<section xmlns="http://xml.house.gov/schemas/uslm/1.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" style="-uslm-lc:I80" id="idc39bc362-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823"><num value="823">§ 823.</num><heading> Registration requirements</heading><subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc363-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a"><num value="a" class="bold">(a)</num><heading class="bold"> Manufacturers of controlled substances in schedule I or II</heading><chapeau>The Attorney General shall register an applicant to manufacture controlled substances in schedule I or II if he determines that such registration is consistent with the public interest and with United States obligations under international treaties, conventions, or protocols in effect on <date date="1971-05-01">May 1, 1971</date>. In determining the public interest, the following factors shall be considered:</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc364-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/1"><num value="1">(1)</num><content> maintenance of effective controls against diversion of particular controlled substances and any controlled substance in schedule I or II compounded therefrom into other than legitimate medical, scientific, research, or industrial channels, by limiting the importation and bulk manufacture of such controlled substances to a number of establishments which can produce an adequate and uninterrupted supply of these substances under adequately competitive conditions for legitimate medical, scientific, research, and industrial purposes;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc365-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/2"><num value="2">(2)</num><content> compliance with applicable State and local law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc366-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/3"><num value="3">(3)</num><content> promotion of technical advances in the art of manufacturing these substances and the development of new substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc367-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/4"><num value="4">(4)</num><content> prior conviction record of applicant under Federal and State laws relating to the manufacture, distribution, or dispensing of such substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc368-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/5"><num value="5">(5)</num><content> past experience in the manufacture of controlled substances, and the existence in the establishment of effective control against diversion; and</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc369-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/a/6"><num value="6">(6)</num><content> such other factors as may be relevant to and consistent with the public health and safety.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc36a-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b"><num value="b" class="bold">(b)</num><heading class="bold"> Distributors of controlled substances in schedule I or II</heading><chapeau>The Attorney General shall register an applicant to distribute a controlled substance in schedule I or II unless he determines that the issuance of such registration is inconsistent with the public interest. In determining the public interest, the following factors shall be considered:</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc36b-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b/1"><num value="1">(1)</num><content> maintenance of effective control against diversion of particular controlled substances into other than legitimate medical, scientific, and industrial channels;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc36c-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b/2"><num value="2">(2)</num><content> compliance with applicable State and local law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc36d-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b/3"><num value="3">(3)</num><content> prior conviction record of applicant under Federal or State laws relating to the manufacture, distribution, or dispensing of such substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc36e-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b/4"><num value="4">(4)</num><content> past experience in the distribution of controlled substances; and</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc36f-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/b/5"><num value="5">(5)</num><content> such other factors as may be relevant to and consistent with the public health and safety.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc370-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/c"><num value="c" class="bold">(c)</num><heading class="bold"> Limits of authorized activities</heading><content><p style="-uslm-lc:I11" class="indent0">Registration granted under subsections (a) and (b) of this section shall not entitle a registrant to (1) manufacture or distribute controlled substances in schedule I or II other than those specified in the registration, or (2) manufacture any quantity of those controlled substances in excess of the quota assigned pursuant to <ref href="/us/usc/t21/s826">section 826 of this title</ref>.</p>
</content>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc371-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d"><num value="d" class="bold">(d)</num><heading class="bold"> Manufacturers of controlled substances in schedule III, IV, or V</heading><chapeau>The Attorney General shall register an applicant to manufacture controlled substances in schedule III, IV, or V, unless he determines that the issuance of such registration is inconsistent with the public interest. In determining the public interest, the following factors shall be considered:</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc372-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/1"><num value="1">(1)</num><content> maintenance of effective controls against diversion of particular controlled substances and any controlled substance in schedule III, IV, or V compounded therefrom into other than legitimate medical, scientific, or industrial channels;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc373-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/2"><num value="2">(2)</num><content> compliance with applicable State and local law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc374-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/3"><num value="3">(3)</num><content> promotion of technical advances in the art of manufacturing these substances and the development of new substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc375-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/4"><num value="4">(4)</num><content> prior conviction record of applicant under Federal or State laws relating to the manufacture, distribution, or dispensing of such substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc376-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/5"><num value="5">(5)</num><content> past experience in the manufacture, distribution, and dispensing of controlled substances, and the existence in the establishment of effective controls against diversion; and</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc377-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/d/6"><num value="6">(6)</num><content> such other factors as may be relevant to and consistent with the public health and safety.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc378-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e"><num value="e" class="bold">(e)</num><heading class="bold"> Distributors of controlled substances in schedule III, IV, or V</heading><chapeau>The Attorney General shall register an applicant to distribute controlled substances in schedule III, IV, or V, unless he determines that the issuance of such registration is inconsistent with the public interest. In determining the public interest, the following factors shall be considered:</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc379-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e/1"><num value="1">(1)</num><content> maintenance of effective controls against diversion of particular controlled substances into other than legitimate medical, scientific, and industrial channels;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc37a-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e/2"><num value="2">(2)</num><content> compliance with applicable State and local law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc37b-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e/3"><num value="3">(3)</num><content> prior conviction record of applicant under Federal or State laws relating to the manufacture, distribution, or dispensing of such substances;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc37c-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e/4"><num value="4">(4)</num><content> past experience in the distribution of controlled substances; and</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc37d-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/e/5"><num value="5">(5)</num><content> such other factors as may be relevant to and consistent with the public health and safety.