Recommended Changes in Federal and State Oversight for OTPs 

 

Currently, many organizations are being compelled to focus on changing policies to make take-home medication more flexible for patients, both stable and unstable, during the COVID-19 pandemic. A good deal has been written about the complexity and comprehensive nature of SAMHSA’s regulations and guidelines for OTPs, especially in the March 2015 Federal Guidelines for OTPs and the fact that it is 79 pages in length. OTPs have followed these guidelines since the SAMHSA regulations were published in 2015 and when SAMHSA released its OTP regulations during May 2001. For the most part, they provide guidance to the field, based on years of proven clinical practice standards and evidence-based care. While they are extremely detailed and should be considered for some modification, as a whole, they provide useful guidance to the field.  

 

The existing SAMHSA criteria in determining take-home doses should be cautiously reevaluated even though the existing requirements appear to be reasonable and based on years of clinical practice. It is also reasonable to change the current regulation paradigm, which cites that the medical director is making the determination of the patient’s ability to receive take-home medication and expanding this decision-making responsibility to program medical practitioners to make such determinations.  

 

SAMHSA criteria for patient take-home doses 

(i) Absence of recent abuse of drugs (opioid or nonnarcotic), including alcohol; 

(ii) Regularity of clinic attendance; 

(iii) Absence of serious behavioral problems at the clinic; 

(iv) Absence of known recent criminal activity, e.g., drug dealing; 

(v) Stability of the patient’s home environment and social relationships; 

(vi) Length of time in comprehensive maintenance treatment;  

(vii)  Assurance that take-home medication can be safely stored within the patient’s home and 

(viii) Whether the rehabilitative benefit the patient derived from decreasing the frequency of clinical attendance outweighs the potential risks of diversion. 

 

Some states currently require that OTPs be open seven days a week, especially in treating newly admitted or unstable patients. Once again, changes in federal regulations should be woven into the policy tapestry and aligned with state regulatory agencies and reimbursement entities.  AATOD recommends that SAMHSA work with State Alcohol and Drug Abuse Authorities in addition to the State Opioid Treatment Authorities to provide greater flexibility in how OTPs provide take-home medication based on the lessons learned during COVID-19. Current regulatory criteria with regard to time and treatment, to be eligible for take-home medication, must be carefully reevaluated.  

 

Additionally, a review of state regulatory policies is needed regarding staffing to patient ratios, the use of pharmacists in preparing onsite and take-home medications, and the use of lockboxes when patients do get take-home medication. The use of lockboxes creates a number of difficulties for the patient, especially since it becomes more obvious to other parties that the patient is carrying such a box. If the treatment program trusts that the patient will use such take-home medication appropriately, the use of a lockbox becomes questionable. Obviously, the circumstances are different if clinically unstable patients are being provided with take-home medication. This is why such regulatory issues need to be better resolved. 

 

@aatod1984
  • Patient access to OTPs saves lives every day.

AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. 

Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
  • Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. 

“Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA 

Read More ➡️ bit.ly/3tKb1gy
  • Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
  • Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. 

Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. 

Register ➡️ bit.ly/461CkkG
  • Final Opportunity to Submit Proposals for the #aatod2024 Conference. The submission window will close tonight at 12am ET.

To submit a proposal, please follow the on-screen instructions, bit.ly/3KxQSzU. For questions or additional information regarding the Call for Presentations, please send an email to meetings@aatod.org or call 856-423-3091.

We look forward to receiving your submissions and hope to see you at the conference for what will be the premier conference on the treatment of opioid use disorders in 2024! #morethanmedicine #programnotapill #opioids #OUD #OpioidUseDisorder #submitproposal
  • Today is the Final Day to Submit Proposals for the #aatod2024 conference, 9/21 ➡️ bit.ly/3KxQSzU

The Workshop Committee encourages you to submit proposals on innovative initiatives to enhance patient outcomes, improve program development and administration, promote integration across the continuum of care, and the development of collaborations with organizations outside of the traditional opioid treatment system.

