Section 325.14416. Take-home methadone; determination of client responsibility.

(1) Take-home methadone shall only be given to a client who, in the reasonable   clinical  judgment  of  the   program  physician,   is responsible in the handling of methadone. Before reducing the frequency of clinic visits, the rationale for this decision shall be  recorded   in  the client's chart by a program physician or one  of his or her designated staff. If a physician's designated staff member records the rationale for the decision, a program physician shall review, countersign, and date the client's record. Additionally, take-home methadone shall only be dispensed in an oral, liquid form so as to minimize its potential for abuse.

(2)    It is recommended practice that this liquid vehicle be non-sweetened and contain a preservative so that a client can be instructed to keep take-home methadone out of the refrigerator in an attempt to minimize the likelihood of accidental overdoses by children  and   fermentation   of   the vehicle.

(3)   The program physician shall, in the exercise of his  or  her reasonable clinical judgment, utilize all of the following information  in determining whether or not  a  client  is  responsible   enough   to   handle take-home methadone:

(a)   Background and history of the client.

(b)   General and special characteristics of the client and the community in which the client resides.

(c)   Absence of recent abuse of non-narcotic drugs, including alcohol.

(d)   Absence of current abuse of non-narcotic drugs and alcohol and narcotic drugs, including methadone.

(e)   Regularity of clinic attendance.

(f)  Absence of serious behavioral problems in the clinic.

(g)   Stability of the client's home environment and social relationships.

(h)   Absence of recent criminal activity.

(i)   Length of time in methadone maintenance treatment.

(j)   Assurance that take-home medication can be safely stored at home.

(k)   Whether the rehabilitative benefit  to   the  patient  derived  from decreasing the frequency of clinic attendance  outweighs  the  potential risks of diversion.

History: 1981 AACS.