Methadone Maintenance Treatment, Specific Guidelines for

Correctional Service of Canada:
Specific Guidelines for
Methadone Maintenance Treatment

Prepared by
Correctional Service of Canada
November 2003

(This version supersedes previous versions)

Table of Contents

Section A: General Background on Offenders and Substance Abuse
Issues and Concerns/Strategies
Harm Reduction Approach
Substance Abuse Programs
Methadone Maintenance Treatment (MMT)

Section B: Methadone Maintenance Treatment in CSC
CSC: Goals and Objectives of MMT
CSC: Admission Criteria and Quality Assurance for MMT
CSC: Methadone Intervention Team (MIT)

Section C: Specific Responsibilities of CSC's MIT Members
Inmate/Offender
Institutional Parole Officer (PO)
Institutional Correctional Programs Officer (CPO)
Nurse
Physician
Officer of Principal Interest (OPI)
CSC Pharmacist
Community Parole Officer
Community Correctional Programs Officer

Section D: Methadone Dosing Issues
Initial Dosing & Stabilization
Dosing Contingencies
Carries/Temporary Arrangements

Section E: Urine Drug Screening
Urine Screens for General Toxicology
Routine Urine Drug Screens
Results of Random General Toxicology and Routine Urinalysis

Section F: Substance Abuse Intervention
Background
Format of Individual or Group Maintenance Sessions
Frequency of Substance Abuse Intervention Sessions

Appendicies
Appendix A: Glossary
Appendix B: References
Appendix C: Policy and Legislation Related to MMT in CSC
Appendix D: DSM IV Diagnostic Criteria for Substance Dependence
Appendix E: DSM IV Diagnostic Criteria for 292.0 Opioid Withdrawal
Appendix F: Resource - Introduction to Urine Drug Testing
Appendix G: Criteria for Selection of OPI
Appendix H: Qualifications of MMT Substance Abuse Program Providers
Appendix I: Guidelines from Provincial Colleges of Physicians and Surgeons
Appendix J: CSC Forms for MMT

Tables and Checklists
Table 1: CSC "Stable" and "Non-Stable" Monitoring Guidelines
Table 2: Institutional Parole Officer - Checklist for Initial Assessment
Table 3: Institutional Correctional Programs Officer - Checklist for Initial Assessment
Table 4: Notes on the Substance Abuse Report
Table 5: Nurse - Checklist for Initial Assessment
Table 6: Notes on the MMT Plan (CSC/SCC 1260-03)
Table 7: Nurse's Guidelines for Methadone Administration
Table 8: Nurse's Guidelines for Specimen Collection for MMT Routine Urine Drug Screening
Table 9: Officer of Principle Interest - Checklist for Initial Assessment
Table 10: Overview of Accessing Methadone during Temporary Absences (see details below)
Table 11: Notes on MMT Substance Abuse Intervention
Table 12: Notes on the Methadone Maintenance Substance Abuse Treatment Plan (CSC/SCC 1260-01)

Acknowledgements

Correctional Service of Canada would like to express appreciation and gratitude to all staff members who contributed directly and indirectly to the completion of these methadone guidelines. Their significant input into the various sections was a critical component in providing clear and specific direction to all staff members involved in delivery of Methadone Maintenance Treatment. This delivery includes methadone initiation, administration, monitoring and release planning - both within CSC institutions and in the community.

Correctional Service of Canada would also like to recognize the professional contribution of various community practitioners and their professional organizations. Incorporation of their input allows for a more consistent approach to methadone delivery across the country.