OAR 415-020-0053: Unsupervised Use of Opioid Agonist Medications

(1) Any patient in comprehensive maintenance treatment may receive a single take-home dose for a day that the clinic is closed for business, including Sundays, and state or federal holidays. (2) Decisions on dispensing opioid treatment medications to patients for unsupervised use shall be made by the program medical director. In determining whether a patient is responsible in handling opioid medications and may be permitted unsupervised use, the medical director shall consider the following criteria; (a) Absence of drugs of abuse, including alcohol; (b) Regularity of program attendance; (c) Absence of serious behavioral problems at the program; (d) Absence of criminal activity while enrolled at the program; (e) Stability of the patient's home environment and social relationships; (f) Length of time in comprehensive maintenance treatment; (g) Assurance that take-home medication can be safely stored in the patient's home; and (h) Whether the rehabilitative benefit the patient derives from decreasing the frequency of program attendance outweighs the potential risks of diversion. (3) Decisions to approve unsupervised use of opioid medications, including the rationale for the approval, shall be documented in the patient record. (4) If it is determined that a patient is responsible in handling opioid agonist medications, the supply shall be limited to the following schedule; (a) During the first 90 days of treatment, the take-home supply is limited to a single dose each week, in addition to take-home doses allowed when the clinic is closed; (b) During the second 90 days of treatment, the take-home supply is limited to two doses per week, in addition to take-home doses allowed when the clinic is closed; (c) During the third 90 days of treatment, the take-home supply is limited to three doses per week, in addition to take-home doses allowed when the clinic is closed; (d) In the remaining months of the first year, a patient may be given a maximum 6-day supply of take-home medication; (e) After one year of continuous abstinence in treatment, a patient may be given a maximum two-week supply of take-home medication; (f) After two years of continuous abstinence treatment, a patient may be given a maximum one-month supply of take-home medication. (5) The dispensing restrictions set forth in 4(a) through 4(f) of this rule do not apply to the partial agonist opioid medication, buprenorphine and buprenorphine products. Patients must meet criteria established in 2(a) through 2(h) of this rule for unsupervised use of buprenorphine and buprenorphine products.