POTENT POTABLES
What 2 medications is suboxone consist of?
buprenorphine & naloxone
When should the adulteration test be perform on the UDS test panel?
between 2 - 5 minutes
How many das off treatment must a client miss before they are officially discharged? What are the steps taken for them to be able to restart?
21 days.
If a client is less than 12 months off treatment, they can restart with a UDS & updated demographics.
If over 12 months off treatment, they can restart by seeing the intake coordinator for psychosocial & demographic updates, a UDS, and signing a consent form and partnership agreement.
How can clients increase from weekly dispensing to alternate week dispensing?
Complete 2 monthly UDS with expected results.
Name 2 reasons why urine is tested prior to a LAIB injection.
substances on board & pregnancy
Microdosing - what is it and why do it?
To switch from one medication to another to avoid withdrawal.
How much urine is required in a specimen bottle?
Enough to reach above the temperature strip.
What is PPA, when is it used, and when does it expire?
Protection of Property Act
Used when clients have displayed violence toward staff/clients/property.
PPAs expire after 6 months.
What is the dispensing process to reach weekly dispensed SROM?
1 additional carry per month that are non-consecutive until they reach 4 dispensed doses where they can obtain 2 consecutive doses.
When can the UDS bathroom be used?
When completing a UDS, when a client is waiting for the doctor, support people who are waiting with clients.
At what dosage of what medication might a doctor request an EKG be performed prior to a dose increase?
Methadone, 120mg
Name two instances a UDS is sent to lab.
Unexpected UDS results & prescribed medication not present in test results
What is the protocol for an involuntary discharged client to renter treatment?
Must be a minimum of six months since discharge
Intake Coordinator presents client to the team for approval
What is the maximum length of time allowed for a doctor to write a buprenorphine Rx for a LAIB client between injections?
1 week
Who brings forward client appeal requests during case conference?
When is a SROM client eligible for take home doses?
6 months on treatment, 4 weeks on stable SROM doses, no incident reports from the pharmacy, stable housing, access to communicate with team through email or phone, has a lockbox.
When and how should UDS results be documented?
On the same day of testing. First in the UDS binder, and then input into the client's chart
Why would a client, who was involuntarily discharged, not be allowed to return to Direction 180 services?
A full team decision based on the severity of the involuntary discharge, specifically Verbal/physical acts of violence towards staff
Who assess the microdosing process in real time?
The client at home with instruction from the prescribing doctor.
What are the steps taken when an unknown substance is found on the premises?
Place item in envelope with date and sign, complete unknown substance found form, hand form and envelope to RN who will secure in office until it is handed off to the pharmacy staff.
Name the new methadone policy qualifications to increase for each dispensing frequency.
Alt day after 4 weeks of treatment with coc, amp, and opi use as well as benzo Rx
Twice weekly after 4 weeks of alt day with 1 random UDS with expected results
Weekly after 4 weeks of twice weekly with 1 random UDS with expected results
How many UDS in total does a client complete to reach weekly dispensed SROM
11
Explain the protocol when the team decides that a client is to be involuntarily discharged.
Intake coordinator connects with other OAT to secure transfer of care.
If the IC is unable to secure a transfer of care or if the client refuses this appointment, doctor should complete a wean Rx
2+ staff members meet with client and inform them of the decision & provides appointment to the transfer clinic or wean Rx.
Please explain the process when a client discloses lost of stolen methadone doses.
A mini team is held ort brought up in case conference to determine if doses will be replaced. If so, they will be daily witnessed until next pick up day.
The client will change to non-consecutive dispensing frequency for 4 weeks.
When they reach 4 weeks, the client should be brought forward to case conference so the team can reassess stability factors such as safe storage.
Please list all exceptions to client confidentiality.
safety of children - protection of others - court orders - suicidal ideation - driving while impaired - in emergency situations