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc37e-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f"><num value="f" class="bold">(f)</num><heading class="bold"> Research by practitioners; pharmacies; research applications; construction of Article 7 of the Convention on Psychotropic Substances</heading><chapeau>The Attorney General shall register practitioners (including pharmacies, as distinguished from pharmacists) to dispense, or conduct research with, controlled substances in schedule II, III, IV, or V and shall modify the registrations of pharmacies so registered to authorize them to dispense controlled substances by means of the Internet, if the applicant is authorized to dispense, or conduct research with respect to, controlled substances under the laws of the State in which he practices. The Attorney General may deny an application for such registration or such modification of registration if the Attorney General determines that the issuance of such registration or modification would be inconsistent with the public interest. In determining the public interest, the following factors shall be considered:</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc37f-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f/1"><num value="1">(1)</num><content> The recommendation of the appropriate State licensing board or professional disciplinary authority.</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc380-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f/2"><num value="2">(2)</num><content> The applicant’s experience in dispensing, or conducting research with respect to controlled substances.</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc381-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f/3"><num value="3">(3)</num><content> The applicant’s conviction record under Federal or State laws relating to the manufacture, distribution, or dispensing of controlled substances.</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc382-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f/4"><num value="4">(4)</num><content> Compliance with applicable State, Federal, or local laws relating to controlled substances.</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc383-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/f/5"><num value="5">(5)</num><content> Such other conduct which may threaten the public health and safety.</content>
</paragraph>

<continuation style="-uslm-lc:I10" class="indent0 firstIndent0">Separate registration under this part for practitioners engaging in research with controlled substances in schedule II, III, IV, or V, who are already registered under this part in another capacity, shall not be required. Registration applications by practitioners wishing to conduct research with controlled substances in schedule I shall be referred to the Secretary, who shall determine the qualifications and competency of each practitioner requesting registration, as well as the merits of the research protocol. The Secretary, in determining the merits of each research protocol, shall consult with the Attorney General as to effective procedures to adequately safeguard against diversion of such controlled substances from legitimate medical or scientific use. Registration for the purpose of bona fide research with controlled substances in schedule I by a practitioner deemed qualified by the Secretary may be denied by the Attorney General only on a ground specified in <ref href="/us/usc/t21/s824/a">section 824(a) of this title</ref>. Article 7 of the Convention on Psychotropic Substances shall not be construed to prohibit, or impose additional restrictions upon, research involving drugs or other substances scheduled under the convention which is conducted in conformity with this subsection and other applicable provisions of this subchapter.</continuation>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc384-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g"><num value="g" class="bold">(g)</num><heading class="bold"> Practitioners dispensing narcotic drugs for narcotic treatment; annual registration; separate registration; qualifications; waiver</heading><paragraph style="-uslm-lc:I11" class="indent0" id="idc39bc385-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/1"><num value="1">(1)</num><chapeau> Except as provided in paragraph (2), practitioners who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment shall obtain annually a separate registration for that purpose. The Attorney General shall register an applicant to dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment (or both)</chapeau><subparagraph style="-uslm-lc:I12" class="indent1" id="idc39bc386-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/1/A"><num value="A">(A)</num><content> if the applicant is a practitioner who is determined by the Secretary to be qualified (under standards established by the Secretary) to engage in the treatment with respect to which registration is sought;</content>
</subparagraph>
<subparagraph style="-uslm-lc:I12" class="indent1" id="idc39bc387-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/1/B"><num value="B">(B)</num><content> if the Attorney General determines that the applicant will comply with standards established by the Attorney General respecting (i) security of stocks of narcotic drugs for such treatment, and (ii) the maintenance of records (in accordance with <ref href="/us/usc/t21/s827">section 827 of this title</ref>) on such drugs; and</content>
</subparagraph>
<subparagraph style="-uslm-lc:I12" class="indent1" id="idc39bc388-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/1/C"><num value="C">(C)</num><content> if the Secretary determines that the applicant will comply with standards established by the Secretary (after consultation with the Attorney General) respecting the quantities of narcotic drugs which may be provided for unsupervised use by individuals in such treatment.</content>
</subparagraph>
</paragraph>
<paragraph style="-uslm-lc:I11" class="indent0" id="idc39bc389-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2"><num value="2">(2)</num><subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc38a-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/A"><num value="A">(A)</num><content> Subject to subparagraphs (D) and (J), the requirements of paragraph (1) are waived in the case of the dispensing (including the prescribing), by a practitioner, of narcotic drugs in schedule III, IV, or V or combinations of such drugs if the practitioner meets the conditions specified in subparagraph (B) and the narcotic drugs or combinations of such drugs meet the conditions specified in subparagraph (C).</content>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc38b-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B"><num value="B">(B)</num><chapeau> For purposes of subparagraph (A), the conditions specified in this subparagraph with respect to a practitioner are that, before the initial dispensing of narcotic drugs in schedule III, IV, or V or combinations of such drugs to patients for maintenance or detoxification treatment, the practitioner submit to the Secretary a notification of the intent of the practitioner to begin dispensing the drugs or combinations for such purpose, and that the notification contain the following certifications by the practitioner:</chapeau><clause style="-uslm-lc:I12" class="indent1" id="idc39bc38c-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/i"><num value="i">(i)</num><content> The practitioner is a qualifying practitioner (as defined in subparagraph (G)).</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc38d-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/ii"><num value="ii">(ii)</num><chapeau> With respect to patients to whom the practitioner will provide such drugs or combinations of drugs, the practitioner has the capacity to provide directly, by referral, or in such other manner as determined by the Secretary—</chapeau><subclause style="-uslm-lc:I13" class="indent2" id="idc39bc38e-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/ii/I"><num value="I">(I)</num><content> all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder, including for maintenance, detoxification, overdose reversal, and relapse prevention; and</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc38f-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/ii/II"><num value="II">(II)</num><content> appropriate counseling and other appropriate ancillary services.</content>
