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MODULE 5 Take-Home Medication

Effective Risk Management Strategies in Outpatient Methadone Treatment: Clinical Guidelines and Liability Prevention Curriculum. MODULE 5 Take-Home Medication. Take-Home Medication . Medical Director responsibility Federal Regulation (42 CFR, Part 8 § 12( i )):

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MODULE 5 Take-Home Medication

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  1. Effective Risk Management Strategies in Outpatient Methadone Treatment: Clinical Guidelines and Liability Prevention Curriculum MODULE 5 Take-Home Medication

  2. Take-Home Medication • Medical Director responsibility • Federal Regulation (42 CFR, Part 8 § 12(i)): • Absence of recent drug and alcohol abuse • Regular OTP attendance • Absence of behavioral problems at the OTP • Absence of recent criminal activity • Stable home environment and social relationships • Acceptable length of time in treatment • Assurance of safe storage • Rehabilitative benefits outweigh potential diversion risk Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  3. Federal Guideline Take-Home Medication: Restrictions Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  4. Take-Home Medication: Exceptions • OTP closed and holidays • Medical conditions • Rehabilitative potential • Emergency circumstances • State & Federal requirements • State approval/coordination • SAMHSA SMA-168 form • SAMHSA • “Dear Colleague” letters • Guidelines for Accreditation Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  5. Take-Home Medication: Monitoring • Review the rationale • Drug Testing • PDMP review • Review of all prescriptions • Attendance for counseling Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  6. Take-Home Medication: Legal Federal regulation permits THs for patients; however, it does not absolve the OTP of their legal responsibility.

  7. Take-Home Medication: Policies • The TIP 43 recommends the following diversion control policies: • Return empty bottles • Procedure for those who fail to return bottles • Stay open 7 days a week Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  8. Take-Home Medication: TOOLKIT • Conduct “call-backs” • Monitor take-home medication • Home safety inspections • Case management staff • Locked containers • Not a total guarantee for safety Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  9. Take-Home Medication: TOOLKIT • Screen for patients who: • Have children • Are using/abusing substances • Policies to address treatment interruptions: • Travel • Illnesses or disabilities • Bereavement / funerals • Emergencies • Hospitalizations Clinical Pharmacology, Chapter 5, (TIP) Treatment Improvement Protocol #43. http://www.ncbi.nlm.nih.gov/books/NBK25944/

  10. In Summary • Criteria for eligibility • State and federal criteria • Clinical judgment • Medical Director responsibility and accountability • Monitor, reassess and document

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