West Virginia Code of State Rules › Agency 69 - Health And Human Resources › Title 69 - LEGISLATIVE RULE DEPARTMENT OF HEALTH AND HUMAN RESOURCES › Series 69-11 - Medication-Assisted Treatment - Opioid Treatment Programs › Section 69-11-31 - Detoxification Program

Current through Register Vol. XLI, No. 28, July 12, 2024
31.1. In
				addition to recovery-oriented medication-assisted treatment services, each MAT
				program shall provide both long-term and short-term detoxification recovery
				treatment services, either onsite or by referral. The program physician or a
				physician extender shall provide onsite medical supervision and oversight of
				the detoxification treatment program. If detoxification treatment is provided
				by referral, the program physician shall maintain documentation and
				communication with the referred detoxification program and keep such
				documentation in the patient's record.
31.2. 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.
31.3. Patients
				with two or more unsuccessful detoxification episodes within a 12-month period
				must be assessed by the MAT program physician for other forms of treatment. A
				program shall not admit a patient for more than two detoxification treatment
				episodes in one year. One year of physiologic dependence is not required for
				detoxification treatment although documentation of current dependency is
				required.
31.4. 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 acknowledgement that
				under the detoxification protocol the strength of maintenance doses of
				medication-assisted treatment medications should decrease over time; that the
				treatment period should be in accordance with national guidelines; and that the
				patient is required to work toward a recovery-oriented lifestyle.
31.5. The estimated time of detoxification
				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. 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 and chart.
31.6. The program physician shall determine
				on an individualized basis the appropriate dosage of medication-assisted
				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.
31.7. Exceptions to treatment guidelines or a
				patient's refusal to participate in the program shall be documented and tracked
				by the program.
31.8. Urine or
				other toxicological screening instruments shall be used by the MAT program
				staff during detoxification treatment in order to demonstrate the absence of
				use of alternative licit or illicit drugs.
31.9. The MAT program shall develop and
				implement a policy regarding recovery-oriented detoxification treatment from
				medication-assisted treatment medication that shall include:
31.9.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;
31.9.b. Implementation of a higher
				stabilizing dose in the event of impending relapse as appropriate and
				possible;
31.9.c. Assurances that
				voluntary detoxification shall be discontinued in the event of relapse and that
				provisions for maintenance treatment shall be made;
31.9.d. Evaluation or testing for pregnancy
				prior to detoxification; and
31.9.e. Provision for continuing care after
				the last dose of methadone or other medication-assisted treatment
				medication.