</subclause>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc390-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/iii"><num value="iii">(iii)</num><subclause style="-uslm-lc:I12" class="indent1" id="idc39bc391-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/iii/I"><num value="I">(I)</num><content> The total number of such patients of the practitioner at any one time will not exceed the applicable number. Except as provided in subclause (II), the applicable number is 30.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc392-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/iii/II"><num value="II">(II)</num><content> The applicable number is 100 if, not sooner than 1 year after the date on which the practitioner submitted the initial notification, the practitioner submits a second notification to the Secretary of the need and intent of the practitioner to treat up to 100 patients.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc393-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/iii/III"><num value="III">(III)</num><content> The Secretary may by regulation change such applicable number.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc394-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/B/iii/IV"><num value="IV">(IV)</num><content> The Secretary may exclude from the applicable number patients to whom such drugs or combinations of drugs are directly administered by the qualifying practitioner in the office setting.</content>
</subclause>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc395-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/C"><num value="C">(C)</num><chapeau> For purposes of subparagraph (A), the conditions specified in this subparagraph with respect to narcotic drugs in schedule III, IV, or V or combinations of such drugs are as follows:</chapeau><clause style="-uslm-lc:I12" class="indent1" id="idc39bc396-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/C/i"><num value="i">(i)</num><content> The drugs or combinations of drugs have, under the Federal Food, Drug, and Cosmetic Act [<ref href="/us/usc/t21/s301">21 U.S.C. 301</ref> et seq.] or <ref href="/us/usc/t42/s262">section 262 of title 42</ref>, been approved for use in maintenance or detoxification treatment.</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc397-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/C/ii"><num value="ii">(ii)</num><content> The drugs or combinations of drugs have not been the subject of an adverse determination. For purposes of this clause, an adverse determination is a determination published in the Federal Register and made by the Secretary, after consultation with the Attorney General, that the use of the drugs or combinations of drugs for maintenance or detoxification treatment requires additional standards respecting the qualifications of practitioners to provide such treatment, or requires standards respecting the quantities of the drugs that may be provided for unsupervised use.</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc398-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D"><num value="D">(D)</num><clause style="-uslm-lc:I11" class="indent0" id="idc39bc399-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/i"><num value="i">(i)</num><chapeau> A waiver under subparagraph (A) with respect to a practitioner is not in effect unless (in addition to conditions under subparagraphs (B) and (C)) the following conditions are met:</chapeau><subclause style="-uslm-lc:I12" class="indent1" id="idc39bc39a-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/i/I"><num value="I">(I)</num><content> The notification under subparagraph (B) is in writing and states the name of the practitioner.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc39b-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/i/II"><num value="II">(II)</num><content> The notification identifies the registration issued for the practitioner pursuant to subsection (f).</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc39c-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/i/III"><num value="III">(III)</num><content> If the practitioner is a member of a group practice, the notification states the names of the other practitioners in the practice and identifies the registrations issued for the other practitioners pursuant to subsection (f).</content>
</subclause>
</clause>
<clause style="-uslm-lc:I11" class="indent0" id="idc39bc39d-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/ii"><num value="ii">(ii)</num><content> Upon receiving a determination from the Secretary under clause (iii) finding that a practitioner meets all requirements for a waiver under subparagraph (B), the Attorney General shall assign the practitioner involved an identification number under this paragraph for inclusion with the registration issued for the practitioner pursuant to subsection (f). The identification number so assigned shall be appropriate to preserve the confidentiality of patients for whom the practitioner has dispensed narcotic drugs under a waiver under subparagraph (A).</content>
</clause>
<clause style="-uslm-lc:I11" class="indent0" id="idc39bc39e-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/D/iii"><num value="iii">(iii)</num><content> Not later than 45 days after the date on which the Secretary receives a notification under subparagraph (B), the Secretary shall make a determination of whether the practitioner involved meets all requirements for a waiver under subparagraph (B) and shall forward such determination to the Attorney General. If the Secretary fails to make such determination by the end of the such 45-day period, the Attorney General shall assign the practitioner an identification number described in clause (ii) at the end of such period.</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc39f-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/E"><num value="E">(E)</num><clause style="-uslm-lc:I11" class="indent0" id="idc39bc3a0-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/E/i"><num value="i">(i)</num><content> If a practitioner is not registered under paragraph (1) and, in violation of the conditions specified in subparagraphs (B) through (D), dispenses narcotic drugs in schedule III, IV, or V or combinations of such drugs for maintenance treatment or detoxification treatment, the Attorney General may, for purposes of <ref href="/us/usc/t21/s824/a/4">section 824(a)(4) of this title</ref>, consider the practitioner to have committed an act that renders the registration of the practitioner pursuant to subsection (f) to be inconsistent with the public interest.</content>
</clause>
<clause style="-uslm-lc:I11" class="indent0" id="idc39bc3a1-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/E/ii"><num value="ii">(ii)</num><subclause style="-uslm-lc:I11" class="indent0" id="idc39bc3a2-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/E/ii/I"><num value="I">(I)</num><content> Upon the expiration of 45 days from the date on which the Secretary receives a notification under subparagraph (B), a practitioner who in good faith submits a notification under subparagraph (B) and reasonably believes that the conditions specified in subparagraphs (B) through (D) have been met shall, in dispensing narcotic drugs in schedule III, IV, or V or combinations of such drugs for maintenance treatment or detoxification treatment, be considered to have a waiver under subparagraph (A) until notified otherwise by the Secretary, except that such a practitioner may commence to prescribe or dispense such narcotic drugs for such purposes prior to the expiration of such 45-day period if it facilitates the treatment of an individual patient and both the Secretary and the Attorney General are notified by the practitioner of the intent to commence prescribing or dispensing such narcotic drugs.</content>
