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 69-7-41 - Toxicology Screens

Current through Register Vol. XLI, No. 28, July 12, 2024
41.1. All
				patients in the opioid treatment program shall undergo monthly drug testing.
				Random drug testing of all patients shall be conducted during the course of
				treatment at least monthly.
41.2.
				Collection and Testing.
41.2.a. Opioid
				treatment programs shall work carefully with toxicology laboratories to ensure
				valid, appropriate results of toxicological screens. Workplace testing
				standards are not appropriate for urine testing. Testing shall be done only by
				laboratories with appropriate federal certification.
41.2.b. Each opioid treatment program shall
				have the capability of obtaining medication blood levels when clinically
				indicated or through random or monthly drug testing of all patients.
41.2.c. Urine drug screening and other
				adequately tested toxicological procedures shall be used as an aid in
				monitoring and evaluating a patient's progress in treatment.
41.2.d. Drug screening procedures shall be
				determined on an individualized basis for each patient, subject to the
				following requirements:
41.2.d.1. A patient
				receiving methadone maintenance services must have at least twelve random drug
				screens per year. The patient shall be tested upon admission; at approximately
				fourteen days of treatment; and then monthly through the remainder of the time
				the patient remains in the treatment program.
41.2.d.2. A patient undergoing
				medically-supervised or other types of withdrawal may be required to have more
				frequent collection and analysis of samples.
41.2.d.3. When using urine as a screening
				mechanism, all patient drug testing shall be observed to minimize the chance of
				adulterating or substituting another individual's urine.
41.2.e. Drug screenings shall include
				toxicological analysis for drugs of abuse, including, but not limited to:
41.2.e.1. Opiates including oxycodone at
				common levels of dosing;
41.2.e.2.
				Methadone or any other medication used by the program as an intervention for
				that patient;
41.2.e.3.
				Benzodiazepines (including testing procedures that detect diazepam, clonazepam,
				alprazolam and lorazepam);
41.2.e.4. Cocaine;
41.2.e.5. Meth-amphetamine/
				amphetamines;
41.2.e.6.
				Tetrahydrocannabinol, delta-9-tetrahydrocannabinol, dronabinol or other similar
				substances; or
41.2.e.7 Other drugs
				or substances as determined by community standards, regional variation or
				clinical indication, such as carisoprodol or barbiturates.
41.2.f. Collection and testing shall be done
				in a manner that assures a method of confirmation for positive results and
				documents the chain of custody of the collection.
41.2.g. When necessary and appropriate,
				breathalyzers or other testing equipment may be used to screen for possible
				alcohol abuse. No individual shall receive a daily dose who has a breathalyzer
				result which is equal to or greater than .02. The individual may return to the
				clinic for dosing during the same day if the breathalyzer results reach
				acceptable limits.
41.2.h. Each
				opioid treatment program shall document both the results of toxicological tests
				and the follow-up therapeutic action taken in the patient record.
41.2.i. Each opioid treatment program shall
				ensure that physicians demonstrate competence in interpretation of "false
				negative" and "false positive" laboratory results as they relate to
				physiological issues, differences among laboratories, and factors that impact
				the absorption, metabolism and elimination of opiates.
41.2.j. The program physician shall
				thoroughly evaluate a positive toxicological screen for any potentially licit
				substance such as benzodiazepines, carisoprodol, barbiturates and amphetamines.
				The program shall verify with appropriate releases of information that:
41.2.j.1. The patient has been prescribed
				these medications by a licensed physician for a legitimate medical purpose;
				and
41.2.j.2. The prescribing
				physician is aware that the patient is enrolled in an opioid treatment
				program.
41.2.k. If a
				patient refuses the release of information to contact his or her physician but
				can produce prescriptions and/or other evidence of legitimate prescription
				(such as current medication bottles, fully labeled), the interdisciplinary team
				shall consider the patient's individual situation and the possibility that he
				or she may be dismissed from the care of his or her physician if the physician
				discovers that the patient is in medication-assisted treatment. The program
				physician shall make the ultimate decision as to the patient's continuing care
				in the clinic and the circumstances of that care.
41.2.l. Nothing contained in this rule shall
				preclude any opioid treatment program from administering any additional drug
				tests it determines are necessary.