Conference Objectives:
1️⃣Conduct a comprehensive review of the latest evidence addressing the opioid epidemic and its implications for patients, clinicians, administrators, and policy makers by identifying the most effective interventions.
2️⃣Discuss peer to peer approaches in treating opioid use disorder in an effort to improve patient outcomes in health systems, organizations, and communities.
3️⃣Evaluate the gaps in current services for opioid use disorder and develop recommendations to improve the delivery of multidisciplinary care in various populations based upon evidence-based practices.
4️⃣Disseminate a comprehensive plan of innovative services designed to treat emerging needs of patients with opioid use disorder and improve patient outcomes by providing examples of effective methods and how to implement them.
5️⃣Identify effective referral pathways to other health services offering treatment for conditions associated with opioid use disorder addiction and/or recovery by developing partnerships within the community.
  • We are pleased to announce that the deadline for submitting presentations for the #aatod2024 Conference has been extended to Thursday, September 21, 2023.

We encourage all interested parties to take advantage of this opportunity and submit their proposals as soon as possible. We look forward to receiving your proposals and to seeing you in Las Vegas in 2024. 

https://conta.cc/3PiV5ck
  • August 31st is International Overdose Awareness Day 
💜 #IOAD2023 
💜 #NaloxoneSavesLives 
💜 #EndOverdoseNow

Please contact your State Opioid Treatment Authority for locations in your community that distribute naloxone kits —> bit.ly/3qVPOPz. 

 Full Video 🎥 bit.ly/3ElzdYD
  • Research shows methadone maintenance is more effective when it includes counseling—and even more so with medical or psychosocial services, like employment or family assistance. This is a key piece of #MAT for #OUD. More info: https://lnkd.in/ehYFCRvu 
#PNAP #ProgramNotaPill
  • Quick Reminder - Our committee deadline for #aatod2024 Conference related presentations is fast approaching on Monday, September 18th. We are encouraging you to submit your presentations since it will certainly contribute to an information-packed conference event.
Patient access to OTPs saves lives every day.

AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. 

Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
Patient access to OTPs saves lives every day. AATOD has been working with policymakers and regulatory authorities to increase access to opioid treatment programs (OTPs) though the expansion of mobile vans and Medication Assisted Treatment in correctional facilities in the United States. Please support AATOD's mission by making an online donation ➡️ https://bit.ly/3uDOeDC #givingtuesday
1 week ago
View on Instagram |
1/10
Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. 

“Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA 

Read More ➡️ bit.ly/3tKb1gy
Lev Facher represented a fair reporting of the current #methadone policy debate that took place at last week’s #STATSummit. “Mark Parrino, AATOD’s founder and president, cautioned during the panel that achieving sweeping change might not be so easy. The health system, he argued, is unprepared and even unwilling to make methadone a part of primary care. Potential obstacles, he said, include doctors’ lack of enthusiasm about prescribing methadone; pharmacists’ unwillingness to stock and dispense it; and drug manufacturers’ reluctance to manufacture and distribute it more widely, especially following the lawsuits and criticism many have experienced in the wake of the opioid crisis and the prescription opioid oversupply that accelerated it.” #morethanmedicine #opioidusedisorder #OpposetheMOTAA Read More ➡️ bit.ly/3tKb1gy
2 months ago
View on Instagram |
2/10
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. 

This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery.

Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1

For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
Earn up to 6 LADC & LPC CEU’s at 9th Annual OKATOD Conference, which is convening this Thursday, Oct 12th in Oklahoma City. This year, the focus turns to the paramount theme of #harmreduction and its profound role in ushering transformative pathways to #recovery. Registration is now officially open, and you can secure your tickets promptly ➡️ bit.ly/45l3mm1 For more information, please visit www.okatod.org or send an email to a_rios@oktreatment.com.
2 months ago
View on Instagram |
3/10
Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. 

Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. 

