Instructions for dispensing methadone to patients undergoing inpatient and outpatient treatment in Vietnam as of March 15, 2024

Instructions for dispensing methadone to patients undergoing inpatient and outpatient treatment in Vietnam as of March 15, 2024 (Internet image)

Regarding this issue, LawNet answers as follows:

On December 29, 2023, the Minister of Health issued Circular 26/2023/TT-BYT guiding the management of methadone in Vietnam.

1. Instructions for dispensing methadone to inpatient patients in Vietnam as of March 15, 2024

According to Article 7 of Circular 26/2023/TT-BYT, the dispensing of methadone to patients undergoing inpatient treatment at medical examination and treatment facilities is as follows:

- Patients who are undergoing methadone treatment while undergoing inpatient treatment at a medical examination and treatment facility are responsible for notifying the medical examination and treatment facility where the patient is undergoing inpatient treatment and the alternative treatment facility about the methadone treatment and medical condition.

- The patient makes a request for methadone medication because he is undergoing inpatient treatment at a medical examination and treatment facility according to Form No. 04 specified in the Appendix issued with Circular 26/2023/TT-BYT.

The application form for methadone medication due to inpatient treatment at a medical examination and treatment facility must be certified by the medical examination and treatment facility where the patient is undergoing inpatient treatment. The patient's representative submits a request for methadone to be provided to the alternative treatment facility.

- Based on the request form for methadone medication due to inpatient treatment at a medical examination and treatment facility, the alternative treatment facility is responsible for:

+ Instructing the patient's representative on how to transport and preserve methadone and writing a commitment to transport, preserve, and hand over methadone according to Form No. 05 specified in the Appendix issued together with Circular 26/2023/TT-BYT.

The commitment to transport, preserve, and hand over methadone medicine is made in 02 copies: 01 copy is kept at the alternative treatment facility, and 01 copy is delivered to the patient's representative;

+ Prescribing methadone for patients as prescribed in Point b of Clause 1of Article 5 of Circular 26/2023/TT-BYT.

- Based on the methadone prescription, the drug dispensing staff of the alternative treatment facility or drug dispensing facility is responsible for:

+ Preparing a sufficient number of medicine bottles, fill in all the information, and attach additional labels to the medicine bottles. The sample label for outpatient methadone medicine is prepared according to Form No. 06 specified in the Appendix issued with Circular 26/2023/TT-BYT;

+ Providing a sufficient quantity of methadone for the patient's representative to take home and use as directed;

+ Checking the tightness of each medicine bottle to ensure that the medicine does not spill or leak when the bottle is turned upside down before handing it back to the patient's representative.

- The patient's representative is responsible for:

+ Checking and comparing the quantity of methadone prescribed in the methadone prescription with the quantity of methadone actually received; confirming the methadone treatment monitoring form according to Form No. 03 specified in the Appendix issued together with Circular 26/2023/TT-BYT;

+ Bringing all valid identification documents; Methadone prescription and commitment to transport, store, and hand over methadone when taking methadone out of the alternative treatment facility or drug dispensing facility;

+ Handing over methadone medicine to the person assigned by the medical examination and treatment facility to receive methadone medicine as prescribed in Point a, Clause 6, Article 7 of Circular 26/2023/TT-BYT.

When handing over methadone, the patient's representative and staff of the medical examination and treatment facility must prepare a methadone handover record according to Form No. 07 specified in the Appendix issued together with Circular 26/2023/TT-BYT;

+ Returning used methadone bottles to the alternative treatment facility or drug dispensing facility when next time you come to receive methadone and after the end of the treatment period;

+ Returning the patient's unused methadone to the alternative treatment facility or drug dispensing facility.

