Current through Register Vol. 35, No. 18, September 24, 2024
A. The
program sponsor shall ensure that policies and procedures are developed,
implemented, and complied with for the use of take-home medication and include:
(1) criteria for determining when a patient
is ready to receive take-home medication;
(2) criteria for when a patient's take-home
medication is increased or decreased;
(3) a requirement that take-home medication
be dispensed according to federal and state law;
(4) a requirement that the program medical
director review a patient's take-home medication regimen at intervals of no
less than 90 days and adjust the patient's dosage, as needed;
(5) procedures for safe handling and secure
storage of take-home medication in a patient's home; and
(6) criteria and duration of allowing a
physician to prescribe a split medication regimen.
B. Treatment program decisions on dispensing
OTP medications to patients for unsupervised use, beyond that set forth in
Subsection C of 8.321.10.23 NMAC below, shall be made by the program medical
director, based on the following criteria:
(1)
absence of recent abuse of drugs, including alcohol;
(2) regularity of program
attendance;
(3) length of time in
comprehensive maintenance treatment;
(4) absence of known criminal
activity;
(5) absence of serious
behavioral problems at the program;
(6) special needs of the patient such as
physical health needs;
(7)
assurance that take-home medication can be safely stored in the patient's
home;
(8) stability of the
patient's home environment and social relationships;
(9) the patient's work, school, or other
daily activity schedule;
(10)
hardship experienced by the patient in traveling to and from the program;
and
(11) whether the benefit the
patient would receive by decreasing the frequency of program attendance
outweighs the potential risk of diversion.
C. A patient in comprehensive maintenance
treatment may receive a single dose of takehome medication for each day that a
provider is closed for business, including Sundays and state and federal
holidays.
D. A program sponsor
shall ensure that take-home medication is only issued to a patient in
compliance with the following restrictions:
(1) during the first 90 days of comprehensive
maintenance treatment, take-home medication is limited to a single dose each
week, in addition to any doses received as described in Subsection C of
8.321.10.23 NMAC above;
(2) during
the second 90 days of comprehensive maintenance treatment, a patient may
receive a maximum of two doses of take-home medication each week in addition to
any doses received as described in Subsection C of 8.321.10.23 NMAC
above;
(3) during the third 90 days
of comprehensive maintenance treatment, a patient may receive a maximum of
three doses of take-home medication each week in addition to any doses received
as described in Subsection C of 8.321.10.23 NMAC above;
(4) in the remaining months of the patient's
first year, a patient may receive a maximum of six days of take-home medication
each week;
(5) after one year of
continuous treatment, a patient may receive a maximum two week supply of
take-home medication;
(6) after two
years of continuous treatment, a patient may receive a maximum of one month's
supply of take-home medication but must make monthly visits;
(7) exceptions to the above take-home
medication restrictions shall be made only as provided for in center for
substance abuse treatment (CSAT) regulations and as approved by the state
methadone authority.
E.
A program sponsor shall ensure that a patient receiving take-home medication
receives:
(1) take-home medication in a
child-proof container; and
(2)
written and verbal information on the patient's responsibilities in protecting
the security of take-home medication.
F. The program sponsor shall ensure that the
program medical director's determination made under Subsection B of 8.321.10.23
NMAC and the reasons for the determination are documented in the patient
record.
G. In accordance with DEA
regulations, the program shall not use U. S. mail or express services such as
fedex or united parcel service to transport, furnish or transfer opioid
treatment medication to any patient, agency, facility or person.
H. The program shall establish policy and
procedure to provide for the safe and secure transportation of opioid treatment
medication from its facility to another agency where the program's patient
temporarily resides, (e.g., from the university of New Mexico's addiction and
substance abuse program (ASAP) to the turquoise lodge treatment
program.).
