02-383-12 Me. Code R. § 2
The Board is obligated under the laws of the State of Maine to protect the public health and safety. The Board recognizes that medical and advanced nursing practice dictate that the people of the State of Maine have access to appropriate, empathetic and effective treatment of opioid use disorder (OUD). This rule establishes minimum requirements for qualified Office Based Opioid Treatment (OBOT) clinicians to prescribe, and in limited circumstances, dispense approved medications to individuals requiring and seeking treatment for OUD.
The Board recognizes the body of evidence regarding the effectiveness of Approved Medications in the office based treatment of OUD, when such treatment is delivered in accordance with current standards of care, the requirements of the Drug Addiction Treatment Act of 2000 (DATA 2000), and this joint rule. Overdoses and deaths due to approved medications can occur and have been reported. Most overdoses, especially fatal ones, involve the concurrent use of another central nervous system (CNS) depressant such as benzodiazepines, other opioids, or alcohol. Approved Medications such as buprenorphine also pose a significant risk to non-tolerant individuals, especially children. The goal is to provide appropriate treatment of the patient's OUD (either directly or through referral), while adequately addressing other aspects of the patient's functioning, including co-occurring medical and psychiatric conditions and psychosocial issues.
The Board also recognizes the importance of appropriate training and education for clinicians providing OBOT. Clinicians providing OBOT are strongly encouraged to complete continuing education in OBOT and to review the published guidelines of SAMHSA and ASAM that are referenced in this rule, as the Board may use these guidelines, as well as other sources and outside expert reviews, as the standard of care when evaluating OBOT provided by clinicians.
The Board will evaluate allegations of inappropriate OBOT by referring to the rules, current clinical practice guidelines, and standards of care. Clinicians should not fear disciplinary action by the Board for providing OBOT if they are following standards of care, established guidelines and the requirements of this rule. Judgment regarding the propriety of any specific course of action must be based on all of the circumstances presented, and thoroughly documented in the patient's medical record.
02-383 C.M.R. ch. 12, § 2