- Healthcare facilities are responsible for:

+ Assign people to receive methadone from the patient's representative;

+ Carry out storage and distribution of methadone medicine to patients and supervise daily methadone taking according to regulations;

+ When the patient runs out of methadone and needs to continue inpatient treatment, the medical examination and treatment facility will continue to confirm the request for methadone medication because he is undergoing inpatient treatment at the medical examination and treatment facility according to Form No. 04 specified in the Appendix issued with Circular 26/2023/TT-BYT;

In case the patient finishes the treatment process at a medical examination and treatment facility without using all the methadone, the person assigned to receive methadone from the medical examination and treatment facility is responsible for handing over the unused methadone to the patient's representative to hand over to the alternative treatment facility or drug dispensing facility according to Form No. 07 specified in the Appendix issued with Circular 26/2023/TT-BYT.

- Responsibilities of the patient:

+ Take all methadone in front of medical staff directly providing care and treatment;

+ Preserve used methadone bottles to return to alternative treatment facilities or drug dispensing facilities.

- After the patient finishes the treatment process at the medical examination and treatment facility, the patient continues treatment according to the provisions of Decree 90/2016/ND-CP on the treatment of opioid addiction with alternative medicine and treatment guidelines issued by the Ministry of Health.

2. Instructions for dispensing methadone to patients undergoing outpatient treatment in Vietnam as of March 15, 2024

In cases where patients undergoing outpatient treatment for other diseases cannot go to an alternative treatment facility or drug dispensing facility to take methadone daily, according to Article 8 of Circular 26/2023/TT-BYT:

- The patient shall make a request for methadone medication according to Form No. 08 specified in the Appendix issued with Circular 26/2023/TT-BYT, accompanied by documents proving that outpatient treatment is required (this document must have a confirmation stamp of the medical examination and treatment facility where the practitioner appoints the patient for outpatient treatment to work) and submit these documents to the alternative treatment facility.

- Based on the request for methadone medication due to outpatient treatment and confirmation of outpatient treatment by the medical examination and treatment facility, the alternative treatment facility is responsible for:

+ Assessing the patient's medical condition and methadone treatment status to decide on outpatient methadone treatment for the patient;

+ Instructing the patient's representative on how to transport, store, and support the patient in using methadone, and writing a commitment to transport, store, and support the patient in using methadone in outpatient treatment according to Form No. 09 specified in the Appendix issued with Circular 26/2023/TT-BYT.

The commitment to transport, preserve, and support the patient in using methadone as an outpatient is made in 02 copies: 01 copy is kept at the alternative treatment facility, and 01 copy is delivered to the patient's representative;

+ Prescribe methadone for patients as prescribed in Point b of Clause 1, Article 5 of Circular 26/2023/TT-BYT. Every day, the patient's representative goes to the alternative treatment facility or drug dispensing facility to receive methadone for the patient.

- Based on the methadone prescription, the drug dispensing staff of the alternative treatment facility or drug dispensing facility shall dispense methadone to the patient's representative according to the provisions of Clause 4 of Article 7 of Circular 26/2023/TT-BYT.

- The patient's representative is responsible for:

+ Check and compare the quantity of methadone prescribed in the prescription with the quantity of methadone actually received; confirm the methadone treatment monitoring form according to Form No. 03 specified in the Appendix issued together with Circular 26/2023/TT-BYT;

+ Bring all valid identification documents; a methadone prescription; and a commitment to transport, preserve, and support patients using outpatient methadone when taking methadone out of the alternative treatment facility or drug dispensing facility;

+ Return used methadone bottles to the alternative treatment facility or drug dispensing facility when next time you come to receive the medication and after the end of the treatment period.

- After the patient finishes the treatment process at the medical examination and treatment facility, the patient continues treatment according to the provisions of Decree 90/2016/ND-CP and treatment guidelines issued by the Ministry of Health.

More details can be found in Circular 26/2023/TT-BYT taking effect on March 15, 2024.

Circular 14/2015/TT-BYT and Clause 9, Article 1 of Circular 29/2020/TT-BYT expire on March 15, 2024.

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