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<br />HCA Contract No. K5885-04 Page 5 of 13 <br />2.2.5. Continue MOUD and MAUD for individuals who are already taking these <br />medications upon entering the facility. <br />2.2.6. Continue the individual on the same medication at the same dose unless ordered <br />otherwise by the prescriber based on clinical need, and as documented in the <br />individual’s medical record, unless one of the following exceptions is applicable: <br />2.2.6.1. Injectable long-acting naltrexone may be converted to an equivalent oral <br />dose until just prior to release at which time the injectable form shall be <br />restarted. <br />2.2.6.2. Injectable long-acting buprenorphine may be converted to an equivalent <br />oral dose until just prior to release at which time the injectable form shall <br />be restarted. <br />2.2.6.3. Oral buprenorphine may be converted to any of the three formulations <br />available; film, tablet with naloxone, or tablet without naloxone. <br />2.2.6.4. If the individual is not pregnant, methadone may be transitioned to <br />buprenorphine if the Contractor is not a licensed Opioid Treatment <br />Program (OTP) and the nearest OTP is not within reasonable driving <br />distance from the jail or there is no OTP within reasonable distance of <br />the individual’s release residence. <br />2.2.6.5. Though MOUD/MAUD may not be discontinued on a policy or <br />administrative basis because of the presence of other illicit or controlled <br />substances, administration of the community-based MOUD or MAUD <br />may be adjusted if clinically necessary due to pharmacologic risks of <br />drug-to-drug interaction. <br />2.2.7. Screen for OUD and AUD without physical dependence (i.e. without a risk of acute <br />withdrawal) after intake, as long as the delay does not impair the ability to begin <br />treatment prior to release. <br />2.2.8. Educate individuals on treatment choices and the process for continuation of <br />access to MOUD during incarceration and upon release. <br />2.2.9. Make available and offer treatment using some formulation of methadone, <br />buprenorphine, and naltrexone based on a mutually agreed-upon plan between the <br />prescriber and the individual, with the following exceptions or caveats: <br />2.2.9.1. The Contractor may decline to offer methadone if the Contractor is not a <br />licensed OTP, and the nearest OTP is not within reasonable driving <br />distance from the jail or there is no OTP within reasonable distance of <br />the individual’s release residence. <br />2.2.9.2. If there is no available buprenorphine provider in the community to <br />which the individual will release, the Contractor must still offer <br />buprenorphine (tapered over several days) if opioid withdrawal is <br />clinically indicated.