Opioid Treatment Programs

which act legalized the use of methadone for treatment of addiction

Narcotic Addict Treatment Act of 1974

what was required by the Narcotic Addict Treatment Act of 1974

practitioners who wished to conduct maintenance and detoxification treatment for addicts using controlled substances can only do so by being separately registered by the DEA as narcotic treatment programs

which products are currently approved for the treatment of narcotic addiction

methadone, levo-alpha-acetyl-methadol (LAAM), buprenorphine, and buprenorphine combination products

which administration is in charge of opioid treatment programs

Substance Abuse and Mental Health Services Administration (SAMHSA)

practitioners intending to treat opioid addiction must apply for a ______________________

certification

an OTP must be reaccredited and recertified every ______________

3 years

detoxification

dispensing of a narcotic drug in decreasing doses to an individual to alleviate adverse physiological or psychological effects incident to withdrawal from continuous/sustained use of a narcotic drug and as a method of bringing the individual to a narcotic free state

short term detoxification does not exceed _____________

30 days

long term detoxification period

30-180 days

maintenance treatment

dispensing for a period in excess of 21 days of a narcotic drug in the treatment of an individual for dependence upon heroin or other morphine-like drugs

methadone

synthetic narcotic analgesic (CII) used for treatment of severe pain and in detoxification of narcotic addiction in OTPs

any licensed pharmacy can dispense methadone but only for _______________ indication

analgesic

methadone 40 mg restriction

restricted to OTPs and is not indicated for pain management

T/F methadone can be dispensed in pharmacies only if indicated for detoxification of addicts if in the regular course of medical practice

F; it CANNOT be prescribed or dispensed for the maintenance or detoxification of addicts in the regular course of medical practice

act that provided an exception to the rule that controlled substances for addiction can only be prescribed and dispensed in an OTP

Drug Addiction Treatment Act (DATA)

Drug Addiction Treatment Act (DATA)

provides for office-based treatment of opioid dependent patients by amending the CSA to allow qualifying physicians to prescribe and dispense schedule III-V opioids that have been approved by the FDA for maintenance or detoxification treatment

Subutex

buprenorphine SL

Suboxone

buprenorphine/naloxone

"qualifying physician" under DATA

board certified in addiction psychiatry or addiction medicine and/or being trained for treating and managing patients with opioid use disorders

each qualifying physician may not treat more that ________ opioid dependent patients at a time for the first year under DATA

30

after 1 year, qualifying physician can submit a notification of the need and intent to treat up to _________ opioid dependent patients

100

physicians who have prescribed buprenorphine to 100 patients for at least 1 year can apply to increase their patient limit to ___________

275

DEA expanded prescribing privileges temporarily to qualified ___________________ and ___________________ under DATA (if state law permitted)

nurse practitioners, physician's assistants

prescriber must obtain _______________ to prescriber under DATA

special DEA number (DATA 2000 waiver ID or X number)

DEA number that allows prescriber to prescribe controlled substances for the treatment of addiction begins with _______

X

Subutex is intended for...

beginning treatment and will likely be administered by physicians from their offices directly to the patient

T/F pharmacists should contact the physician for verification if they receive a prescription for Suboxone

F; contact for Subutex

_____________ is intended for beginning of opioid addiction treatment whereas _____________ is preferred for long term therapy

Subutex; Suboxone

T/F pharmacists can accept prescriptions from multiple prescribers for opioid addiction treatment for one patient since multiple prescribers may work in collaboration for optimized treatment

F; pharmacist should refuse to fill the prescriptions and notify the prescribers

T/F it is illegal to fill a prescription for buprenorphine if the DEA does not begin with "X" to signify that the prescription is for addiction management

F; off-label prescribing for pain is not illegal and would not require a special DEA number

"three-day rule"

exception to prescriber registration requirement; allows prescribers that have not obtained a special DEA number to administer but not prescribe narcotic drugs to patients for the purpose of relieving acute withdrawal symptoms while arranging for the patient's referral for treatment

Congress authorized the medical community to treat addicts for their addiction in _____________ in response to...

1974 in response to skyrocketing heroin addiction

community pharmacies can only dispense methadone when prescribed for __________

pain

DATA allows for...

office based treatment of opioid dependent patients (rather than OTP)