My decisions to revoke take home doses provoke more anger and outrage from my patients than anything else I do. This is a sensitive issue.
To understand their fury at losing take home doses, I need to describe how hard it is to get those take homes in the first place. Patients don’t waltz into treatment and get take home doses right away.
For patients on methadone at opioid treatment programs, (OTPs), eight criteria must be met before the patient can get any take home doses.
1. Time in treatment
2. Urine drug screens negative for illicit drugs and alcohol
3. Ability to store medication safely
4. Stable home environment, stable social relationships
5. No recent criminal activities
6. Regular clinic attendance – doesn’t frequently miss days
7. No behavioral problems at the opioid treatment program
8. Rehabilitative benefits of take homes outweigh the risk of take homes
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