Standards for public agencies

2020 Edition

Opioid Treatment (PA-OTP) 8: Medical Services

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

Currently viewing: OPIOID TREATMENT (PA-OTP)



Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions: exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement.
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented. 
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.

Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  

  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.  
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner.  
  • Service quality or agency functioning may be compromised.  
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.
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

PA-OTP 8.01

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

Fundamental Practice

PA-OTP 8.02

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

PA-OTP 8.03

The agency 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.

PA-OTP 8.04

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

Fundamental Practice

PA-OTP 8.05

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


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.

PA-OTP 8.06

The agency 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.