The draft accreditation guidelines for opioid treatment programs (OTPs) released last spring (see AT Forum July 19, 2013) by the Substance Abuse and Mental Health Services Administration (SAMHSA) are still going through the review process within the federal government, and will be out no later than next April, AT Forum has learned.
“We have gotten a lot of comments, and we’ve been going through every one of them,” said Robert Lubran, MS, MPA, director of the Division of Pharmacologic Therapies at SAMHSA’s Center for Substance Abuse Treatment. “We got to a point at which we thought we needed to confer with the lawyers, and we’re having a discussion about interpreting the language,” he said. The holdup has been inconsistency in the language referring to midlevel providers, Mr. Lubran told AT Forum on April 10.
The final draft will be completed within the next several months, after which the external workgroup that developed the guidelines will be convened again, said Mr. Lubran. “Hopefully there will be few changes.” After the final draft comes out, the Drug Enforcement Administration (DEA) and Office of National Drug Control Policy (ONDCP) will be asked if they would like a briefing. The DEA never commented on the draft guidelines, which means that they don’t have a problem with them.
Originally, there were some concerns that the DEA might oppose the involvement of midlevel providers—people who are not physicians—in making treatment decisions. But Mr. Lubran said the DEA doesn’t have any say on whether midlevel providers can be used, because that is a medical practice issue. He doesn’t expect that the DEA will want to be briefed, but the ONDCP has already requested a briefing, so that will take place.
“Once that all transpires we go to SAMHSA and HHS [the Department of Health and Human Services] to get the whole thing cleared,” he said.
The final guidelines will be available by the April 2015 conference of the American Association for the Treatment of Opioid Dependence (AATOD), said Mr. Lubran.
Keep in mind that the SAMHSA accreditation guidelines are just that—guidelines, which accrediting bodies such as The Joint Commission can use.