Section 4731-33-04 - Medication-assisted treatment using naltrexone(A) In addition to the requirements of paragraphs (A) to (E) of rule 4731-33-03 of the Administrative Code, the physician using naltrexone to treat opioid use disorder shall comply with the following requirements:(1) Before initiating naltrexone, the physician shall take measures to ensure that the patient is opioid abstinent for an adequate period of time after completing opioid withdrawal to avoid precipitated withdrawal. The physician shall alert the patient of the risk of potentially lethal opioid overdose if they stop naltrexone and use opioids.(2) The physician shall use oral naltrexone only for treatment of patients 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 qualified behavioral healthcare provider, as defined in rule 4731-33-01 of the Administrative Code, who has the education and experience to provide substance use disorder counseling.(B) The physician may treat a patient with extended-release naltrexone for opioid or alcohol dependence or for co-occurring opioid and alcohol use disorders. (1) The physician should consider treatment with extended-release naltrexone for patients who have difficulties with treatment adherence.(2) The dosage shall strictly comply with the United States food and drug administration approved labeling for extended-release naltrexone.(3) The physician shall determine the effectiveness of treatment with extended-release naltrexone by utilizing drug testing, serum medication levels, and oral fluid testing throughout the course of treatment.(4) 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 use disorder counseling. Replaces: 4731-33-04
Ohio Admin. Code 4731-33-04
Effective: 10/31/2024
Five Year Review (FYR) Dates: 10/31/2029
Promulgated Under: 119.03
Statutory Authority: 4731.05, 4731.056
Rule Amplifies: 4731.056, 4731.83
Prior Effective Dates: 04/30/2019