</subclause>
<subclause style="-uslm-lc:I11" class="indent0" id="idc39bc3a3-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/E/ii/II"><num value="II">(II)</num><content> For purposes of subclause (I), the publication in the Federal Register of an adverse determination by the Secretary pursuant to subparagraph (C)(ii) shall (with respect to the narcotic drug or combination involved) be considered to be a notification provided by the Secretary to practitioners, effective upon the expiration of the 30-day period beginning on the date on which the adverse determination is so published.</content>
</subclause>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc3a4-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/F"><num value="F">(F)</num><clause style="-uslm-lc:I11" class="indent0" id="idc39bc3a5-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/F/i"><num value="i">(i)</num><content> With respect to the dispensing of narcotic drugs in schedule III, IV, or V or combinations of such drugs to patients for maintenance or detoxification treatment, a practitioner may, in his or her discretion, dispense such drugs or combinations for such treatment under a registration under paragraph (1) or a waiver under subparagraph (A) (subject to meeting the applicable conditions).</content>
</clause>
<clause style="-uslm-lc:I11" class="indent0" id="idc39bc3a6-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/F/ii"><num value="ii">(ii)</num><content> This paragraph may not be construed as having any legal effect on the conditions for obtaining a registration under paragraph (1), including with respect to the number of patients who may be served under such a registration.</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc3a7-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/G"><num value="G">(G)</num><chapeau> For purposes of this paragraph:</chapeau><clause style="-uslm-lc:I12" class="indent1" id="idc39bc3a8-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/G/i"><num value="i">(i)</num><content> The term “group practice” has the meaning given such term in <ref href="/us/usc/t42/s1395nn/h/4">section 1395nn(h)(4) of title 42</ref>.</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc3a9-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/G/ii"><num value="ii">(ii)</num><chapeau> The term “qualifying physician” means a physician who is licensed under State law and who meets one or more of the following conditions:</chapeau><subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3aa-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/G/ii/I"><num value="I">(I)</num><content> The physician holds a board certification in addiction psychiatry or addiction medicine from the American Board of Medical Specialties.</content>
</subclause>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I12" class="indent1" id="idc39bc3ab-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II"><num value="II">(II)</num><chapeau> The physician holds an addiction certification or board certification from the American Society of Addiction Medicine or the American Board of Addiction Medicine.</chapeau><subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3ac-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/III"><num value="III">(III)</num><content> The physician holds a board certification in addiction medicine from the American Osteopathic Association.</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3ad-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV"><num value="IV">(IV)</num><chapeau> The physician has, with respect to the treatment and management of opiate-dependent patients, completed not less than 8 hours of training (through classroom situations, seminars at professional society meetings, electronic communications, or otherwise) that is provided by the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Psychiatric Association, or any other organization that the Secretary determines is appropriate for purposes of this subclause. Such training shall include—</chapeau><item style="-uslm-lc:I14" class="indent3" id="idc39bc3ae-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/aa"><num value="aa">(aa)</num><content> opioid maintenance and detoxification;</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3af-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/bb"><num value="bb">(bb)</num><content> appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder;</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b0-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/cc"><num value="cc">(cc)</num><content> initial and periodic patient assessments (including substance use monitoring);</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b1-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/dd"><num value="dd">(dd)</num><content> individualized treatment planning, overdose reversal, and relapse prevention;</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b2-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/ee"><num value="ee">(ee)</num><content> counseling and recovery support services;</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b3-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/ff"><num value="ff">(ff)</num><content> staffing roles and considerations;</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b4-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/gg"><num value="gg">(gg)</num><content> diversion control; and</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3b5-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/IV/hh"><num value="hh">(hh)</num><content> other best practices, as identified by the Secretary.</content>
</item>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3b6-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/V"><num value="V">(V)</num><content> The physician has participated as an investigator in one or more clinical trials leading to the approval of a narcotic drug in schedule III, IV, or V for maintenance or detoxification treatment, as demonstrated by a statement submitted to the Secretary by the sponsor of such approved drug.</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3b7-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/VI"><num value="VI">(VI)</num><content> The physician has such other training or experience as the State medical licensing board (of the State in which the physician will provide maintenance or detoxification treatment) considers to demonstrate the ability of the physician to treat and manage opiate-dependent patients.</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3b8-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/g/2/II/VII"><num value="VII">(VII)</num><content> The physician has such other training or experience as the Secretary considers to demonstrate the ability of the physician to treat and manage opiate-dependent patients. Any criteria of the Secretary under this subclause shall be established by regulation. Any such criteria are effective only for 3 years after the date on which the criteria are promulgated, but may be extended for such additional discrete 3-year periods as the Secretary considers appropriate for purposes of this subclause. Such an extension of criteria may only be effectuated through a statement published in the Federal Register by the Secretary during the 30-day period preceding the end of the 3-year period involved.</content>
</subclause>
</subparagraph>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I12" class="indent1" id="idc39bc3b9-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii"><num value="iii">(iii)</num><chapeau> The term “qualifying practitioner” means—</chapeau><subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3ba-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/I"><num value="I">(I)</num><content> a qualifying physician, as defined in clause (ii); or</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3bb-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/II"><num value="II">(II)</num><content> during the period beginning on <date date="2016-07-22">July 22, 2016</date> and ending on <date date="2021-10-01">October 1, 2021</date>, a qualifying other practitioner, as defined in clause (iv).</content>
