Current through Register Vol. 54, No. 12, March 23, 2024
(a) A
narcotic treatment program shall determine whether a patient may be provided
take-home medications.
(1) A narcotic
treatment program may give take-home medications only to a patient who the
narcotic treatment physician has determined is responsible and able to handle
narcotic drugs outside the narcotic treatment program.
(2) The narcotic treatment physician shall
make this determination after consultations with staff involved in the
patient's care.
(3) The narcotic
treatment physician shall document in the patient record the rationale for
permitting take-home medication.
(4) A narcotic treatment physician may
rescind take-home medication privileges.
(5) A narcotic treatment program shall
develop written policies and procedures relating to granting and rescinding
take-home medication privileges.
(b) The narcotic treatment physician shall
consider the following in determining whether, in exercising reasonable
clinical judgment, a patient is responsible in handling narcotic drugs:
(1) Absence of recent abuse of drugs
(narcotic or non-narcotic), including alcohol.
(2) Regular narcotic treatment program
attendance.
(3) Absence of serious
behavioral problems at the narcotic treatment program.
(4) Absence of known recent criminal
activity.
(5) Stability of the
patient's home environment and social relationships.
(6) Length of time in comprehensive
maintenance treatment.
(7)
Assurance that take-home medication can be safely stored within the patient's
home.
(8) Whether the
rehabilitative benefit to the patient derived from decreasing the frequency of
attendance outweighs the potential risks of drug diversion.
(c) A narcotic treatment program
shall require a patient to come to the narcotic treatment program for
observation daily or at least 6 days a week for comprehensive maintenance
treatment, unless a patient is permitted to receive take-home medication as
follows:
(1) A narcotic treatment program may
permit a patient to reduce attendance at the narcotic treatment program for
observation to three times weekly and receive no more than a 2-day take-home
supply of medication when, in the reasonable clinical judgment of the narcotic
treatment physician, which is documented in the patient record:
(i) A patient demonstrates satisfactory
adherence to narcotic treatment program rules for at least 3 months.
(ii) A patient demonstrates substantial
progress in rehabilitation.
(iii) A
patient demonstrates responsibility in handling narcotic drugs.
(iv) A patient demonstrates that
rehabilitation progress would improve by decreasing the frequency of attendance
for observation.
(2) A
narcotic treatment program may permit a patient to reduce attendance at the
narcotic treatment program for observation to two times weekly and receive no
more that a 3-day take-home supply of medication when in the reasonable
clinical judgment of the narcotic treatment physician, which is documented in
the patient record:
(i) A patient demonstrates
satisfactory adherence to narcotic treatment program rules for at least 2
years.
(ii) A patient demonstrates
substantial progress in rehabilitation.
(iii) A patient demonstrates responsibility
in handling narcotic drugs.
(iv) A
patient demonstrates that rehabilitation progress would improve by decreasing
the frequency of attendance for observation.
(3) A narcotic treatment program may permit a
patient to reduce attendance at the narcotic treatment program for observation
to one time weekly and receive no more than a 6-day take-home supply of
medication when in the reasonable clinical judgment of the narcotic treatment
physician, which is documented in the patient record:
(i) A patient demonstrates satisfactory
adherence to narcotic treatment program rules for at least 3 years.
(ii) A patient demonstrates substantial
progress in rehabilitation.
(iii) A
patient demonstrates responsibility in handling narcotic drugs.
(iv) A patient demonstrates that
rehabilitation progress would improve by decreasing the frequency of attendance
for observation.
(v) A patient
demonstrates no major behavioral problems.
(vi) A patient is employed, is actively
seeking employment, attends school, is a homemaker or is considered
unemployable for mental or physical reasons.
(vii) A patient is not known to have abused
alcohol or other drugs within the previous year.
(viii) A patient is not known to have engaged
in any criminal activity within the previous year.
(d) A narcotic treatment program
may make exceptions to the requirements in subsection (c) relating to the
length of time of satisfactory adherence to narcotic treatment program rules
and number of days of take-home medication when, in the reasonable clinical
judgment of the narcotic treatment physician, which is documented in the
patient record:
(1) A patient has a permanent
physical disability.
(2) A patient
has a temporary disability.
(3) A
patient has an exceptional circumstance such as illness, personal or family
crisis, or travel which interferes with the patient's ability to conform to the
applicable mandatory attendance schedules. In all cases, the patient shall
demonstrate an ability to responsibly handle narcotic drugs.
(e) With an exception granted
under subsection (d), a narcotic treatment program may not permit a patient to
receive more than a 2-week take-home supply of medication.
(f) An exception granted under subsection (d)
shall continue only for as long as the temporary disability or exceptional
circumstance exists. When a patient is permanently disabled, that case shall be
reviewed at least annually to determine whether the need for the exception
still exists.
