FOR IMMEDIATE RELEASE

Licensee Alert: “Three Day Rule” for Opioid Use Disorder Treatment

Date: November 4, 2025

To: Prescriber Licensees (and acute care hospitals)

This notice provides important information about dispensing opioid treatments to initiate maintenance or detoxification treatment for patients with opioid use disorder (OUD) under the federal “Three Day Rule” (21 CFR § 1306.07(b)).

Business and Professions Code section 750 requires the Board to post this material online and annually disseminate it to licensees authorized to write or issue controlled substance prescriptions pursuant to Health and Safety Code section 11150.  

Overview of the “Three Day Rule”

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

Key Requirements

• Practitioners may dispense up to a three-day supply of a Schedule II narcotic medication while referral to an opioid treatment program is being arranged.
• No more than a three-day supply may be dispensed to one person for that person’s use. This emergency treatment may not be renewed or extended.
• The rule is intended solely as a short-term emergency bridge until the patient can be admitted to a licensed narcotic treatment program (NTP).

The “Three Day Rule” is one pathway for practitioners to initiate treatment for OUD using Schedule II medications. Other pathways may also be available; refer to the resources below for additional guidance.

Information on Licensed Narcotic Treatment Programs

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

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

Additional Resources

• DEA Guidance on Development of Revised Three Day Rule (Jan. 12, 2023)
• DEA Notice of Final Rule, Dispensing of Narcotic Drugs to Relieve Acute Withdrawal Symptoms of Opioid Use Disorder (Aug. 8, 2023)
• DEA Practitioner’s Manual, An Informational Outline of the Controlled Substances Act (Rev. 2023)
• Substance Abuse and Mental Health Services Administration, Federal Guidelines for Opioid Treatment Programs (Fall 2024)
• California Department of Public Health, Substance and Addiction Prevention Branch, Resources: Health Care Providers
• Medical Board of California, Guidelines for Prescribing Controlled Substances for Pain (July 2023)

FOR IMMEDIATE RELEASE

Rancho Cucamonga, CA – January 31, 2025 – The Journal of Osteopathic Family Physicians of California (JOFPCA) is proud to feature the study, “Latuda in Maternal and Newborn Health”, in its Winter 2025 issue.

By Niyati Panchal, OMS; Marissa Tran, OMS; Ifra Malik, AMS; Aditi Priya Jhingan, Pharm.D. Candidate; Richard Burwick, MD, MPH

This case study investigates the effects of Latuda (lurasidone) on maternal and neonatal health. The authors provide insights into its therapeutic potential, safety considerations, and implications for perinatal psychiatry.

The findings contribute to the growing body of research on antipsychotic medication use during pregnancy and its impact on both mothers and newborns.

For a detailed look at this study, read the full article in the Winter 2025 issue of JOFPCA.

Access the full article here: Read More

FOR IMMEDIATE RELEASE

Rancho Cucamonga, CA – January 31, 2025 – The Journal of Osteopathic Family Physicians of California (JOFPCA) presents a groundbreaking case study, “Bupropion Therapy in a Dravet Syndrome Patient with a SCN2A Mutation”, in its Winter 2025 issue.

By Niyati Panchal, OMS; Aditi Priya Jhingan, Pharm.D. Candidate; Anisha Verma, OMS; Marissa Tran, OMS; David Baron, DO, MSEd

This case report explores the novel use of bupropion in treating a patient with Dravet Syndrome linked to a unique SCN2A mutation. The authors analyze the drug’s efficacy, potential benefits, and broader implications for managing genetic epilepsy syndromes.

The study highlights how pharmacogenetics can influence treatment approaches and improve outcomes for rare neurological disorders.

For more insights on this case, read the full article in the Winter 2025 issue of JOFPCA.

Access the full article here: Read More

FOR IMMEDIATE RELEASE

Rancho Cucamonga, CA – January 31, 2025 – The Journal of Osteopathic Family Physicians of California (JOFPCA) is proud to highlight the case report “Using Osteopathic Manipulative Treatment: A Trauma-Informed Approach to a Human Trafficking Survivor” in its Winter 2025 issue.

By Emma Marcus, DO, PGY2; Reagan Summers, MD, Dipl-ABFM, Dipl-AOBFP

This compelling case study presents the role of osteopathic manipulative treatment (OMT) in the recovery of a human trafficking survivor.