</subclause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc3bc-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv"><num value="iv">(iv)</num><chapeau> The term “qualifying other practitioner” means a nurse practitioner or physician assistant who satisfies each of the following:</chapeau><subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3bd-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv/I"><num value="I">(I)</num><content> The nurse practitioner or physician assistant is licensed under State law to prescribe schedule III, IV, or V medications for the treatment of pain.</content>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3be-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv/II"><num value="II">(II)</num><chapeau> The nurse practitioner or physician assistant has—</chapeau><item style="-uslm-lc:I14" class="indent3" id="idc39bc3bf-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv/II/aa"><num value="aa">(aa)</num><content> completed not fewer than 24 hours of initial training addressing each of the topics listed in clause (ii)(IV) (through classroom situations, seminars at professional society meetings, electronic communications, or otherwise) provided by the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Nurses Credentialing Center, the American Psychiatric Association, the American Association of Nurse Practitioners, the American Academy of Physician Assistants, or any other organization that the Secretary determines is appropriate for purposes of this subclause; or</content>
</item>
<item style="-uslm-lc:I14" class="indent3" id="idc39bc3c0-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv/II/bb"><num value="bb">(bb)</num><content> has such other training or experience as the Secretary determines will demonstrate the ability of the nurse practitioner or physician assistant to treat and manage opiate-dependent patients.</content>
</item>
</subclause>
<subclause style="-uslm-lc:I13" class="indent2" id="idc39bc3c1-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/iv/III"><num value="III">(III)</num><content> The nurse practitioner or physician assistant is supervised by, or works in collaboration with, a qualifying physician, if the nurse practitioner or physician assistant is required by State law to prescribe medications for the treatment of opioid use disorder in collaboration with or under the supervision of a physician.</content>
</subclause>

<continuation style="-uslm-lc:I17" class="indent1 firstIndent0">The Secretary may, by regulation, revise the requirements for being a qualifying other practitioner under this clause.</continuation>
</clause>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc3c2-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H"><num value="H">(H)</num><clause style="-uslm-lc:I11" class="indent0" id="idc39bc3c3-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H/i"><num value="i">(i)</num><chapeau> In consultation with the Administrator of the Drug Enforcement Administration, the Administrator of the Substance Abuse and Mental Health Services Administration, the Director of the National Institute on Drug Abuse, and the Commissioner of Food and Drugs, the Secretary shall issue regulations (through notice and comment rulemaking) or issue practice guidelines to address the following:</chapeau><subclause style="-uslm-lc:I12" class="indent1" id="idc39bc3c4-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H/i/I"><num value="I">(I)</num><content> Approval of additional credentialing bodies and the responsibilities of additional credentialing bodies.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc3c5-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H/i/II"><num value="II">(II)</num><content> Additional exemptions from the requirements of this paragraph and any regulations under this paragraph.</content>
</subclause>
<subclause style="-uslm-lc:I12" class="indent1" id="idc39bc3c6-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H/i/III"><num value="III">(III)</num><content> Such other elements of the requirements under this paragraph as the Secretary determines necessary for purposes of implementing such requirements.</content>
</subclause>

<continuation style="-uslm-lc:I10" class="indent0 firstIndent0">Nothing in such regulations or practice guidelines may authorize any Federal official or employee to exercise supervision or control over the practice of medicine or the manner in which medical services are provided.</continuation>
</clause>
<clause style="-uslm-lc:I11" class="indent0" id="idc39bc3c7-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/H/ii"><num value="ii">(ii)</num><content> Not later than 18 months after the date of enactment of the Opioid Use Disorder Treatment Expansion and Modernization Act,<ref class="footnoteRef" idref="fn002100">1</ref><note type="footnote" id="fn002100"><num>1</num> See References in Text note below.</note> the Secretary shall update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings. The Secretary shall update such protocol in consultation with experts in opioid use disorder research and treatment.</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="idc39bc3c8-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/I"><num value="I">(I)</num><chapeau> Notwithstanding <ref href="/us/usc/t21/s903">section 903 of this title</ref>, nothing in this paragraph shall be construed to preempt any State law that—</chapeau><clause style="-uslm-lc:I12" class="indent1" id="idc39bc3c9-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/I/i"><num value="i">(i)</num><content> permits a qualifying practitioner to dispense narcotic drugs in schedule III, IV, or V, or combinations of such drugs, for maintenance or detoxification treatment in accordance with this paragraph to a total number of patients that is more than 30 or less than the total number applicable to the qualifying practitioner under subparagraph (B)(iii)(II) if a State enacts a law modifying such total number and the Attorney General is notified by the State of such modification; or</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="idc39bc3ca-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/iii/I/ii"><num value="ii">(ii)</num><content> requires a qualifying practitioner to comply with additional requirements relating to the dispensing of narcotic drugs in schedule III, IV, or V, or combinations of such drugs, including requirements relating to the practice setting in which the qualifying practitioner practices and education, training, and reporting requirements.</content>
</clause>
</subparagraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc3cb-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h"><num value="h" class="bold">(h)</num><heading class="bold"> Applicants for distribution of list I chemicals</heading><chapeau>The Attorney General shall register an applicant to distribute a list I chemical unless the Attorney General determines that registration of the applicant is inconsistent with the public interest. Registration under this subsection shall not be required for the distribution of a drug product that is exempted under clause (iv) or (v) of <ref href="/us/usc/t21/s802/39/A">section 802(39)(A) of this title</ref>. In determining the public interest for the purposes of this subsection, the Attorney General shall consider—</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc3cc-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h/1"><num value="1">(1)</num><content> maintenance by the applicant of effective controls against diversion of listed chemicals into other than legitimate channels;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc3cd-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h/2"><num value="2">(2)</num><content> compliance by the applicant with applicable Federal, State, and local law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc3ce-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h/3"><num value="3">(3)</num><content> any prior conviction record of the applicant under Federal or State laws relating to controlled substances or to chemicals controlled under Federal or State law;</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc3cf-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h/4"><num value="4">(4)</num><content> any past experience of the applicant in the manufacture and distribution of chemicals; and</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="idc39bc3d0-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/h/5"><num value="5">(5)</num><content> such other factors as are relevant to and consistent with the public health and safety.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc3d1-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/i"><num value="i" class="bold">(i)</num><heading class="bold"> Registration to manufacture certain controlled substances for use only in a clinical trial</heading><paragraph style="-uslm-lc:I11" class="indent0" id="idc39bc3d2-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/i/1"><num value="1">(1)</num><content> For purposes of registration to manufacture a controlled substance under subsection (d) for use only in a clinical trial, the Attorney General shall register the applicant, or serve an order to show cause upon the applicant in accordance with <ref href="/us/usc/t21/s824/c">section 824(c) of this title</ref>, not later than 180 days after the date on which the application is accepted for filing.</content>
