Rule 4731-33-04 | Medication-assisted treatment using naltrexone.
(A) In addition to the requirements of paragraphs (A) to (F) of rule 4731-33-03 of the Administrative Code, the physician using naltrexone to treat opioid use disorder shall comply with all of the following requirements:
(1) Prior to treating a patient with naltrexone the physician shall inform the patient about the risk of opioid overdose if the patient ceases naltrexone and then uses opioids. The physician shall take measures to ensure that the patient is adequately detoxified from opioids and is no longer physically dependent prior to treatment with naltrexone.
(2) The physician shall use oral naltrexone only for treatment of patients who can be closely supervised and who are highly motivated.
(a) The dosage regime shall strictly comply with the food and drug administration approved labeling for naltrexone hydrochloride tablets.
(b) The patient shall be encouraged to have a support person administer and supervise the medication. Examples of a support person are a family member, close friend, or employer.
(c) The physician shall require urine drug screens,serum medication levels, or oral fluid drug testing at least every three months for the first year of treatment and at least every six months thereafter.
(d) The physician shall incorporate relapse prevention strategies into counseling or assure that they are addressed by a qualifed behavioral healthcare provider, as defined in rule 4731-33-01 of the Administrative Code, who has the education and experience to provide substance abuse counseling.
(B) The physician may treat a patient with extended-release naltrexone for opioid dependence or for co-occuring opioid and alcohol use disorders.
(1) The physician should consider treatment with extended-release naltrexone for patients who have issues with treatment adherence.
(2) The injections dosage shall strictly comply with the United States food and drug administration approved labeling for extended-release naltrexone.
(3) The physician shall incorporate relapse prevention strategies into counseling or assure that they are addressed by a qualified behavioral healthcare provider, as defined in rule 4731-33-01 of the Administrative Code, who has the education and experience to provide substance abuse counseling.
Supplemental Information