In a recent blog posting, Dr. Jana Burson discusses the process for determining if patients should be provided with extra take home doses for the days when travel will be treacherous. In North Carolina, a group of OTP physicians are re-evaluating criteria for extra take homes in these bad weather situations, along with help from the State Opioid Treatment Authority (SOTA).

Last week, this group of physicians were discussing the issue of severe weather take home exceptions. The following factors were some of the things taken in consideration:

  1. Since buprenorphine has a greater margin of safety than methadone, many were willing to grant bad weather take home doses for buprenorphine patients, unless there are other concerns to be considered.
  2. Patients in the induction phase of treatment, the riskiest time in treatment for methadone patients, shouldn’t get extra take homes.
  3. Patients who already receive take home doses for Sundays and holidays are likely OK for bad weather days, too.
  4. Patients using alcohol or benzodiazepines are at higher risk, and may not be appropriate for extra take home doses.
  5. Patients who live in a home with other people with active substance use disorders may not be able safely to store their medication, and may not be appropriate for the extra take home.
  6. Patients who have had recent episodes of suspected diversion won’t get extra take homes.
  7. Patients who live around the corner, are healthy, and can easily walk to the opioid treatment program don’t need extra take homes.
  8. Patients who live in more treacherous terrain or longer driving distance may need take homes.

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