</paragraph>
<paragraph style="-uslm-lc:I11" class="indent0" id="idc39bc3d3-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/i/2"><num value="2">(2)</num><content> For purposes of registration to manufacture a controlled substance under subsection (a) for use only in a clinical trial, the Attorney General shall, in accordance with the regulations issued by the Attorney General, issue a notice of application not later than 90 days after the application is accepted for filing. Not later than 90 days after the date on which the period for comment pursuant to such notice ends, the Attorney General shall register the applicant, or serve an order to show cause upon the applicant in accordance with <ref href="/us/usc/t21/s824/c">section 824(c) of this title</ref>, unless the Attorney General has granted a hearing on the application under <ref href="/us/usc/t21/s958/i">section 958(i) of this title</ref>.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="idc39bc3d4-8eec-11e6-a076-e06bbb453686" identifier="/us/usc/t21/s823/j"><num value="j" class="bold">(j)</num><heading class="bold"> “Factors as may be relevant to and consistent with the public health and safety” defined</heading><content><p style="-uslm-lc:I11" class="indent0">In this section, the phrase “factors as may be relevant to and consistent with the public health and safety” means factors that are relevant to and consistent with the findings contained in <ref href="/us/usc/t21/s801">section 801 of this title</ref>.</p>
</content>
</subsection>
<sourceCredit id="idc39bc3d5-8eec-11e6-a076-e06bbb453686">(<ref href="/us/pl/91/513/tII">Pub. L. 91–513, title II</ref>, § 303, <date date="1970-10-27">Oct. 27, 1970</date>, <ref href="/us/stat/84/1253">84 Stat. 1253</ref>; <ref href="/us/pl/93/281">Pub. L. 93–281</ref>, § 3, <date date="1974-05-14">May 14, 1974</date>, <ref href="/us/stat/88/124">88 Stat. 124</ref>; <ref href="/us/pl/95/633/tI">Pub. L. 95–633, title I</ref>, § 109, <date date="1978-11-10">Nov. 10, 1978</date>, <ref href="/us/stat/92/3773">92 Stat. 3773</ref>; <ref href="/us/pl/98/473/tII">Pub. L. 98–473, title II</ref>, § 511, <date date="1984-10-12">Oct. 12, 1984</date>, <ref href="/us/stat/98/2073">98 Stat. 2073</ref>; <ref href="/us/pl/103/200">Pub. L. 103–200</ref>, § 3(c), <date date="1993-12-17">Dec. 17, 1993</date>, <ref href="/us/stat/107/2336">107 Stat. 2336</ref>; <ref href="/us/pl/106/310/dB/tXXXV">Pub. L. 106–310, div. B, title XXXV</ref>, § 3502(a), <date date="2000-10-17">Oct. 17, 2000</date>, <ref href="/us/stat/114/1222">114 Stat. 1222</ref>; <ref href="/us/pl/107/273/dB/tII">Pub. L. 107–273, div. B, title II</ref>, § 2501, <date date="2002-11-02">Nov. 2, 2002</date>, <ref href="/us/stat/116/1803">116 Stat. 1803</ref>; <ref href="/us/pl/109/56">Pub. L. 109–56</ref>, § 1(a), (b), <date date="2005-08-02">Aug. 2, 2005</date>, <ref href="/us/stat/119/591">119 Stat. 591</ref>; <ref href="/us/pl/109/177/tVII">Pub. L. 109–177, title VII</ref>, § 712(a)(3), <date date="2006-03-09">Mar. 9, 2006</date>, <ref href="/us/stat/120/263">120 Stat. 263</ref>; <ref href="/us/pl/109/469/tXI">Pub. L. 109–469, title XI</ref>, § 1102, <date date="2006-12-29">Dec. 29, 2006</date>, <ref href="/us/stat/120/3540">120 Stat. 3540</ref>; <ref href="/us/pl/110/425">Pub. L. 110–425</ref>, § 3(b), <date date="2008-10-15">Oct. 15, 2008</date>, <ref href="/us/stat/122/4824">122 Stat. 4824</ref>; <ref href="/us/pl/114/89">Pub. L. 114–89</ref>, § 3, <date date="2015-11-25">Nov. 25, 2015</date>, <ref href="/us/stat/129/701">129 Stat. 701</ref>; <ref href="/us/pl/114/145">Pub. L. 114–145</ref>, § 2(a)(1), <date date="2016-04-19">Apr. 19, 2016</date>, <ref href="/us/stat/130/354">130 Stat. 354</ref>; <ref href="/us/pl/114/198/tIII">Pub. L. 114–198, title III</ref>, § 303(a)(1), (b), <date date="2016-07-22">July 22, 2016</date>, <ref href="/us/stat/130/720">130 Stat. 720</ref>, 723.)</sourceCredit>
<notes type="uscNote" id="idc39bc3d6-8eec-11e6-a076-e06bbb453686">
<note style="-uslm-lc:I75" topic="referencesInText" id="idc39bc3d7-8eec-11e6-a076-e06bbb453686">
<heading class="centered smallCaps">References in Text</heading><p style="-uslm-lc:I21" class="indent0">Schedules I, II, III, IV, and V, referred to in subsecs. (a) to (f) and (g)(2), are set out in <ref href="/us/usc/t21/s812/c">section 812(c) of this title</ref>.</p>
<p style="-uslm-lc:I21" class="indent0">The Federal Food, Drug, and Cosmetic Act, referred to in subsec. (g)(2)(C)(i), is <ref href="/us/act/1938-06-25/ch675">act June 25, 1938, ch. 675</ref>, <ref href="/us/stat/52/1040">52 Stat. 1040</ref>, as amended, which is classified generally to chapter 9 (§ 301 et seq.) of this title. For complete classification of this Act to the Code, see <ref href="/us/usc/t21/s301">section 301 of this title</ref> and Tables.</p>
<p style="-uslm-lc:I21" class="indent0">The date of enactment of the Opioid Use Disorder Treatment Expansion and Modernization Act, referred to in subsec. (g)(2)(H)(ii), probably means the date of enactment of <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, known as the Comprehensive Addiction and Recovery Act of 2016, which was approved <date date="2016-07-22">July 22, 2016</date>. The Opioid Use Disorder Treatment Expansion and Modernization Act was H.R. 4981 of the 114th Congress, as introduced on <date date="2016-04-18">Apr. 18, 2016</date>. Amendatory provisions of H.R. 4981 were incorporated into <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, but no such Short Title was enacted.</p>
</note>
<note style="-uslm-lc:I74" topic="amendments" id="idc39bc3d8-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Amendments</heading><p style="-uslm-lc:I21" class="indent0">2016—Subsec. (g)(2)(B). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(A), added cls. (i) to (iii) and struck out former cls. (i) to (iii) which read as follows:</p>
<p style="-uslm-lc:I21" class="indent0">“(i) The practitioner is a qualifying physician (as defined in subparagraph (G)).</p>
<p style="-uslm-lc:I21" class="indent0">“(ii) With respect to patients to whom the practitioner will provide such drugs or combinations of drugs, the practitioner has the capacity to refer the patients for appropriate counseling and other appropriate ancillary services.</p>
<p style="-uslm-lc:I21" class="indent0">“(iii) The total number of such patients of the practitioner at any one time will not exceed the applicable number. For purposes of this clause, the applicable number is 30, unless, not sooner than 1 year after the date on which the practitioner submitted the initial notification, the practitioner submits a second notification to the Secretary of the need and intent of the practitioner to treat up to 100 patients. A second notification under this clause shall contain the certifications required by clauses (i) and (ii) of this subparagraph. The Secretary may by regulation change such total number.”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(D)(ii). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(B)(i), substituted “Upon receiving a determination from the Secretary under clause (iii) finding that a practitioner meets all requirements for a waiver under subparagraph (B)” for “Upon receiving a notification under subparagraph (B)”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(D)(iii). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(B)(ii), inserted “and shall forward such determination to the Attorney General” after “a waiver under subparagraph (B)” and substituted “assign the practitioner” for “assign the physician”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(G)(ii)(I). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(C)(i), amended subcl. (I) generally. Prior to amendment, subcl. (I) read as follows: “The physician holds a subspecialty board certification in addiction psychiatry from the American Board of Medical Specialties.