303(g) of the Controlled Substances Act and inserting any practitioner dispensing narcotic drugs for the purpose of maintenance or detoxification treatment.

(5)

Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended by striking subsection (bb).

(6)

Section 1834(o) of the Social Security Act (42 U.S.C. 1395m(o)) is amended by striking paragraph (3).

(7)

Section 1866F(c)(3) of the Social Security Act (42 U.S.C. 1395cc–6(c)(3)) is amended—

(A)

in subparagraph (A), by inserting and at the end;

(B)

in subparagraph (B), by striking ; and and inserting a period; and

(C)

by striking subparagraph (C).

(8)

Section 1903(aa)(2)(C) of the Social Security Act (42 U.S.C. 1396b(aa)(2)(C)) is amended—

(A)

in clause (i), by inserting and at the end;

(B)

by striking clause (ii); and

(C)

by redesignating clause (iii) as clause (ii).

3.

National education campaign

(a)

In general

The Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, shall conduct a national campaign to educate practitioners with respect to the elimination of the separate registration requirement under section 303(g) of the Controlled Substances Act (21 U.S.C. 823(g)), as in effect on the day before the date of enactment of this Act, for dispensing narcotic drugs in schedule III, IV, and V for maintenance or detoxification treatment.

(b)

Required components

The national education campaign under subsection (a) shall—

(1)

encourage practitioners to integrate substance use treatment into their practices; and

(2)

include education on publicly available educational resources and training modules that can assist practitioners in treating patients with a substance use disorder.

4.

Community health aides and community health practitioners

(a)

Practice of telemedicine

Section 102 of the Controlled Substances Act (21 U.S.C. 802) is amended—

(1)

in paragraph (54)(A), by striking clause (i) and inserting the following:

(i)

while the patient is—

(I)

being treated by, and physically located in, a hospital or clinic registered under section 303(f); or

(II)

for purposes of section 302(h), being treated by a community health aide or community health practitioner; and

;

(2)

by redesignating paragraph (58) as paragraph (59);

(3)

by redesignating the second paragraph designated as paragraph (57) (relating to the definition of serious drug felony) as paragraph (58);

(4)

by moving paragraphs (57), (58) (as so redesignated), and (59) (as so redesignated) 2 ems to the left; and

(5)

by adding at the end the following:

(60)

The terms community health aide and community health practitioner have the meanings within the meaning of section 119 of the Indian Health Care Improvement Act (25 U.S.C. 1616l).

.

(b)

Dispensation of narcotic drugs in schedule III, IV, or V

Section 302 of the Controlled Substances Act (21 U.S.C. 822) is amended by adding at the end the following:

(h)

Dispensation of narcotic drugs in schedule III, IV, or V by certain practitioners

(1)

In general

Notwithstanding subsection (a)(2), a community health aide or community health practitioner may dispense a narcotic drug in schedule III, IV, or V, such as buprenorphine, or a combination of such drugs, to an individual for maintenance treatment or detoxification treatment (or both) without being registered under this title if the drug is prescribed by a practitioner through the practice of telemedicine.

(2)

Preemption

Notwithstanding section 708, a State may not require a community health aide or community health practitioner to be licensed by the State in order to dispense narcotic drugs in accordance with paragraph (1) of this subsection.

.