Register ➡️ bit.ly/461CkkG
Join OKATOD, one of AATOD’s state chapters, in Oklahoma City on Oct 12 as they convene their ninth annual OKATOD Conference. This year’s theme is HARM REDUCTION: A TRANSFORMATIVE APPROACH. Speakers include Mark Parrino (AATOD President), Maia Szalavitz, Teresa Stephensen, Dr. Larry Lovelace, Angela Harnden, Shajine Blake, and Jason Hall. Register ➡️ bit.ly/461CkkG
3 months ago
View on Instagram |
4/10
Final Opportunity to Submit Proposals for the #aatod2024 Conference. The submission window will close tonight at 12am ET. To submit a proposal, please follow the on-screen instructions, bit.ly/3KxQSzU. For questions or additional information regarding the Call for Presentations, please send an email to meetings@aatod.org or call 856-423-3091. We look forward to receiving your submissions and hope to see you at the conference for what will be the premier conference on the treatment of opioid use disorders in 2024! #morethanmedicine #programnotapill #opioids #OUD #OpioidUseDisorder #submitproposal
3 months ago
View on Instagram |
5/10
Today is the Final Day to Submit Proposals for the #aatod2024 conference, 9/21 ➡️ bit.ly/3KxQSzU The Workshop Committee encourages you to submit proposals on innovative initiatives to enhance patient outcomes, improve program development and administration, promote integration across the continuum of care, and the development of collaborations with organizations outside of the traditional opioid treatment system. Conference Objectives: 1️⃣Conduct a comprehensive review of the latest evidence addressing the opioid epidemic and its implications for patients, clinicians, administrators, and policy makers by identifying the most effective interventions. 2️⃣Discuss peer to peer approaches in treating opioid use disorder in an effort to improve patient outcomes in health systems, organizations, and communities. 3️⃣Evaluate the gaps in current services for opioid use disorder and develop recommendations to improve the delivery of multidisciplinary care in various populations based upon evidence-based practices. 4️⃣Disseminate a comprehensive plan of innovative services designed to treat emerging needs of patients with opioid use disorder and improve patient outcomes by providing examples of effective methods and how to implement them. 5️⃣Identify effective referral pathways to other health services offering treatment for conditions associated with opioid use disorder addiction and/or recovery by developing partnerships within the community.
3 months ago
View on Instagram |
6/10
We are pleased to announce that the deadline for submitting presentations for the #aatod2024 Conference has been extended to Thursday, September 21, 2023. We encourage all interested parties to take advantage of this opportunity and submit their proposals as soon as possible. We look forward to receiving your proposals and to seeing you in Las Vegas in 2024. https://conta.cc/3PiV5ck
3 months ago
View on Instagram |
7/10
August 31st is International Overdose Awareness Day 💜 #IOAD2023 💜 #NaloxoneSavesLives 💜 #EndOverdoseNow Please contact your State Opioid Treatment Authority for locations in your community that distribute naloxone kits —> bit.ly/3qVPOPz. Full Video 🎥 bit.ly/3ElzdYD
3 months ago
View on Instagram |
8/10
Research shows methadone maintenance is more effective when it includes counseling—and even more so with medical or psychosocial services, like employment or family assistance. This is a key piece of #MAT for #OUD. More info: https://lnkd.in/ehYFCRvu 
#PNAP #ProgramNotaPill
Research shows methadone maintenance is more effective when it includes counseling—and even more so with medical or psychosocial services, like employment or family assistance. This is a key piece of #MAT for #OUD. More info: https://lnkd.in/ehYFCRvu #PNAP #ProgramNotaPill
3 months ago
View on Instagram |
9/10
Quick Reminder - Our committee deadline for #aatod2024 Conference related presentations is fast approaching on Monday, September 18th. We are encouraging you to submit your presentations since it will certainly contribute to an information-packed conference event.
4 months ago
View on Instagram |
10/10

For this #GIVINGTUESDAY, please consider making a tax-deductible gift to AATOD, so that we can continue to expand access to quality #OUD treatment services, which has been our hallmark since 1984.
DONATE --> http://bit.ly/3uDOeDC
Patient access to #OTPs saves lives every day.

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2024 Conference Las Vegas

2024 Conference

AATOD, Inc.
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