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(G)(ii)(II). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(C)(ii), amended subcl. (II) generally. Prior to amendment, subcl. (II) read as follows: “The physician holds an addiction certification from the American Society of Addiction Medicine.”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(G)(ii)(III). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(C)(iii), struck out “subspecialty” before “board certification”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(G)(ii)(IV). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(C)(iv), amended subcl. (IV) generally. Prior to amendment, subcl. (IV) read as follows: “The physician has, with respect to the treatment and management of opiate-dependent patients, completed not less than eight hours of training (through classroom situations, seminars at professional society meetings, electronic communications, or otherwise) that is provided by the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, the American Psychiatric Association, or any other organization that the Secretary determines is appropriate for purposes of this subclause.”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(G)(iii), (iv). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(C)(v), added cls. (iii) and (iv).</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(H)(i)(III). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(D)(i), added subcl. (III).</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(H)(ii). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(a)(1)(D)(ii), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “Not later than 120 days after <date date="2000-10-17">October 17, 2000</date>, the Secretary shall issue a treatment improvement protocol containing best practice guidelines for the treatment and maintenance of opiate-dependent patients. The Secretary shall develop the protocol in consultation with the Director of the National Institute on Drug Abuse, the Administrator of the Drug Enforcement Administration, the Commissioner of Food and Drugs, the Administrator of the Substance Abuse and Mental Health Services Administration and other substance abuse disorder professionals. The protocol shall be guided by science.”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(I), (J). <ref href="/us/pl/114/198">Pub. L. 114–198</ref>, § 303(b), added subpar. (I) and struck out former subpars. (I) and (J) which limited a State’s ability to preclude a practitioner from dispensing or prescribing certain approved drugs and provided the effective date of the paragraph and authorized the Secretary and the Attorney General to make certain determinations.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (j). <ref href="/us/pl/114/145">Pub. L. 114–145</ref> added subsec. (j).</p>
<p style="-uslm-lc:I21" class="indent0">2015—Subsec. (i). <ref href="/us/pl/114/89">Pub. L. 114–89</ref> added subsec. (i).</p>
<p style="-uslm-lc:I21" class="indent0">2008—Subsec. (f). <ref href="/us/pl/110/425">Pub. L. 110–425</ref>, in introductory provisions, inserted “and shall modify the registrations of pharmacies so registered to authorize them to dispense controlled substances by means of the Internet” after “schedule II, III, IV, or V” and substituted “or such modification of registration if the Attorney General determines that the issuance of such registration or modification” for “if he determines that the issuance of such registration”.</p>
<p style="-uslm-lc:I21" class="indent0">2006—Subsec. (g)(2)(B)(iii). <ref href="/us/pl/109/469">Pub. L. 109–469</ref>, § 1102(1), substituted “unless, not sooner than 1 year after the date on which the practitioner submitted the initial notification, the practitioner submits a second notification to the Secretary of the need and intent of the practitioner to treat up to 100 patients. A second notification under this clause shall contain the certifications required by clauses (i) and (ii) of this subparagraph. The” for “except that the”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(J)(i). <ref href="/us/pl/109/469">Pub. L. 109–469</ref>, § 1102(2)(A), substituted “thereafter.” for “thereafter except as provided in clause (iii) (relating to a decision by the Secretary or the Attorney General that this paragraph should not remain in effect).”</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(J)(ii). <ref href="/us/pl/109/469">Pub. L. 109–469</ref>, § 1102(2)(B), substituted “<date date="2006-12-29">December 29, 2006</date>” for “<date date="2000-10-17">October 17, 2000</date>” in introductory provisions.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(J)(iii). <ref href="/us/pl/109/469">Pub. L. 109–469</ref>, § 1102(2)(C), substituted “subparagraph (B)(iii) should be applied by limiting the total number of patients a practitioner may treat to 30, then the provisions in such subparagraph (B)(iii) permitting more than 30 patients shall not apply, effective” for “this paragraph should not remain in effect, this paragraph ceases to be in effect”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (h). <ref href="/us/pl/109/177">Pub. L. 109–177</ref> substituted “clause (iv) or (v) of <ref href="/us/usc/t21/s802/39/A">section 802(39)(A) of this title</ref>” for “<ref href="/us/usc/t21/s802/39/A/iv">section 802(39)(A)(iv) of this title</ref>” in introductory provisions.</p>
<p style="-uslm-lc:I21" class="indent0">2005—Subsec. (g)(2)(B)(iii). <ref href="/us/pl/109/56">Pub. L. 109–56</ref>, § 1(b), substituted “The total” for “In any case in which the practitioner is not in a group practice, the total”.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(B)(iv). <ref href="/us/pl/109/56">Pub. L. 109–56</ref>, § 1(a), struck out cl. (iv) which read as follows: “In any case in which the practitioner is in a group practice, the total number of such patients of the group practice at any one time will not exceed the applicable number. For purposes of this clause, the applicable number is 30, except that the Secretary may by regulation change such total number, and the Secretary for such purposes may by regulation establish different categories on the basis of the number of practitioners in a group practice and establish for the various categories different numerical limitations on the number of such patients that the group practice may have.”</p>
<p style="-uslm-lc:I21" class="indent0">2002—Subsec. (g)(2)(I). <ref href="/us/pl/107/273">Pub. L. 107–273</ref>, § 2501(1), which directed the substitution of “on the date of approval by the Food and Drug Administration of a drug in schedule III, IV, or V, a State may not preclude a practitioner from dispensing or prescribing such drug, or combination of such drugs,” for “on <date date="2000-10-17">October 17, 2000</date>, a State may not preclude a practitioner from dispensing or prescribing drugs in schedule III, IV, or V, or combinations of such drugs,”, was executed by making the substitution for the phrase which in the original began with “on the date of the enactment of the Drug Addiction Treatment Act of 2000,” rather than the editorial translation “on <date date="2000-10-17">October 17, 2000</date>,” to reflect the probable intent of Congress.</p>
<p style="-uslm-lc:I21" class="indent0">Subsec. (g)(2)(J)(i). <ref href="/us/pl/107/273">Pub. L. 107–273</ref>, § 2501(2), which directed the substitution of “the date referred to in subparagraph (I),” for “<date date="2000-10-17">October 17, 2000</date>,” was executed by making the substitution for text which in the original read “the date of the enactment of the Drug Addiction Treatment Act of 2000,” rather than the editorial translation “<date date="2000-10-17">October 17, 2000</date>,” to reflect the probable intent of Congress.</p>
<p style="-uslm-lc:I21" class="indent0">2000—Subsec. (g). <ref href="/us/pl/106/310">Pub. L. 106–310</ref> designated existing provisions as par. (1), substituted “Except as provided in paragraph (2), practitioners who dispense” for “Practitioners who dispense”, redesignated former pars. (1) to (3) as subpars. (A) to (C), respectively, of par. (1) and redesignated former subpars. (A) and (B) of former par. (2) as cls. (i) and (ii), respectively, of subpar. (B) of par. (1), and added par. (2).</p>
<p style="-uslm-lc:I21" class="indent0">1993—Subsec. (h). <ref href="/us/pl/103/200">Pub. L. 103–200</ref> added subsec. (h).</p>
