Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-8 - HEALTHCARE FACILITY REGULATION › Subject 111-8-53 - RULES AND REGULATIONS FOR NARCOTIC TREATMENT PROGRAMS › Rule 111-8-53-.15 - Narcotic Drugs

Current through Rules and Regulations filed through June 27, 2024
Programs shall develop and implement written policies and
				  procedures for prescription and administration of narcotic drugs and their
				  security. These policies and procedures must include the following:
(a) Administration.
1. The program physician shall determine the
				patient's initial and subsequent dose and schedule. If the program physician
				did not perform the medical assessment required in Rule
				111-8-53-.12, the program physician
				must consult with the person who performed the assessment before determining
				the patient's initial dose and schedule. The program physician shall
				communicate the initial and subsequent doses and schedule to the pharmacy or
				the person supervising medication. The program physician may assign such dose
				and schedule by verbal order; however, the program physician must confirm all
				such orders in writing within 72 hours.
2. Individual doses shall be based on the
				clinical judgment of the program physician who has personally reviewed the
				patient's record and who has considered all available relevant information,
				including, but not limited to, drug screens, quantitative levels of methadone
				and related drugs, patient interview, and specific circumstances pertaining to
				the individual patient.
3. A
				program shall maintain current procedures that are adequate to ensure that the
				following dosage form and initial dosage requirements are met:
(i) Methadone shall be administered or
				dispensed only in oral form and shall be formulated in such a way as to reduce
				its potential for parenteral abuse;
(ii) For each new patient enrolled in a
				program, the initial dose of methadone shall not exceed 30 milligrams and the
				total dose for the first day shall not exceed 40 milligrams, unless the program
				physician documents in the patient's record that 40 milligrams did not suppress
				opiate abstinence symptoms; and
(iii) For the use of any other approved
				opioid agonist treatment medication, the program shall ensure that the dosage
				form and initial dosage requirements are in accordance with currently accepted
				standards of treatment.
4. Patients are stabilized on methadone or a
				related drug when they are receiving a therapeutic dose that is sufficient to
				stop opioid use and sufficient to keep the patient comfortable for at least 24
				hours with no need to resort to illicit opiates to satisfy opiate
				cravings.
5. The dose must either
				be administered by a licensed medical professional authorized by law to do so
				or be self-administered by the patient while under the supervision of a
				licensed medical professional. No methadone or any other drug may be
				administered unless the applicant has undergone all of the screening and
				admission procedures required, unless there is an emergency situation that is
				fully documented in the records. In that case, intake procedures must be
				completed on the next working day. No take-home medication may be given in such
				an emergency.
6. The program shall
				be responsible for ensuring that all dosages are within therapeutically
				acceptable limits;