Standards for private organizations

2020 Edition

Opioid Treatment (OTP) 8: Medical Services

Medical services are provided, directly or by referral, according to individual needs.
2020 Edition

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Purpose

Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.
1
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.
2
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.
3
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. 
4
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 making referrals to medical, psychiatric, or pain management services
  • Procedures for obtaining medication blood levels
  • Procedures for evaluating the benefits derived from treatment
  • PDMP procedures
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

OTP 8.01

The organization provides or makes referrals to medical and psychiatric services for necessary screening and follow-up.

 
Fundamental Practice

OTP 8.02

The organization obtains medication blood levels and conducts other medical and diagnostic procedures when clinically indicated.

 

OTP 8.03

The organization uses opioid agonist treatment medications approved by the U.S. Food and Drug Administration in the treatment of opioid addiction.
Examples: Opioid addiction treatment medications include: buprenorphine, methadone and naltrexone.

 

OTP 8.04

Individuals are maintained on opioid treatment medication as long as they desire, and derive benefit from treatment.

 
Fundamental Practice

OTP 8.05

The organization makes referrals for consultation with a specialist in pain medicine for individuals with chronic pain disorder.

Interpretation

Generally, individuals with chronic pain disorder should not be admitted to receive opioids only for pain, but there are exceptions if the program is the only available resource in the community. Individuals with both chronic pain and addiction should receive integrated treatment from appropriate medical specialists.

 

OTP 8.06

The organization queries the state prescription drug monitoring program (PDMP):  
  1. prior to initiating dosing for new patients;
  2. at clinical decision points, such as ordering take home medication; and
  3. routinely for all patients.
NA There is no PDMP available in the state.