The NTP guidelines that follow represent a joint initiative between DEA and the American Methadone Treatment Association. Their development grew out of the need to provide guidance to NTPs throughout the United States regarding common sense practices for the reconciliation of opioid replacement medications.

The guidelines provide information on a variety of issues related to compliance with DEA regulatory requirements and to the enhancement of NTP operations. Topics addressed range from procedures used when ordering and receiving medications and best practices for using automated dispensing systems, including the use of computer software in the dispensing/ reconciliation process, to recordkeeping and security requirements and procedures.

The guidelines can be used by NTP personnel to access specific information addressing issues or problems that arise during the day to day operation of the NTP. The intent of these guidelines is to ensure greater stability in the treatment process through the use of the same standard throughout the United States. Key management and dispensing personnel are encouraged to study the document as a whole.

In the text to follow, typeface and language are used to differentiate regulatory requirements from recommended practices.

• Recommended practices are presented in standard typeface and typically include the word "should" (e.g., "The designated staff member who receives a particular shipment should sign for the shipment only after all of the ordered medication has been accounted for.").
   
• The word "must" is typically used in presenting regulatory requirements, which are printed in italics and bold. Further, the part and section of Title 21 of the Code of Federal Regulations (CFR) where a specific regulatory requirement is found is presented in brackets after the requirement (e.g., "To order needed medication, a DEA Form-222 must be completed by the NTP. [ 21 CFR 1305.06].").

This document also includes appendices which provide information to support material found in the body of the document. These include a compilation of questions that DEA is frequently asked - about the ordering and delivery of medication, recordkeeping, destruction of medication, security, and other issues - and the answers to these questions (Appendix A). There are also sample DEA forms (Appendix B) and a checklist that NTPs may use when preparing for a DEA investigation (Appendix C).

An appendix listing all local DEA diversion field offices also is included (Appendix D). When an NTP contacts the local DEA office to obtain information from or provide it to DEA personnel, callers should ask to speak with the "Diversion Group" of that office.

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