Standards for private organizations

2020 Edition

Opioid Treatment (OTP) 7: Service Elements

Services are responsive to individual strengths, needs, and goals.
2020 Edition

Currently viewing: OPIOID TREATMENT (OTP)



Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.
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.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for referring individuals for services
  • Service agreements and formal referral arrangements
  • Educational materials or other documentation of information provided to persons served
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

OTP 7.01

The organization provides, directly or by formal arrangement:
  1. substance use counseling that is coordinated with other counseling and services;
  2. access to physicians with knowledge of appropriate prescribing practices for individuals with addiction;
  3. activities that address the importance of drug and alcohol-free lifestyles and de-emphasize the role of intoxicants; and
  4. activities that address issues of particular concern to women, including intimacy, intimate partner violence, physical trauma, sexual trauma, prevention of exposure to and transmission of HIV/AIDS and other STDs, child care, pregnancy, and family planning.
Examples: Formal arrangements can include service agreements and formal referral arrangements.

OTP 7.02

Persons served, and adults with whom they live, are educated about:
  1. program guidelines, rules, and regulations;
  2. the nature of addictive disorders;
  3. signs and symptoms of overdose and when to seek emergency assistance;
  4. the dangers of cross-tolerance;
  5. dependency substitution and self-medication;
  6. therapeutic effects of opioid treatment medication;
  7. common myths about opioid treatment medication;
  8. the benefits of treatment and the recovery process;
  9. dispensing medication; and
  10. toxicology testing procedures.

OTP 7.03

Persons served receive:
  1. infectious disease prevention and risk reduction information and education;
  2. counseling on the importance of treatment adherence and honest communication with the provider;
  3. counseling on HIV infection and other infectious diseases and referral for testing;
  4. intensive clinical support for continued active use of alcohol and other drugs, including tobacco;
  5. supplemental psychotherapy services or referrals for co-occurring mental health disorders;
  6. support, information, and referral when seeking alternative therapies;
  7. access to vocational rehabilitation, evaluation, education, and training services; 
  8. access to parenting workshops;
  9. access to support and specialized recovery groups if the person and his/her family is affected by HIV/AIDS; and
  10. noncompliance and discharge procedures.

OTP 7.04

The organization uses multiple models of care in the treatment process to meet individual needs and embraces a recovery-oriented system of care framework that is: 
  1. person-centered;
  2. strengths-based;
  3. culturally-responsive;
  4. facilitative and self-directed;
  5. supported by formal and informal resources; and
  6. ongoing.
Examples: The organization may organize treatment in a group format based on the characteristics of a particular population, for example, by gender, age, sexual orientation, or racial, ethnic, and cultural background.

OTP 7.05

The organization provides, either directly or by referral, peer support and self-help services.
Examples: Peer support refers to services provided by individuals who have shared, lived experience. Peer support workers may be part of the treatment team. Services promote resiliency and recovery and can include peer recovery groups, peer-to-peer counseling, peer mentoring or coaching, family and youth peer support, or other consumer-run services.

OTP 7.06

Individuals diagnosed as having co-occurring health, mental health, and substance use conditions receive integrated treatment directly or through active involvement with a cooperating service provider.
Note: An organization that has a specialized outpatient co-occurring disorder treatment program must also complete Mental Health and/or Substance Use Services (MHSU), recognizing that the mental health standards may need to be adapted for specialized core services provided within the context of services for substance use conditions.

OTP 7.07

The organization coordinates with the criminal justice system to advocate for continuous treatment for individuals who are incarcerated, or on probation or parole.
NA The organization does not serve any individual involved in the criminal justice system.

OTP 7.08

The organization provides, or makes referrals for, relapse prevention services including counseling, support, and education for individuals who want to discontinue opioid treatment.