Additional Opioid Treatment Provider Requirements: Medically Supervised Withdrawal

(A) Admission. In accordance with federal requirements: (1) When admitting an individual for opioid medically supervised withdrawal management, the Licensed or Approved Provider shall obtain and include in the patient's record a medical evaluation by a Practitioner or psychiatrist which confirms the appropriateness of outpatient medically supervised withdrawal management for the patient. (2) A program physician shall conduct an assessment to determine the appropriate form of treatment. Should such physician determine treatment other than opioid medically supervised withdrawal is necessary, the physician shall directly connect the patient with a provider for such treatment. (3) A program physician may determine persons younger than 18 years old may be admitted upon determination such individual is currently physiologically dependent upon opioids as defined in 105 CMR 164.305(B)(2). (4) Patients with two or more unsuccessful episodes of supervised withdrawal within a 12- month period may not be admitted to opioid medically supervised withdrawal management treatment. A waiting period of at least one week is required between withdrawal attempts. An authorized staff physician shall document in the patient record that the patient continues to be or is again physiologically dependent on an opioid drug. (B) Treatment. The Licensed or Approved Provider shall ensure the following provisions are met: (1) A program physician shall determine for each patient the rate at which the opioid drug is to be decreased; At least one drug screening shall be performed upon admission to opioid medically supervised withdrawal treatment. If the withdrawal management period exceeds 30 calendar days, the Licensed or Approved Provider shall obtain at least one drug screen per month for the duration of medically supervised withdrawal treatment; Treatment plans shall be reviewed with the patient periodically and as needed to determine the appropriate accommodation of treatment and services; (4) The Licensed or Approved Provider shall dispense opioid agonist treatment medications to the patient daily at the facility under the direct supervision of a physician or other qualified medical person; and The Licensed or Approved Provider shall not provide take-home medication for withdrawal management.