MOUD In Recovery
Lead-Up to MDDCSAM’s bill that now prohibits mandatory MOUD tapers in certified recovery residences
APRIL 2026: MDDCSAM’s BILL IS ENACTED.
SEPTEMBER 2025: MDDCSAM SEEKS A REGULATORY SOLUTION:
MDDCSAM had a series of communications with the MD Behavioral Health Administration (BHA) starting in September 2026, explaining the need to address the problem of recovery residences prohibiting and restricting access to MOUD (medications for opioid use disorder) and refusing admission to individuals for whom these medications have been prescribed (or dispensed). BHA was certifying and re-certifying recovery houses regardless of their use of these harmful, discriminatory practices. Allowing access to MOUD was not considered to be a certification standard. In response to a request for comments to BHA’s draft update on regulations for recovery residences in the fall of 2025, MDDCSAM submitted formal comments pointing out that MOUD access in recovery housing was the standard of care according to SAMHSA, ASAM, the WHO, and the National Academies of Sciences, Engineering and Medicine, with an annotated bibliography. In response to an argument that this need not be included as a certification standards because discrimination against those on MOUD was already illegal under federal laws such as the ACA and FHA, we pointed out that federal enforcement of MOUD access in recovery residences is non-existent. Essentially no-one who is in need of recovery housing is likely to file complaints with federal agencies, nor able to hire a lawyer. Even if they were, none of these federal laws has ever been used to protect MOUD access in recovery residences.
SEPTEMBER 2024: MEDCHI RESOLUTION FOR MOUD ACCESS AS A CERTIFICATION STANDARD:
In September 2024, MedChi (the MD State Medical Society) House of Delegates adopted a resolution for MOUD access as a certification standard for recovery residences titled “Inappropriate Certification of Recovery Residences.”
Excerpt:
“Whereas, the use of ineffective treatments for opioid use disorder (OUD), and barriers to the use of medications for OUD (MOUD), the most effective OUD treatment, are major obstacles to addressing the opioid crisis in Maryland and elsewhere (References 1, 2, 3, 4); . . .
Whereas, . . . many recovery residences limit or prohibit access to MOUD contrary to the preferences of a resident or prospective resident and contrary to a prescriber’s recommendation. . . this is a discriminatory practice which denies individuals access to the most basic standard of care for OUD; and
Whereas, the Legal Action Center has identified signs of discrimination in recovery residences as including: (a) “Residence has a policy not to admit people taking methadone or buprenorphine,” (b) “Residence limits the number of people in the facility who can take MOUD, e.g. having designated ‘MAT beds’ “, (c) “Residence requires people to taper their dose of methadone or buprenorphine,” and (d) “Residence only admits people who take under a certain dose of methadone or buprenorphine.” . . .
Whereas, Within the Maryland Certification of Recovery Residences program (MCORR) of the Maryland Department of Health (MDH), . . . Residences routinely receive quality certification from the program even when they limit or restrict access to MOUD contrary to the preferences of a resident or prospective resident and contrary to the recommendation of a physician; . . .
Resolved, that MedChi advocate for a policy within the Maryland Department of Health not to grant or renew certification by the MCORR program (MD Certification Of Recovery Residences) for recovery residences which limit or restrict access to MOUD, and
Resolved, that if MedChi’s efforts to encourage the MCORR program to stop granting or renewing certifications to recovery residences which limit or prohibit access to MOUD are unsuccessful, then MedChi advocate for legislation to accomplish this. . .”
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