<p style="-uslm-lc:I21" class="indent0">1984—Subsec. (f). <ref href="/us/pl/98/473">Pub. L. 98–473</ref> amended subsec. (f) generally, substituting provisions relating to registration authority of Attorney General respecting dispensation or conduct of research with controlled research, and separate authority of Secretary respecting registration, for provisions relating to general registration requirements respecting dispensation or conduct of research with controlled or nonnarcotic controlled substances.</p>
<p style="-uslm-lc:I21" class="indent0">1978—Subsec. (f). <ref href="/us/pl/95/633">Pub. L. 95–633</ref> inserted provision relating to the construction of the Convention on Psychotropic Substances.</p>
<p style="-uslm-lc:I21" class="indent0">1974—Subsec. (g). <ref href="/us/pl/93/281">Pub. L. 93–281</ref> added subsec. (g).</p>
</note>
<note style="-uslm-lc:I74" topic="effectiveDateOfAmendment" id="idc39e34d9-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Effective Date of 2008 Amendment</heading><p style="-uslm-lc:I21" class="indent0">Amendment by <ref href="/us/pl/110/425">Pub. L. 110–425</ref> effective 180 days after <date date="2008-10-15">Oct. 15, 2008</date>, except as otherwise provided, see <ref href="/us/pl/110/425/s3/j">section 3(j) of Pub. L. 110–425</ref>, set out as a note under <ref href="/us/usc/t21/s802">section 802 of this title</ref>.</p>
</note>
<note style="-uslm-lc:I74" topic="effectiveDateOfAmendment" id="idc39e34da-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Effective Date of 2005 Amendment</heading><p><ref href="/us/pl/109/56">Pub. L. 109–56</ref>, § 1(c), <date date="2005-08-02">Aug. 2, 2005</date>, <ref href="/us/stat/119/591">119 Stat. 591</ref>, provided that: <quotedContent origin="/us/pl/109/56">“This section [amending this section] shall take effect on the date of enactment of this Act [<date date="2005-08-02">Aug. 2, 2005</date>].”</quotedContent>
</p>
</note>
<note style="-uslm-lc:I74" topic="effectiveDateOfAmendment" id="idc39e34db-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Effective Date of 1993 Amendment</heading><p style="-uslm-lc:I21" class="indent0">Amendment by <ref href="/us/pl/103/200">Pub. L. 103–200</ref> effective on date that is 120 days after <date date="1993-12-17">Dec. 17, 1993</date>, see <ref href="/us/pl/103/200/s11">section 11 of Pub. L. 103–200</ref>, set out as a note under <ref href="/us/usc/t21/s802">section 802 of this title</ref>.</p>
</note>
<note style="-uslm-lc:I74" topic="effectiveDateOfAmendment" id="idc39e34dc-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Effective Date of 1978 Amendment</heading><p style="-uslm-lc:I21" class="indent0">Amendment by <ref href="/us/pl/95/633">Pub. L. 95–633</ref> effective on date the Convention on Psychotropic Substances enters into force in the United States [<date date="1980-07-15">July 15, 1980</date>], see <ref href="/us/pl/95/633/s112">section 112 of Pub. L. 95–633</ref>, set out as an Effective Date note under <ref href="/us/usc/t21/s801a">section 801a of this title</ref>.</p>
</note>
<note style="-uslm-lc:I74" topic="miscellaneous" id="idc39e34dd-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Update Regulations</heading><p><ref href="/us/pl/114/198/tIII">Pub. L. 114–198, title III</ref>, § 303(c), <date date="2016-07-22">July 22, 2016</date>, <ref href="/us/stat/130/723">130 Stat. 723</ref>, provided that: <quotedContent origin="/us/pl/114/198/tIII">“Not later than 18 months after the date of enactment of this Act [<date date="2016-07-22">July 22, 2016</date>], the Attorney General and the Secretary of Health and Human Services, as appropriate, shall update regulations regarding practitioners described in subsection (a)(3)(B)(vii) (as amended by this section) [probably means subsec. (a)(3)(B)(vii) “of this section”, set out as a note below] to include nurse practitioners and physician assistants to ensure the quality of patient care and prevent diversion.”</quotedContent>
</p>
</note>
<note style="-uslm-lc:I74" topic="miscellaneous" id="idc39e34de-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Reports to Congress</heading><p><ref href="/us/pl/114/198/tIII">Pub. L. 114–198, title III</ref>, § 303(a)(3), <date date="2016-07-22">July 22, 2016</date>, <ref href="/us/stat/130/722">130 Stat. 722</ref>, provided that:<quotedContent origin="/us/pl/114/198/tIII">
<subparagraph style="-uslm-lc:I21" class="indent0"><num value="A">“(A)</num><heading> <inline class="small-caps">In general</inline>.—</heading><chapeau>Not later than 3 years after the date of enactment of this Act [<date date="2016-07-22">July 22, 2016</date>] and not later than 3 years thereafter, the Secretary of Health and Human Services, in consultation with the Drug Enforcement Administration and experts in opioid use disorder research and treatment, shall—</chapeau><clause style="-uslm-lc:I22" class="indent1"><num value="i">“(i)</num><content> perform a thorough review of the provision of opioid use disorder treatment services in the United States, including services provided in opioid treatment programs and other specialty and nonspecialty settings; and</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="ii">“(ii)</num><content> submit a report to the Congress on the findings and conclusions of such review.</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I21" class="indent0"><num value="B">“(B)</num><heading> <inline class="small-caps">Contents</inline>.—</heading><chapeau>Each report under subparagraph (A) shall include an assessment of—</chapeau><clause style="-uslm-lc:I22" class="indent1"><num value="i">“(i)</num><content> compliance with the requirements of section 303(g)(2) of the Controlled Substances Act (<ref href="/us/usc/t21/s823/g/2">21 U.S.C. 823(g)(2)</ref>), as amended by this section;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="ii">“(ii)</num><content> the measures taken by the Secretary of Health and Human Services to ensure such compliance;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="iii">“(iii)</num><content> whether there is further need to increase or decrease the number of patients a practitioner, pursuant to a waiver under section 303(g)(2) of the Controlled Substances Act (<ref href="/us/usc/t21/s823/g/2">21 U.S.C. 823(g)(2)</ref>), is permitted to treat;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="iv">“(iv)</num><content> the extent to which, and proportions with which, the full range of Food and Drug Administration-approved treatments for opioid use disorder are used in routine health care settings and specialty substance use disorder treatment settings;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="v">“(v)</num><content> access to, and use of, counseling and recovery support services, including the percentage of patients receiving such services;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="vi">“(vi)</num><content> changes in State or local policies and legislation relating to opioid use disorder treatment;</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="vii">“(vii)</num><content> the use of prescription drug monitoring programs by practitioners who are permitted to dispense narcotic drugs to individuals pursuant to a waiver described in clause (iii);</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="viii">“(viii)</num><content> the findings resulting from inspections by the Drug Enforcement Administration of practitioners described in clause (vii); and</content>
</clause>
<clause style="-uslm-lc:I22" class="indent1"><num value="ix">“(ix)</num><content> the effectiveness of cross-agency collaboration between [the] Department of Health and Human Services and the Drug Enforcement Administration for expanding effective opioid use disorder treatment.”</content>
</clause>
</subparagraph>
</quotedContent>
</p>
</note>
<note style="-uslm-lc:I74" topic="miscellaneous" id="idc39e34df-8eec-11e6-a076-e06bbb453686"><heading class="centered smallCaps">Provisional Registration</heading><p style="-uslm-lc:I21" class="indent0">For provisional registration of persons engaged in manufacturing, distributing, or dispensing of controlled substances on the day before the effective date of <ref href="/us/usc/t21/s822">section 822 of this title</ref> who are registered on such date under <ref href="/us/usc/t21/s360">section 360 of this title</ref> or <ref href="/us/usc/t26/s4722">section 4722 of Title 26</ref>, Internal Revenue Code, see <ref href="/us/pl/91/513/s703">section 703 of Pub. L. 91–513</ref>, set out as a note under <ref href="/us/usc/t21/s822">section 822 of this title</ref>.</p>
</note>
</notes>
</section>