§ 715.16. Take-home privileges.

 (a)  A narcotic treatment program shall determine whether a patient may be provided take-home medications.

   (1)  A narcotic treatment program may give take-home medications only to a patient who the narcotic treatment physician has determined is responsible and able to handle narcotic drugs outside the narcotic treatment program.

   (2)  The narcotic treatment physician shall make this determination after consultations with staff involved in the patient’s care.

   (3)  The narcotic treatment physician shall document in the patient record the rationale for permitting take-home medication.

   (4)  A narcotic treatment physician may rescind take-home medication privileges.

   (5)  A narcotic treatment program shall develop written policies and procedures relating to granting and rescinding take-home medication privileges.

 (b)  The narcotic treatment physician shall consider the following in determining whether, in exercising reasonable clinical judgment, a patient is responsible in handling narcotic drugs:

   (1)  Absence of recent abuse of drugs (narcotic or non-narcotic), including alcohol.

   (2)  Regular narcotic treatment program attendance.

   (3)  Absence of serious behavioral problems at the narcotic treatment program.

   (4)  Absence of known recent criminal activity.

   (5)  Stability of the patient’s home environment and social relationships.

   (6)  Length of time in comprehensive maintenance treatment.

   (7)  Assurance that take-home medication can be safely stored within the patient’s home.

   (8)  Whether the rehabilitative benefit to the patient derived from decreasing the frequency of attendance outweighs the potential risks of drug diversion.

 (c)  A narcotic treatment program shall require a patient to come to the narcotic treatment program for observation daily or at least 6 days a week for comprehensive maintenance treatment, unless a patient is permitted to receive take-home medication as follows:

   (1)  A narcotic treatment program may permit a patient to reduce attendance at the narcotic treatment program for observation to three times weekly and receive no more than a 2-day take-home supply of medication when, in the reasonable clinical judgment of the narcotic treatment physician, which is documented in the patient record:

     (i)   A patient demonstrates satisfactory adherence to narcotic treatment program rules for at least 3 months.

     (ii)   A patient demonstrates substantial progress in rehabilitation.

     (iii)   A patient demonstrates responsibility in handling narcotic drugs.

     (iv)   A patient demonstrates that rehabilitation progress would improve by decreasing the frequency of attendance for observation.

   (2)  A narcotic treatment program may permit a patient to reduce attendance at the narcotic treatment program for observation to two times weekly and receive no more that a 3-day take-home supply of medication when in the reasonable clinical judgment of the narcotic treatment physician, which is documented in the patient record:

     (i)   A patient demonstrates satisfactory adherence to narcotic treatment program rules for at least 2 years.

     (ii)   A patient demonstrates substantial progress in rehabilitation.

     (iii)   A patient demonstrates responsibility in handling narcotic drugs.

     (iv)   A patient demonstrates that rehabilitation progress would improve by decreasing the frequency of attendance for observation.

   (3)  A narcotic treatment program may permit a patient to reduce attendance at the narcotic treatment program for observation to one time weekly and receive no more than a 6-day take-home supply of medication when in the reasonable clinical judgment of the narcotic treatment physician, which is documented in the patient record:

     (i)   A patient demonstrates satisfactory adherence to narcotic treatment program rules for at least 3 years.

     (ii)   A patient demonstrates substantial progress in rehabilitation.

     (iii)   A patient demonstrates responsibility in handling narcotic drugs.

     (iv)   A patient demonstrates that rehabilitation progress would improve by decreasing the frequency of attendance for observation.

     (v)   A patient demonstrates no major behavioral problems.

     (vi)   A patient is employed, is actively seeking employment, attends school, is a homemaker or is considered unemployable for mental or physical reasons.

     (vii)   A patient is not known to have abused alcohol or other drugs within the previous year.

     (viii)   A patient is not known to have engaged in any criminal activity within the previous year.

 (d)  A narcotic treatment program may make exceptions to the requirements in subsection (c) relating to the length of time of satisfactory adherence to narcotic treatment program rules and number of days of take-home medication when, in the reasonable clinical judgment of the narcotic treatment physician, which is documented in the patient record:

   (1)  A patient has a permanent physical disability.

   (2)  A patient has a temporary disability.

   (3)  A patient has an exceptional circumstance such as illness, personal or family crisis, or travel which interferes with the patient’s ability to conform to the applicable mandatory attendance schedules. In all cases, the patient shall demonstrate an ability to responsibly handle narcotic drugs.

 (e)  With an exception granted under subsection (d), a narcotic treatment program may not permit a patient to receive more than a 2-week take-home supply of medication.

 (f)  An exception granted under subsection (d) shall continue only for as long as the temporary disability or exceptional circumstance exists. When a patient is permanently disabled, that case shall be reviewed at least annually to determine whether the need for the exception still exists.



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