Section 4731-33-01 - Definitions(A) "Office-based opioid treatment" or "OBOT" means pharmacotherapy in a private office or public sector clinic that is not otherwise regulated by practitioners authorized to prescribe outpatient supplies of medications approved by the United States food and drug administration for the treatment of opioid use disorder. OBOT includes treatment with all controlled substance medications approved by the United States food and drug administration for such treatment. OBOT does not include treatment that occurs in the following settings: (1) A state or local correctional facility, as defined in section 5163.45 of the Revised Code;(2) A hospital, as defined in section 3727.01 of the Revised Code;(3) A provider certified to provide residential and inpatient substance use disorder services, including withdrawal management, by the Ohio department of mental health and addiction services;(4) An opioid treatment program certified by SAMHSA and accredited by an independent SAMHSA-approved accrediting body;(5) A youth services facility, as defined in section 103.75 of the Revised Code; and(6) An emergency medical services agency as authorized under Chapter 4729. of the Revised Code.(B) "SAMHSA" means the United States substance abuse and mental health services administration.(C) "Addiction specialist physician" means a physician who holds one of the following medical subspecialty certifications: (1) Subspecialty board certification in addiction medicine by the American board of preventative medicine ("ABPM");(2) Subspecialty board certification in addiction psychiatry by the American board of psychiatry and neurology ("ABPN");(3) Subspecialty board certification in addiction medicine by the American osteopathic association ("AOA"); or(4) Certification by the American board of addiction medicine ("ABAM")(D) "Medications for Opioid Use Disorder" or "MOUD" refers to all medications approved by the United States food and drug administration for the treatment of opioid use disorder.(E) "Substance use disorder" indicates a problematic pattern of substance use leading to clinically significant impairment or distress as determined by application of the diagnostic criteria in the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Text Revision" or "DSM-5-TR."(F) "OARRS" means the "Ohio Automated Rx Reporting System" drug database established and maintained pursuant to section 4729.75 of the Revised Code.(G) For purposes of the rules in this chapter: (1) "Qualified behavioral healthcare provider" means the following healthcare providers practicing within the scope of the professional license: (a) Addiction medicine specialist physician, or board-certified psychiatrist, licensed under Chapter 4731. of the Revised Code;(b) Psychologist, as defined in division (A) of section 4732.01 of the Revised Code, licensed under Chapter 4732. of the Revised Code;(c) Licensed independent chemical dependency counselor-clinical supervisor, licensed independent chemical dependency counselor, licensed chemical dependency counselor III, licensed chemical dependency counselor II, or licensed chemical dependency counselor assistant licensed under Chapter 4758. of the Revised Code;(d) Professional clinical counselor, licensed professional counselor, licensed independent social worker, licensed social worker, or marriage and family therapist, licensed under Chapter 4757. of the Revised Code;(e) Advanced practice registered nurse, licensed as a clinical nurse specialist under Chapter 4723. of the Revised Code, who holds certification as a psychiatric mental health clinical nurse specialist issued by the American nurses credentialing center;(f) Advanced practice registered nurse, licensed as a nurse practitioner under Chapter 4723. of the Revised Code, who holds certification as a psychiatric mental health nurse practitioner issued by the American nurses credentialing center; and(g) An advanced practice registered nurse, licensed under Chapter 4723. of the Revised Code, who holds subspecialty certification as a certified addiction registered nurse-advanced practice issued by the addictions nursing certification board.(2) Nothing in this paragraph shall be construed to prohibit a physician assistant licensed under Chapter 4730. of the Revised Code who practices under a supervision agreement with a board-certified addiction psychiatrist, board certified addiction medicine specialist, or psychiatrist who is licensed as a physician under Chapter 4731. of the Revised Code, from providing services within the normal course of practice and expertise of the supervising physician, including addiction services, other mental health services, and physician delegated prescriptive services in compliance with Ohio and federal laws and rules.(H) "Community addiction services provider" has the same meaning as in section 5119.01 of the Revised Code.(I) "Community mental health services provider" has the same meaning as in section 5119.01 of the Revised Code(J) "Induction phase" means the phase of MOUD during which the patient is started on an FDA-approved medication for substance use disorder treatment.(K) "Stabilization phase" means the period of time following the induction phase, when medication doses are adjusted to target a reduction in substance use disorder symptoms.(L) "Maintenance phase" means the ongoing period of time when the patient's medication dose reaches a therapeutic level, allowing the patient to focus on other recovery activities.(M) "Withdrawal management" is a set of medical interventions aimed at managing the acute physical symptoms of intoxication and withdrawal. Withdrawal management occurs when the patient has a substance use disorder and either evidence of the characteristic withdrawal syndrome produced by withdrawal from that substance or evidence that supports the expectation that such a syndrome would develop without the provision of medical withdrawal management services. Withdrawal management alone does not constitute completed substance use disorder treatment or rehabilitation.(N) "Ambulatory withdrawal management" means withdrawal management delivered in a medical office, public sector clinic, or urgent care facility by a physician authorized to prescribe outpatient supplies of drugs approved by the United States food and drug administration for the treatment of substance use disorder. Ambulatory withdrawal management is the provision of medically supervised evaluation, treatment, and referral services without extended onsite monitoring. For the purpose of rule 4731-33-02 of the Administrative Code, ambulatory withdrawal management does not include withdrawal management that occurs in the following settings: (1) A state or local correctional facility, as defined in section 5163.45 of the Revised Code;(2) In-patient treatment in a hospital, as defined in section 3727.01 of the Revised Code;(3) A provider certified to provide residential and inpatient substance use disorder services, including withdrawal management, by the Ohio department of mental health and addition services;(4) An opioid treatment program certified by SAMHSA and accredited by an independent SAMHSA-approved accrediting body;(5) A youth services facility, as defined in section 103.75 of the Revised Code; and(6) An emergency medical services agency as authorized under Chapter 4729. of the Revised Code. Replaces: 4731-33-01
Ohio Admin. Code 4731-33-01
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, 10/31/2020