Professional Statements and Societal Positions Guidelines
42 CFR 8.12 - Federal opioid treatment standards 2017
An Opioid Treatment Programs (OTPs) organizational structure and facilities shall be adequate to ensure quality individual care and to meet the requirements of all pertinent Federal, State, and local laws and regulations. At a minimum, each OTP shall formally designate a program sponsor and medical director. The program sponsor shall agree on behalf of the OTP to adhere to all requirements set forth in this part and any regulations regarding the use of opioid agonist treatment medications in the treatment of opioid use disorder which may be promulgated in the future. The medical director shall assume responsibility for administering all medical services performed by the OTP. In addition, the medical director shall be responsible for ensuring that the OTP is in compliance with all applicable Federal, State, and local laws and regulations.
Centers for Disease Control and Prevention (CDC) 2016
- When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.
The guideline is intended to improve communication between clinicians and individuals about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death.
Substance Abuse and Mental Health Service Administration (SAMHSA) 2015
Medication-Assisted Treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-individual approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.
Federal legislation, regulations, and guidelines govern MAT for opioid addiction. SAMHSA's Division of Pharmacologic Therapies (DPT), part of the SAMHSA Center for Substance Abuse Treatment (CSAT), oversees accreditation standards and certification processes for OTPs. DPT also works with the Drug Enforcement Administration (DEA) and the states to regulate certain medications used in MAT. Additionally, DPT works directly with MAT professionals to improve treatment outcomes and to meet regulatory criteria.
American Society of Addiction Medicine (ASAM) 2017
Appropriate Use of Drug Testing in Clinical Addiction Medicine was published by ASAM in 2017.
- 'As a general principle, drug testing should be scheduled more frequently at the beginning of treatment. The Expert Panel recommends that an individual in early recovery be tested at least weekly. As the individual becomes more stable in recovery, the frequency of drug testing should be decreased, but performed at least on a monthly basis. Individual consideration may be given for less frequent testing if an individual is in stable recovery. If the individual returns to substance use after a period of abstinence, the provider should resume the early recovery testing schedule, possibly in conjunction with an adapted or intensified treatment plan.'
