	Opioid Treatment

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

OTP 10: Take-Home Privileges for Unsupervised Use of Medication

The organization establishes criteria to determine when take-home privileges can become part of an individual’s service plan and how medications are provided in accordance with applicable federal regulations concerning the prescription and distribution of controlled substances.

OTP 10.01

Direct service personnel, medical and other appropriate personnel, service recipients, and, whenever possible, family members, participate in determining if the individual meets criteria for take-home medication.

OTP 10.02

To support the initiation of take-home privileges, the medical director considers:

length of time in treatment;
consistency of clinic attendance;
clinical status;
progress in rehabilitation;
medical necessity;
behavioral factors;
geographic considerations;
employment schedules that create hardship for an individual to meet limited clinic hours;
results of toxicology tests; and
other special needs.

Interpretation: “Other special needs" may include, and are not limited to, emergency circumstances, split dosing, and pain treatment.

Interpretation: All elements should be considered collectively in determining whether take home privileges are appropriate for an individual. Decisions should not be based solely on toxicology test reports.

OTP 10.03

For each person provided with take-home medication, the organization:

schedules toxicology tests to ensure he or she consumes the opioid treatment medication provided and remains free of substance use;
implements measures to help avoid diversion of controlled substances;
has a physician review his or her status at least every 90 days, or more frequently if clinically indicated; and
periodically reviews the benefits and drawbacks of continued take-home privileges.

OTP 10.04

The medical director uses established criteria to decide when take-home medication is contraindicated, including:

signs or symptoms of withdrawal;
evidence of continued alcohol and drug use;
the absence of laboratory evidence of the opioid treatment medication in toxicology samples;
potential complications from concurrent disorders;
ongoing criminal behavior; and
absence of stable social relationships or a stable home environment.

OTP 10.05

Individuals receive guidance on how to safely secure take-home medication.

Interpretation: The medical director considers whether the medication can be safely stored in the person’s place of residence when determining if the individual may be permitted unsupervised use of medication.

OTP 10.06

Take-home medication is prohibited for individuals receiving short-term detoxification or interim maintenance treatment.

NA The organization does not provide short-term detoxification or interim maintenance treatment.

OTP 10.07

The organization labels take-home medication with the organization’s name, address, and telephone number.

Note: See also Risk Prevention and Management for standards regarding Medication Control and Administration.

QUICK JUMP TO


	PURPOSE: Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.

RELATED FILES


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	CRITERIA Systematically developed, objective, and quantifiable statements used to assess the appropriateness of specific decisions, services, and outcomes.


	SERVICE PLAN A written plan of action based on the assessment of consumer needs and strengths that identifies problems, sets goals, and describes a strategy for achieving those goals and engaging in joint problem solving with the consumer. Also known as a "treatment plan".


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	PERSONNEL The body of employees and/or volunteers that carries out the organization's tasks under the organization's administration and/or supervision. This definition does not include foster parents who are specifically referenced in relevant standards


	SERVICE RECIPIENT The individuals, groups, organizations, or communities that use, receive, or benefit from programs and services. Service recipients can include consumers, patients, family members, legal guardians, advocates, public/private organizations, employers, and purchasers. All are regarded as significant stakeholders served in a variety of agencies and practice settings.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	CLINICAL The study, assessment, and diagnosis of the client situation followed by direct treatment to help the client achieve prescribed goals.


	SPECIAL NEEDS A designation used in reference to conditions or characteristics of a person that reflect a need for special care, services, or treatment. When the term is used in the context of adoption services, special needs refers to conditions that make a child harder to place for adoption. This includes children who are members of sibling groups, older children, children with disabilities, children of certain racial /ethnic backgrounds, etc. When the term is used in the context of foster care it refers to the need for a higher degree of specialized case services and attention due to mental and physical disabilities. When the term is used in the context of out-of-school time services, a child or youth may have special physical, behavioral, medical, emotional, or cognitive needs that should be addressed or accommodated. The term is also used in other contexts. See also DEVELOPMENTAL DISABILITIES.


	SAMPLE A portion or representative percentage of a greater whole.


	DETOXIFICATION The process by which drugs or other harmful substances are removed from a person's body for a time period sufficient to restore adequate physiological and psychosocial functioning.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	MANAGEMENT See ADMINISTRATION


	ADMINISTRATION The personnel responsible for management functions of the organization, including fiscal management, human resources, and service delivery. Such personnel determine organizational goals, acquire and allocate resources to carry out a program, coordinate activities toward goal achievement, and monitor, evaluate, and make needed changes in processes and procedures to improve the likelihood of goal achievement. The term is synonymously used with MANAGEMENT.