The authors discuss how trauma-informed care and osteopathic principles can facilitate healing, addressing both physical and psychological well-being in vulnerable patient populations.

For an in-depth exploration of how OMT supports trauma recovery, read the full article in the Winter 2025 issue of JOFPCA.

Access the full article here: Read More

FOR IMMEDIATE RELEASE

Rancho Cucamonga, CA – January 31, 2025 – The Journal of Osteopathic Family Physicians of California (JOFPCA) is honored to feature “Life, Loss and Empathy During Clinical Rotations” in its Winter 2025 issue.

By Joohee Yeam, MPH, OMS | Western University of Health Sciences, College of Osteopathic Medicine of the Pacific

In this deeply personal article, Joohee Yeam shares her experiences during clinical rotations, highlighting the emotional challenges and transformative moments that shape future physicians.

The piece underscores the significance of empathy in patient care, illustrating how real-world experiences help medical students develop the humanistic side of medicine beyond textbook learning.

For a compelling reflection on the role of empathy in medical education, read the full article in the Winter 2025 issue of JOFPCA.

Access the full article here: Read More

FOR IMMEDIATE RELEASE

Rancho Cucamonga, CA – January 31, 2025 – The Journal of Osteopathic Family Physicians of California (JOFPCA) is pleased to feature “Interprofessional Collaboration in Musculoskeletal Care: A Family Medicine Perspective” in its Winter 2025 issue.

By Marissa Meyer, DO; Julia Stelter, DO; Priscilla Tu, DO

Interdisciplinary teamwork is essential for improving musculoskeletal care. This article explores the benefits of collaboration between osteopathic family physicians and other healthcare professionals in optimizing patient outcomes.

The authors highlight how an integrated approach enhances diagnosis, treatment planning, and long-term management of musculoskeletal conditions, reducing patient burden and improving care efficiency.

For more insights on this topic, read the full article in the Winter 2025 issue of JOFPCA.

Access the full article here: Read More

Rancho Cucamonga, CA – January 31, 2025 – The Journal of the American College of Osteopathic Family Physicians of California  (JOFPCA), is pleased to announce the Winter 2025 issue, Healing Through Compassion. This issue explores empathy, teamwork, and new approaches in family medicine.

Articles:

Interprofessional Collaboration in Musculoskeletal Care: A Family Medicine Perspective

Marissa Meyer, DO; Julia Stelter, DO; Priscilla Tu, DO
Interdisciplinary teamwork improves patient outcomes in musculoskeletal care. The authors discuss the importance of collaboration between osteopathic family physicians and other healthcare providers for better patient management.

Life, Loss and Empathy During Clinical Rotations

Joohee Yeam, MPH, OMS | Western University of Health Sciences, College of Osteopathic Medicine of the Pacific
Joohee Yeam shares her personal experiences of growth during clinical rotations. This article highlights the role of empathy in medical training and patient care for future physicians.

Case Reports:

Using Osteopathic Manipulative Treatment: A Trauma-Informed Approach to a Human Trafficking Survivor

Emma Marcus, DO, PGY2; Reagan Summers, MD, Dipl-ABFM, Dipl-AOBFP
This case report describes the use of osteopathic manipulative treatment (OMT) in a human trafficking survivor. The authors discuss how trauma-informed care and osteopathic principles can help heal and restore well-being in vulnerable populations.

Bupropion Therapy in a Dravet Syndrome Patient with a SCN2A Mutation

Niyati Panchal, OMS; Aditi Priya Jhingan, Pharm.D. Candidate; Anisha Verma, OMS; Marissa Tran, OMS; David Baron, DO, MSEd
This case report describes the use of bupropion in a Dravet Syndrome patient with a SCN2A mutation. The authors discuss the drug’s effectiveness, benefits, and implications for genetic epilepsy syndromes.

Latuda in Maternal and Newborn Health

Niyati Panchal, OMS; Marissa Tran, OMS; Ifra Malik, AMS; Aditi Priya Jhingan, Pharm.D. Candidate; Richard Burwick, MD, MPH
This case study looks at Latuda (lurasidone) in maternal and newborn health. The authors discuss its therapeutic potential, safety, and perinatal psychiatry implications.

Osteopathic Family Medicine Excellence

The Winter 2025 issue of JOFPCA is is about compassion, interprofessionalism, and new ways of thinking for patient-centered care.

Visit JOFPCA.com to read the latest issue.