19
Considerations for Office-Based Opioid Treatment (OBOT)
Settings
Î For patients in OBOT settings, the drug test panel should include the
therapeutic drug and/or its metabolites.
Î In addition to drug testing, diversion can be reduced or prevented by
frequent office visits, Prescription Monitoring Programs, observed
dosing, and medication counts.
Î In order to provide buprenorphine or naltrexone treatment, providers
must have access to drug testing laboratories.
Î Frequency of drug testing in buprenorphine treatment should be at
least monthly, unless otherwise clinically indicated (e.g., patients who
have become stable in recovery may require less frequent testing).
Î Drug testing (and negative test result for opioids) is indicated before
starting treatment of opioid use disorder using naltrexone. Drug
testing also is indicated throughout treatment using naltrexone.
Î Frequency of drug testing in treatment of opioid use disorder using
naltrexone should be at least monthly, unless otherwise clinically
indicated.
Recovery Residences
Î Weekly random drug testing is appropriate in a recovery residence.
Î Any patient expelled from a recovery residence should be able to
continue an ongoing therapeutic relationship with his or her outpatient
addiction treatment provider.
