Opioid Treatment (OTP) 10: Take-Home Privileges for Unsupervised Use of Medication
The organization establishes criteria to determine when take-home privileges can become part of an individual’s service plan and how medications are provided in accordance with applicable federal regulations concerning the prescription and distribution of controlled substances.
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
Procedures need strengthening; or
With few exceptions, procedures are understood by staff and are being used; or
For the most part, established timeframes are met; or
Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
Procedures and/or case record documentation need significant strengthening; or
Procedures are not well-understood or used appropriately; or
Timeframes are often missed; or
Several client records are missing important information; or
Client participation is inconsistent.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
No written procedures, or procedures are clearly inadequate or not being used; or
Documentation is routinely incomplete and/or missing.
Procedures regarding take-home medication
Criteria regarding take-home privileges
Material that is given to persons served that addresses safe storage of take-home medication
Interviews may include:
Review case records
Direct service personnel, medical and other appropriate personnel, persons served, and, whenever possible, family members, participate in determining if the individual meets criteria for take-home medication.
To support the initiation of take-home privileges, the medical director considers:
length of time in treatment;
consistency of clinic attendance;
progress in rehabilitation;
employment schedules that create hardship for an individual to meet limited clinic hours;
results of toxicology tests; and
other special needs.
All elements should be considered collectively in determining whether take home privileges are appropriate for an individual. Decisions should not be based solely on toxicology test reports.
Time in treatment should not be a factor for patients prescribed buprenorphine for take-home use.