	Opioid Treatment

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-OTP 7: Service Elements

Services are responsive to individual strengths, needs, and goals.

PA-OTP 7.01

The agency provides, directly or by formal arrangement:

substance use counseling that is coordinated with other counseling and services;
access to physicians with knowledge of appropriate prescribing practices for an addicted population;
activities that address the importance of drug and alcohol-free lifestyles and de-emphasize the role of intoxicants; and
activities that address issues of particular concern to women, including intimacy, prevention of exposure to and transmission of HIV/AIDS and other STDs, child care, pregnancy, and family planning.

Interpretation: The agency should establish and maintain relationships with other providers in the community. Formal arrangements include service agreements and formal referral arrangements.

PA-OTP 7.02

Service recipients, and adults with whom they live, are educated about:

program guidelines, rules, and regulations;
the nature of addictive disorders;
signs and symptoms of overdose and when to seek emergency assistance;
the dangers of cross-tolerance;
dependency substitution and self-medication;
therapeutic effects of opioid treatment medication;
common myths about opioid treatment medication;
the benefits of treatment and the recovery process;
dispensing medication; and
toxicology testing procedures.

PA-OTP 7.03

Individuals receive:

infectious disease prevention and risk reduction information and education;
counseling on HIV infection and other infectious diseases and referral for testing;
intensive clinical support for continued active use of alcohol and other drugs;
supplemental psychotherapy services or referrals for co-occurring mental health disorders;
support, information, and referral when seeking alternative therapies;
access to vocational rehabilitation, evaluation, education, and training services; and parenting workshops;
access to support and specialized recovery groups if the person and his/her family is affected by HIV/AIDS; and
non-compliance and discharge procedures.

Interpretation: Counseling addresses the importance of treatment adherence and honesty and communication with the provider.

Research Note: Research suggests that individuals in opioid treatment programs who receive a combination of counseling, medical, psychiatric, employment, and family services remain in treatment longer than those that receive minimal counseling only.

PA-OTP 7.04

Multiple models of care are used during different phases of the treatment process to meet the individual needs of service recipients, families, and significant others.

Interpretation: The agency may organize treatment in a group format based on the characteristics of a particular population, for example, by gender, age, sexual orientation, and racial, ethnic, and cultural background.

PA-OTP 7.05

The agency links individuals to peer support and self-help services when available.

Interpretation: Sometimes self-help services, such as 12-step programs are unfamiliar with opioid addiction treatment. The agency can establish their own program or make efforts to identify groups that are familiar with and accepting of individuals receiving opioid treatment.

PA-OTP 7.06

Individuals diagnosed as having co-occurring health, mental health, and substance use conditions receive integrated treatment directly or through active involvement with a cooperating service provider.

Interpretation: It is critical for providers to have an understanding of both the substance use and co-occurring disorder. If that level of expertise is unavailable, the organization should arrange for appropriate care elsewhere and facilitate the coordination of treatment and any other medications prescribed.

Note: Agencies that treat substance use conditions are expected to have core capability to address co-occurring mental health conditions. An agency that has a specialized outpatient co-occurring disorder treatment program must also complete Outpatient Mental Health Services, recognizing that the mental health standards may need to be adapted for specialized core services provided within the context of services for substance use conditions.

Research Note: The presence of a substance use and a mental health condition can make diagnosis and treatment significantly more difficult, resulting in poorer treatment outcomes. Research has demonstrated that integrated treatment is most effective for this service population. Treatment should be motivational, individualized, and comprehensive to accommodate the wide range of treatment needs.

PA-OTP 7.07

The agency coordinates with the criminal justice system to advocate for continuous treatment for individuals who are incarcerated, or on probation or parole.

NA The agency does not serve any individual involved in the criminal justice system.

PA-OTP 7.08

The agency provides, or makes referrals for, relapse prevention services including counseling, support, and education for individuals who want to discontinue opioid treatment.

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.


	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.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	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.


	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."


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	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.


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


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


	PSYCHOTHERAPY Interaction between a client and a clinical social worker or other mental health professional in which a relationship is established to help resolve mental health problems, relationship problems, psychosocial stress and distress, and difficulties in coping with or functioning in the social environment.


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	DISCHARGE See CASE CLOSING


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	REFERRALS Resource suggestions provided to consumers to address problems or needs that are beyond the scope of the organization's mission.


	EVALUATION The review and assessment of organizational operations, programs and services.


	DIAGNOSIS The process by which a social, physical, or mental health problem and its underlying cause are identified and a plan of action formulated toward resolution of the problem. The diagnostic process involves collection and analysis of relevant information. See also ASSESSMENT.


	SERVICE POPULATION A group or target population that the organization's services are designed to serve in accord with its mission, and which includes the organization's service recipients. An organization's service population may be defined by geographic location, specific problems or needs, religion, ethnicity, culture, or other factors.