Opioid treatment programs (OTPs) are licensed by the Department of Health (DOH) and use medications for opioid use disorder (OUD) that are approved by the U.S. Food and Drug Administration in combination with counseling and behavioral therapies, to provide a “whole patient” approach to individuals diagnosed with OUD.
- Medications to treat opioid use disorder (OUD)
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There are three medications approved by the Food and Drug Administration to treat OUD.
- Methadone – reduces opioid cravings and withdrawal and blunts or blocks the effects of opioids.
- Naltrexone – blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria.
- Buprenorphine – suppresses and reduces cravings for opioids.
- OTP Licensing and Accreditation
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OTPs are clinics licensed by the Department of Health and federally accredited to provide medication-assisted treatment (MAT) services.
- Find an OTP
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- Washington State Opioid Treatment Program Guide (PDF)
- DOH BHA Directory (PDF) – List of all BHAs and OTPs licensed in Washington state. Includes services each one is certified to provide along with contact information.
- OTP Directory – Substance Abuse and Mental Health Services Administration (SAMHSA). List of all certified OTPs by state.
- Critical Incident and OTP Death Reporting
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Critical Incident Reporting Requirements. Includes instructions and forms to report critical incidents.
Death Reporting
Deaths that occur on the campus of a BHA should be reported as a critical incident.
Opioid Treatment Program (OTP) patient deaths that do not occur on the campus of the licensed agency should be reported by submitting:
- OTP Death Reporting Form online
- And contacting your accrediting body
- Change of Program Sponsor or Medical Director
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Under WAC 246-341-1000(10), “an agency providing opioid treatment program services must ensure that notification to the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the department is made within three weeks of any replacement or other change in the status of the program, program sponsor or medical director, as defined in 42 C.F.R. Part 8.
Notification of changes must be sent by the OTP Program administrator to DOH HSQA Facilities Credentialing (HSQAFC@doh.wa.gov) with a "cc" to the Facilities Program Manager (michelle.weatherly@doh.wa.gov).
Include the following information:
- A brief description of the change, including the name, title, phone, and email of the new program sponsor or medical director.
- BHA/OTP license number (example BHA.FS.123456)
- Washington state medical license number for change in medical director.
SAMHSA notification – instructions on how to notify SAMHSA are online.
- Change of Program Administrator
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Within 30 days of the new administrator’s appointment, send an amended behavioral health agency application (PDF), copy of the disclosure statement and background check of the new administrator completed within three months of the application date to:
Department of Health
Behavioral Health Agencies
P.O. Box 47877
Olympia, WA 98504-7877 - File a Complaint
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Anyone may submit a report to the department of an alleged violation of licensing and certification laws and rules.
- Policy and Interpretive Statements
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Drugs that May be Ordered, Possessed, and Used by an OTP (PDF)
- Laws and Regulations
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Washington state regulations
- Chapter 246-341 WAC – Behavioral Health Agency Licensing and Certification Requirements.
- WAC 246-341-0300 – Agency Licensure and Certification
- WAC 246-341-1000 – OTP - Certification Standards
Washington state laws
- RCW 71.24.560 – Opioid Treatment Programs – Pregnant Individuals – Information and education.
- RCW 71.24.585 – Opioid and substance use disorder treatment – State response.
- RCW 71.24.587 – Opioid use disorder treatment – Possession or use of lawfully prescribed medication – Declaration by state.
- RCW 71.24.589 – Substance use disorders – Law enforcement assisted diversion – Pilot project.
- RCW 71.24.590 – Opioid treatment – Program licensing or certification by department, department duties – Use of medications by program – Definition.
- RCW 71.24.593 – Opioid use disorder treatment – Care of individuals and their newborns – Authority recommendations required.
- RCW 71.24.594 – Opioid overdose reversal medications – Education – Distribution – Labeling – Liability (Effective January 1, 2022).
- RCW 71.24.595 – Statewide treatment and operating standards for opioid treatment programs – Evaluation and report.
- RCW 71.24.597 – Opioid overdose reversal medication – Coordinated purchasing and distribution.
Federal regulations and guidance
- 42 CFR Part 8 – Medication for the Treatment of Opioid Use Disorders
- 21 CFR – Food and Drugs - Drug Enforcement Administration (DEA)
- Federal Guidelines for Opioid Treatment Programs (2024) – SAMHSA
- SAMHSA OTP Guidance Documents
- Federal DEA Guide to Narcotic Treatment Program Regulations (PDF)
Contact information
Questions about OTP licensing and certification regulations:
Questions about the Pharmacy Quality Assurance Commission Drug Other Controlled Substance registration: WSPQAC@doh.wa.gov
Questions about application status: HSQAFC@doh.wa.gov
Questions about the DEA approval process: Seattle.diversion@dea.gov.