415-020-0040 Treatment Services General (1) Treatment Services: The Opioid Treatment Program (OTP) shall provide patients the following services and activities and document the time or manner of each service or activity in the patient record: (a) Dispensing of approved opioid agonist medications; (b) Individual group, or family counseling, as clinically indicated; (c) Information and training in parenting skills; (d) HIV, AIDS, tuberculosis, sexually transmitted diseases, and other infectious disease information; (e) Completion of HIV, TB, STD risk assessment within 30 days of admission; (f) Relapse prevention training; and (g) For pregnant patients in a treatment program who were not admitted under OAR 415-020-0025(5), a treatment program shall give them the opportunity for prenatal care. If a program cannot provide direct prenatal care for pregnant patients in treatment, it shall establish a system of referring them for prenatal care, which may be either publicly or privately funded. If there is no publicly funded prenatal care available to which a patient may be referred, and the program cannot provide such services, or the patient cannot afford or refuses prenatal care services, then the treatment program shall, at a minimum, offer them basic prenatal instruction on maternal, physical, and dietary care as a part of its counseling service. (2) Community Resources: The program, to the extent of community resources available and as clinically indicated, shall provide patients with information and referral to the following services: (a) Self-help groups and other support groups; (b) Educational services; (c) Recreational programs and activities; (d) Prevocational, occupational, and vocational rehabilitation; (e) Life skills training; (f) Legal services; (g) Smoking cessation programs; (h) Medical services; (i) Housing assistance; (j) Financial assistance counseling programs; (k) Crisis intervention; and (l) Comprehensive drug education. (3) Non-compliance: Patients who are non-compliant with program rules may be discharged following medically supervised withdrawal. Clinical justification for medically supervised withdrawal schedules of less than 21 days must be documented in the patient record. For discharges because of failure to pay fees, detoxification periods of less than 21 days are not permitted. (4) Testing for Drug Use: The program shall use observed urine drug screening as an aid in monitoring and evaluating a patient's progress in treatment. The urine drug screening shall include; (a) A sensitive, rapid, and inexpensive immunoassay screen to eliminate "true negative" specimens; and (b) If the initial test is positive, a confirmatory test, which is a second analytical procedure used to identify the presence of a specific drug or metabolite in a urine specimen. The confirmatory test must be conducted by a different analytical method from that of the initial test, to ensure reliability and accuracy. (5) Standards for Urine Tests: All urine tests shall be performed by laboratories meeting the licensing standards of OAR 333-024-0305 through 333-024-0365. (6) All urine tests shall, at a minimum, screen for synthetic opiates, opiates, amphetamines, cocaine, and benzodiazepines.. (7) Frequency of urine testing: The OTP must provide adequate testing or analysis for drugs of abuse, including at least eight random drug abuse tests per year, for each patient in maintenance treatment, in accordance with generally accepted clinical practice. More frequent drug testing shall be done if clinically indicated. The program shall document in the patient record the results of any tests and interventions made by the program to address those tests which are positive for illicit substances. Statutory/Other Authority: ORS 430.256 Statutes/Other Implemented: ORS 430.010(4)(b) & 430.560 - 430.590 History: ADS 2-2023, amend filed 04/07/2023, effective 04/07/2023 ADS 2-2008, f. & cert. ef. 11-13-08 ADS 1-2003, f. 6-13-03, cert. ef. 7-1-03 ADAP 3-1995, f. 12-1-95, cert. ef. 3-1-96 HR 17-1993, f. & cert. ef. 7-23-93, Renumbered from 410-006-0040 HR 4-1988, f. & cert. ef. 5-10-88