Ala. Admin. Code r. 580-9-46-.03

Residential Detoxification

This Alabama regulation establishes operating standards for residential detoxification programs, covering supervised withdrawal from alcohol and drugs for individuals who require 24-hour supervision but can be treated outside an acute hospital setting. Operators must ensure 24/7 physician and nursing coverage, written physician-approved protocols for medical detoxification (including medication administration, vital sign monitoring, and emergency procedures), and documented staff training in detoxification and withdrawal management. Programs must also screen all clients upon admission with a registered nurse, conduct a physical examination within 24 hours, and maintain documented access to a local licensed hospital for emergency care.

Ala. Admin. Code r. 580-9-46-.03 - Residential Detoxification 

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(1)

 Supervised withdrawal from alcohol and drug intoxication for an individual who
 can safely be treated outside an acute general hospital setting, using
 medication after medical evaluation and following physician approved
 guidelines, but who requires 24 hour a day supervision.

(2)
 Programs providing detoxification
 services must have coverage by a licensed physician trained in detoxification
 protocols and/or addiction medicine.

(3)
 Medical supervision of detoxification
 must be available twenty-four (24) hours a day, seven (7) days a
 week.

(4)
 Criteria for determining
 the need for detoxification with medication must be described in a written
 procedure approved by the physician. The procedures must include: 
 
(a)
 Description of symptoms requiring medical
 detoxification.

(b)
 Continuous
 nursing assessment following admission to the program to determine if there are
 any changes in detoxification needs.

(5)
 All clients will be screened by a
 registered nurse upon admission and will be administered a physical examination
 by a physician, physician's assistant or certified nurse practitioner within 24
 hours of admission.

(6)
 The program
 must provide for physical and/or laboratory examination in accordance with the
 supervising physician's written medical procedures.

(7)
 There must be written protocols approved
 by the physician that describe care given during medical detoxification,
 including administration of medication, monitoring of vital signs, and
 emergency procedures.

(8)
 The
 licensed physician must be consulted prior to the initiation of medical
 detoxification.

(9)
 The program
 must provide and document clinical staff training in all detoxification
 protocols and emergency procedures.

(10)
 When detoxification procedures are
 initiated by phone order with the physician, these must be reviewed and signed
 by the physician within 24 hours of the initiation of detoxification.

(11)
 All programs providing detoxification
 must demonstrate by written document the client's accessibility to a local
 licensed hospital for the purpose of providing emergency hospital
 care.

(12)
 The program shall have
 transportation available on a 24 hour a day basis for emergency
 purposes.

(13)
 The program shall
 have a full time registered nurse on staff and on-call registered nurse
 accessibility at all times. Any time the registered nurse is not on site, an
 L.P.N. will be on site.

(14)
 The
 program shall have staff on duty and awake 24 hours a day.

(15)
 Detoxification programs will provide
 psychosocial assessment and/or support services to the client and family, when
 deemed clinically appropriate.

(16)

 All direct care staff employed in programs providing detoxification shall be
 provided basic education in methodology of detoxification treatment, the signs
 and symptoms of withdrawal, and approved intervention techniques.

Notes

Ala. Admin. Code
 r. 
580-9-46-.03

New: Filed July 22, 1992.
 Extended: September 30, 1992. Extended: December 31, 1992. Certified: March 30,
 1993. Effective: May 5, 1993.

Author:
 Substance Abuse Services Division

Statutory Authority:

Code of Ala.
 1975
, §
 
22-50-11
.

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