Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
380 - STATE BOARD OF NURSING
Chapter 12 - JOINT RULE REGARDING OFFICE BASED TREATMENT OF OPIOID USE DISORDER
Section 380-12-1 - DEFINITIONS

1. Administrative Discharge means the involuntary process of medically supervised withdrawal from medications for Opioid Use Disorder.

2. Approved Medications means medications that are FDA approved for the treatment of Opioid Use Disorder (OUD) in an office based setting that is not a certified Opioid Treatment Program (OTP).

3. ASAM means the American Society of Addiction Medicine.

4. Board means the Board of Licensure in Medicine, the State Board of Nursing, and the Board of Osteopathic Licensure.

5. Clinical Discharge means the voluntary process, agreed upon by both the patient and provider, of medically-supervised withdrawal by gradually tapering medication for ultimate cessation of therapy.

6. Clinician means a Maine-licensed physician, physician assistant, or advanced practice registered nurse.

7. Co-occurring Disorder means an individual who has a co-existing mental illness and a substance use disorder.

8. DATA 2000 means the federal Drug Addiction Treatment Act of 2000, which permits clinicians who meet certain qualifications to treat individuals with OUD by prescribing FDA Approved Medications such as buprenorphine.

9. DATA 2000 Waiver means a DEA authorization for a licensed clinician who has met the training and credentialing registration requirements of DATA 2000 to prescribe Approved Medications to patients in settings other than OTPs.

10. DEA means the Drug Enforcement Administration in the U.S. Department of Justice.

11. Drug Diversion means the transfer of a controlled substance from authorized legal and medically necessary use or possession to illegal and unauthorized use or possession.

12. FDA means the U.S. Food and Drug Administration.

13. Informed Consent means written agreement by a patient to a medical procedure, or for participation in OBOT, after achieving an understanding of the relevant medical facts, risks and benefits, and alternative treatments.

14. Medical Emergency means an acute injury or illness that poses an immediate risk to a person's life or long-term health.

15. Misuse means all uses of a prescription medication other than those that are directed by a clinician in accordance with the plan of treatment.

16. Office Based Opioid Treatment (OBOT) means providing medication and other non-pharmacologic modalities to treat OUD in outpatient medical settings other than certified OTPs. OBOT does not include the administration of buprenorphine in any setting that allows a clinician who is not certified as a waivered DATA 2000 clinician to administer (but not prescribe) buprenorphine to a patient for the purpose of relieving acute withdrawal symptoms while arranging for a patient's referral for treatment and provided that in accordance with Title 21, Code of Federal Regulations, Part 1306.07(b):

17. Opioid Treatment Program (OTP) - (sometimes referred to as a "methadone clinic" or "narcotic treatment program") means any treatment program certified by SAMHSA in conformance with 42 Code of Federal Regulations (CFR), Part 8, to provide supervised assessment and medication assisted treatment of patients with OUD. Only federally certified and accredited OTPs may prescribe and/or dispense methadone for the treatment of OUD.

18. Opioid Use Disorder (OUD) means the criteria in the current edition of the Diagnostic and Statistical Manual of Mental Disorders for OUD.

19. Outpatient means a health care setting where the patient is not admitted to a hospital, skilled nursing facility or long-term care facility.

20. Psychosocial Assessment means an evaluation of the psychological and social factors that are experienced by an individual or family as the result of addiction. The factors may complicate an individual's recovery or act as assets to recovery.

21. Recovery means a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

22. SAMHSA means the federal Substance Abuse and Mental Health Services Administration.

23. Telehealth means the provision of health care services using electronic audio-visual communications and information technologies or other means, including interactive audio with asynchronous store-and-forward transmission, between a clinician in one location and a patient in another location with or without an intervening health care provider. Telehealth includes asynchronous store-and-forward technologies, telemonitoring, and real-time interactive services, including teleradiology and telepathology. When necessary and appropriate under the circumstances and if in compliance with the applicable standard of care, telehealth includes the use of audio-only technology. Telehealth shall not include the provision of health care services between a licensee in one location and a patient in another location with or without an intervening health care provider only through e-mail, instant messaging, facsimile transmission, or U.S. mail or other parcel service, or any combination thereof.

24. Toxicology Tests means any laboratory analysis for the purpose of detecting the presence of alcohol and/or various scheduled or illicit drugs.