24 Miss. Code. R. 2-53.6 - Withdrawal Management
A. Medically
supervised withdrawal management from a synthetic narcotic with a continuum of
care must be a part of the treatment protocol for the OTP. The program must
develop, implement, maintain, and document implementation of written policies
and procedures that include, at a minimum:
1.
A process for voluntary medically supervised withdrawal that shall:
(a) Acknowledge that participation in the OTP
is voluntary and that the person is free to leave treatment at any
time;
(b) Identify the steps to be
taken by the program when a person and program employee agree on a need to
initiate the withdrawal procedures;
(c) Identify the steps to be taken by the
program when a person requests withdrawal against the medical advice of the
program employee; and
(d) Ensure
availability of a variety of supportive options to improve the chances of a
successful episode of medically supervised withdrawal.
2. A process for involuntary medically
supervised withdrawal that shall:
(a) Identify
the circumstances under which involuntary administrative withdrawal procedures
will be implemented;
(b) Identify
the steps to be taken to delineate the responsibilities of program employees in
implementation of involuntary administrative withdrawal procedures;
(c) Ensure availability of a variety of
supportive options to improve the chances of a successful episode of medically
supervised withdrawal; and
(d)
Provide for the referral or transfer of the person to an appropriate treatment
program upon completion of the withdrawal process.
3. The program Medical Director shall approve
all requests for voluntary and involuntary withdrawal from an OTP.
4. The Medical Director shall establish a
person's withdrawal dosage schedule in accordance with sound medical treatment
and ethical considerations and based on an objective assessment of each
person's unique needs.
5. Each
person's withdrawal schedule shall be for a time period of not less than 30
days, unless otherwise clinically contraindicated with supporting documentation
from the Medical Director.
6.
Take-home medication shall NOT be allowed during medically supervised
withdrawal.
7. A history of one (1)
year of physiological dependence shall not be required for admission to an
Opioid Treatment Program for supervised withdrawal.
8. People who have two (2) or more
unsuccessful detoxification episodes within a 12-month period shall be assessed
by the program Medical Director for other forms of treatment.
9. A service shall not admit a person for
more than two (2) detoxification episodes in one (1) year.
10. Drug screens during detoxification shall
be performed as follows:
(a) An initial drug
screen shall be performed at the beginning of the detoxification
process.
(b) At least one (1)
random drug screen shall be performed monthly during the detoxification
process.
11. Decreasing
the dose of the synthetic narcotic to accomplish gradual, but complete
withdrawal, within the tolerance level of the person.
12. Therapy of the type and quantity designed
to motivate the continuation of the withdrawal process.
13. Assurance that voluntary withdrawal would
be discontinued, and maintenance resumed in the event of impending
relapse.
14. Provisions for the
continuance of care after the completion of withdrawal.
B. Documentation must be maintained regarding
the person's condition during the total withdrawal process to include:
1. Signs and symptoms of medical and
emotional distress;
2. Actions
taken to avoid discharge; and
3.
Progress of the person served.
Notes
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