Maryland Expands Prescriber–Pharmacist Agreements and Opens New Opportunities for Opioid Use Disorder Treatment - Buchanan Ingersoll & Rooney PC
Maryland has expanded prescriber-pharmacist collaborative agreements, allowing pharmacists to initiate and manage treatment for opioid use disorder (OUD) under a protocol. This change opens new opportunities for pharmacies to provide OUD treatment services but requires compliance with updated state regulations and DEA requirements.
Aforeworn detected this change in the Pharmacy & Controlled Substances space on July 28, 2026 and published this briefing so affected operators are forewarned rather than caught off guard. It is rated High urgency. Independent pharmacies, retail chains, and long-term-care pharmacies in Maryland that dispense controlled substances or are interested in providing OUD treatment. should confirm how it applies to their specific situation before acting. There is a time constraint attached: Immediately, as the change is effective upon enactment. Pharmacies should act within 30 days to avoid non-compliance risks.. Acting after that point can mean penalties, a lapsed licence, or lost eligibility — exactly the kind of surprise Aforeworn exists to prevent. Aforeworn monitors Pharmacy & Controlled Substances continuously and turns every detected change into a plain-English briefing like this one, so you always know first. Forewarned is forearmed.
What changed
Maryland now permits pharmacists to initiate and manage buprenorphine-based OUD treatment under a collaborative agreement with a prescriber, expanding beyond traditional dispensing roles.
Who it affects
Independent pharmacies, retail chains, and long-term-care pharmacies in Maryland that dispense controlled substances or are interested in providing OUD treatment.
What you must do
Review and update collaborative practice agreements to include OUD treatment protocols; ensure pharmacists obtain necessary training and DEA waivers (if required); update policies and procedures for dispensing and monitoring buprenorphine.
Deadline
Immediately, as the change is effective upon enactment. Pharmacies should act within 30 days to avoid non-compliance risks.
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