Authority: IC 12-23-1-6; IC 12-23-18

Affected: IC 12-23-18-1; IC 12-23-18-2.5

Sec. 22. (a) An OTP shall do the following:

1. (1) Use medically recognized drug testing protocols:

   1. (A) to determine legitimate treatment use; and
   2. (B) as a clinical tool for the purpose of diagnosis and treatment planning.
2. (2) Perform all drug testing as specified in this section.
3. (3) Have written procedures for drug testing, including protocols to assure the chain of custody of bodily fluid samples.
4. (4) Contract for drug testing only with a laboratory that is in compliance with all applicable federal proficiency testing and licensing standards.
5. (5) Require an OTP staff person to observe each patient's provision of a bodily fluid sample for drug testing to assure that a false sample is not provided by the patient.

(b) The results of all drug tests shall be recorded in the patient's record.

(c) An OTP shall periodically and randomly test a patient, including before receiving treatment, for the following:

1. (1) Methadone.
2. (2) Cocaine.
3. (3) Opiates.
4. (4) Amphetamines.
5. (5) Barbiturates.
6. (6) Tetrahydrocannabinol.
7. (7) Benzodiazepines.
8. (8) Any other suspected or known drug that may have been abused by the patient.

(d) A patient shall have a drug test under this section at the following times:

1. (1) After admission but before the patient receives treatment medication.
2. (2) At least eight (8) times during each twelve (12) month period after the patient's admission.
3. (3) As required under subsection (f) following a positive drug test.

(e) The OTP and a patient shall comply with the requirements of subsection (f) if the patient tests positive for any of the following:

1. (1) A controlled substance for which the patient does not have a prescription.
2. (2) A controlled substance that is not part of the patient's treatment plan at the OTP.
3. (3) An illegal drug other than a drug that is part of the patient's treatment plan at the OTP.

(f) If a patient tests positive under a test for a controlled substance or an illegal drug that is not allowed under subsection (e), the following provisions shall be met:

1. (1) The OTP shall refer the patient to the on-site physician for a clinical evaluation that shall be conducted not more than ten (10) days after the date of the patient's positive test.
2. (2) The physician shall consult with medical and behavioral staff at the OTP to conduct the evaluation.

3. (3) The clinical evaluation shall recommend a remedial action for the patient that may include either of the following:

   1. (A) Discharge from the OTP.
   2. (B) Amending the patient's treatment plan to require a higher level of supervision.

4. (4) The OTP may not allow the patient to take any opioid treatment medications from the facility for self-administration until the patient has:

   1. (A) completed the clinical evaluation under this subdivision; and
   2. (B) passed a random test.

5. (5) The patient shall do the following:

   1. (A) Attend the OTP daily until the on-site physician, after consultation with the medical and behavioral staff, determines that daily treatment is no longer necessary.
   2. (B) Take a weekly random test until the patient passes a test under this subdivision.

(g) The results of a single drug test shall not be the sole basis for making significant treatment decisions; provided, however, that this subsection shall not exempt an OTP from complying with the requirements of this section.

(Division of Mental Health and Addiction; 440 IAC 10-4-22; filed Dec 30, 2009, 2:00 p.m.: 20100127-IR-440080412FRA; readopted filed May 10, 2016, 11:24 a.m.: 20160608-IR-440160134RFA; readopted filed Nov 9, 2022, 4:31 p.m.: 20221207-IR- 440220292RFA)