1. (a) OTPs shall develop and maintain written policies and procedures that are adequate to ensure that the following dosage form and initial dosing requirements are met:

   1. (1) Methadone shall be administered or dispensed only in oral form and shall be formulated in such a way as to reduce its potential for parenteral abuse.
2. (2) For each new person served enrolled in an OTP, the initial dose of methadone shall be individually determined and shall include consideration of the type(s) of opioid(s) involved in the individual's opioid use disorder, other medications or substances being taken, medical history, and severity of opioid withdrawal.

3. (3) The total dose for the first day should not exceed fifty (50) milligrams unless the OTP practitioner, licensed under the appropriate State law and registered under the appropriate State and Federal laws to administer or dispense MOUD, finds sufficient medical rationale, including but not limited to if the individual is transferring from another OTP on a higher dose that has been verified, and documents in the clinical record that a higher dose was clinically indicated.

   1. (4) Buprenorphine may be administered in tablet or sublingual form.
   2. (5) Initial and later treatment dosing shall be determined by the medical director and according to best medical practice.

4. (b) Compliance with 450:70-3-5.16 may be determined by:

   1. (1) A review of policies and procedures,
   2. (2) Treatment records, and
   3. (3) Other facility documentation.

Added at 30 Ok Reg 1425, eff 7-1-13

Amended at 34 Ok Reg 1830, eff 10-1-17

Amended at 40 Ok Reg 1079, eff 9-15-23

Amended at 42 Ok Reg, Number 20, effective 9-1-25