[Code of Federal Regulations]

[Title 42, Volume 1]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR8.2]



[Page 55-57]

 

                         TITLE 42--PUBLIC HEALTH

 

    CHAPTER I--PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN 

                                SERVICES

 

PART 8_CERTIFICATION OF OPIOID TREATMENT PROGRAMS--Table of Contents

 

                         Subpart A_Accreditation

 

Sec. 8.2  Definitions.



    The following definitions apply to this part:

    Accreditation means the process of review and acceptance by an 

accreditation body.

    Accreditation body means a body that has been approved by SAMHSA 

under Sec. 8.3 to accredit opioid treatment programs using opioid 

agonist treatment medications.

    Accreditation body application means the application filed with 

SAMHSA for purposes of obtaining approval as an accreditation body, as 

described in Sec. 8.3(b).

    Accreditation elements mean the elements or standards that are 

developed and adopted by an accreditation body and approved by SAMHSA.

    Accreditation survey means an onsite review and evaluation of an 

opioid treatment program by an accreditation body for the purpose of 

determining compliance with the Federal opioid treatment standards 

described in Sec. 8.12.

    Accredited opioid treatment program means an opioid treatment 

program that is the subject of a current, valid accreditation from an 

accreditation body approved by SAMHSA under Sec. 8.3(d).

    Certification means the process by which SAMHSA determines that an 

opioid treatment program is qualified to provide opioid treatment under 

the Federal opioid treatment standards.

    Certification application means the application filed by an opioid 

treatment program for purposes of obtaining certification from SAMHSA, 

as described in Sec. 8.11(b).

    Certified opioid treatment program means an opioid treatment program 

that is the subject of a current, valid certification under Sec. 8.11.

    Comprehensive maintenance treatment is maintenance treatment 

provided in conjunction with a comprehensive range of appropriate 

medical and rehabilitative services.

    Detoxification treatment means the dispensing of an opioid agonist 

treatment medication in decreasing doses to an individual to alleviate 

adverse physical or psychological effects incident to withdrawal from 

the continuous or sustained use of an opioid drug and as a method of 

bringing the individual to a drug-free state within such period.

    Federal opioid treatment standards means the standards established 

by the



[[Page 56]]



Secretary in Sec. 8.12 that are used to determine whether an opioid 

treatment program is qualified to engage in opioid treatment. The 

Federal opioid treatment standards established in Sec. 8.12 also 

include the standards established by the Secretary regarding the 

quantities of opioid drugs which may be provided for unsupervised use.

    For-cause inspection means an inspection of an opioid treatment 

program by the Secretary, or by an accreditation body, that may be 

operating in violation of Federal opioid treatment standards, may be 

providing substandard treatment, or may be serving as a possible source 

of diverted medications.

    Interim maintenance treatment means maintenance treatment provided 

in conjunction with appropriate medical services while a patient is 

awaiting transfer to a program that provides comprehensive maintenance 

treatment.

    Long-term detoxification treatment means detoxification treatment 

for a period more than 30 days but not in excess of 180 days.

    Maintenance treatment means the dispensing of an opioid agonist 

treatment medication at stable dosage levels for a period in excess of 

21 days in the treatment of an individual for opioid addiction.

    Medical director means a physician, licensed to practice medicine in 

the jurisdiction in which the opioid treatment program is located, who 

assumes responsibility for administering all medical services performed 

by the program, either by performing them directly or by delegating 

specific responsibility to authorized program physicians and healthcare 

professionals functioning under the medical director's direct 

supervision.

    Medical and rehabilitative services means services such as medical 

evaluations, counseling, and rehabilitative and other social programs 

(e.g., vocational and educational guidance, employment placement), that 

are intended to help patients in opioid treatment programs become and/or 

remain productive members of society.

    Medication unit means a facility established as part of, but 

geographically separate from, an opioid treatment program from which 

licensed private practitioners or community pharmacists dispense or 

administer an opioid agonist treatment medication or collect samples for 

drug testing or analysis.

    Opiate addiction is defined as a cluster of cognitive, behavioral, 

and physiological symptoms in which the individual continues use of 

opiates despite significant opiate-induced problems. Opiate dependence 

is characterized by repeated self-administration that usually results in 

opiate tolerance, withdrawal symptoms, and compulsive drug-taking. 

Dependence may occur with or without the physiological symptoms of 

tolerance and withdrawal.

    Opioid agonist treatment medication means any opioid agonist drug 

that is approved by the Food and Drug Administration under section 505 

of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) for use in 

the treatment of opiate addiction.

    Opioid drug means any drug having an addiction-forming or addiction-

sustaining liability similar to morphine or being capable of conversion 

into a drug having such addiction-forming or addiction-sustaining 

liability.

    Opioid treatment means the dispensing of an opioid agonist treatment 

medication, along with a comprehensive range of medical and 

rehabilitative services, when clinically necessary, to an individual to 

alleviate the adverse medical, psychological, or physical effects 

incident to opiate addiction. This term encompasses detoxification 

treatment, short-term detoxification treatment, long-term detoxification 

treatment, maintenance treatment, comprehensive maintenance treatment, 

and interim maintenance treatment.

    Opioid treatment program or ``OTP'' means a program or practitioner 

engaged in opioid treatment of individuals with an opioid agonist 

treatment medication.

    Patient means any individual who undergoes treatment in an opioid 

treatment program.

    Program sponsor means the person named in the application for 

certification described in Sec. 8.11(b) as responsible for the 

operation of the opioid treatment program and who assumes responsibility 

for all its employees, including any practitioners, agents, or



[[Page 57]]



other persons providing medical, rehabilitative, or counseling services 

at the program or any of its medication units. The program sponsor need 

not be a licensed physician but shall employ a licensed physician for 

the position of medical director.

    Registered opioid treatment program means an opioid treatment 

program that is registered under 21 U.S.C. 823(g).

    Short-term detoxification treatment means detoxification treatment 

for a period not in excess of 30 days.

    State Authority is the agency designated by the Governor or other 

appropriate official designated by the Governor to exercise the 

responsibility and authority within the State or Territory for governing 

the treatment of opiate addiction with an opioid drug.

    Treatment plan means a plan that outlines for each patient 

attainable short-term treatment goals that are mutually acceptable to 

the patient and the opioid treatment program and which specifies the 

services to be provided and the frequency and schedule for their 

provision.