West Virginia Code of State Rules › Agency 69 - Health And Human Resources › Title 69 - LEGISLATIVE RULE DEPARTMENT OF HEALTH AND HUMAN RESOURCES › Series 69-07 - Regulations of Opioid Treatment Programs › Section 69-7-38 - Detoxification Program

Current through Register Vol. XLI, No. 28, July 12, 2024
38.1. In
				addition to recovery-oriented opioid treatment services, each opioid treatment
				program shall provide both long-term and short-term detoxification recovery
				treatment services. The program physician or a physician extender shall provide
				onsite medical supervision and oversight of the detoxification treatment
				program.
38.2. All potential
				patients shall be offered the opportunity to participate in either a
				recovery-oriented long-term detoxification treatment services plan or a
				short-term detoxification services plan of varying durations. A detoxification
				treatment services plan shall be implemented only if agreed upon by the patient
				and deemed appropriate by the physician or physician extender through utilizing
				and applying established diagnostic criteria.
38.3. Patients with two or more unsuccessful
				detoxification episodes within a 12-month period must be assessed by the opioid
				treatment program physician for other forms of treatment. A program shall not
				admit a patient for more than two detoxification treatment episodes in one
				year.
38.4. The patient's
				individualized treatment plan of care shall state whether the patient chose
				detoxification treatment services and, if so, whether the patient selected the
				short-term or long-term detoxification treatment program. If the patient
				selected the option for detoxification treatment services, the patient's chart
				shall include a consent form signed by the patient reflecting selection of such
				an option. The consent form shall include the patient's acknowledgment that
				under the detoxification protocol the strength of maintenance doses of
				methadone should decrease over time; that the treatment should be limited to a
				defined period of time in accordance with national guidelines; and that the
				patient is required to work toward a drug-free lifestyle.
38.5. The estimated time of time of titration
				required to reach the point of elimination of the medication shall be specified
				by the physician and documented in the patient's individualized treatment plan
				of care of care. The titration schedule may be modified at any time. Any
				extension or modification of the titration schedule shall be documented in the
				patient's individualized treatment plan of care of care and chart.
38.6. The program physician shall determine
				on an individualized basis the appropriate dosage of opioid treatment
				medication to ensure stabilization during detoxification. The determination
				shall be based upon individual clinical data in accordance with guidelines and
				protocols established by approved authorities.
38.7. Exceptions to treatment guidelines or a
				patient's refusal to participate in the program shall be documented and tracked
				by the program.
38.8. Urine and/or
				other toxicological screening instruments shall be used by the opioid program
				staff during detoxification treatment in order to demonstrate the absence of
				use of alternative licit and/or illicit drugs.
38.9. The opioid treatment program shall have
				a policy regarding recovery-oriented detoxification treatment from opioid
				treatment medication that shall include:
38.9.a. Individualized determination of a
				schedule of detoxification that is well tolerated by the patient and consistent
				with approved national guidelines and sound medical practices;
38.9.b. Implementation of a higher
				stabilizing dose in the event of impending relapse as appropriate and
				possible;
38.9.c. Assurances that
				voluntary detoxification shall be discontinued in the event of relapse and that
				provisions for maintenance treatment shall be made;
38.9.d. Evaluation and/or testing for
				pregnancy prior to detoxification; and
38.9.e. Provision for continuing care after
				the last dose of methadone or other treatment medication.