Thông tư 18/2021/TT-BYT quy định tiêu chuẩn chẩn đoán và quy trình chuyên môn xác định tình trạng nghiện ma túy

CIRCULAR

Regulating standards for diagnosis and professional process for determination of state of drug addiction

___________

THE MINISTER OF HEALTH

Pursuant to Law on Medical Examination and Treatment No. 40/2009/QH12 dated November 23, 2009;

Pursuant to Law on Drug Prevention and Control No. 73/2021/QH14 dated March 30, 2021;

Pursuant to Decree No. 75/2017/ND-CP dated June 20, 2017 of the Government defining the functions, tasks, powers and organizational structure of the Ministry of Health;

At the proposal of the Director of Medical Services Administration;

The Minister of Health promulgates the Circular stipulating standards for diagnosis and professional process for determination of state of drug addiction.

Article 1. Scope of adjustment

This Circular prescribes standards for diagnosis and professional process for determination of state of drug addiction for individuals specified in Clause 1, Article 27 of the Law on Drug Prevention and Control 2021.

Article 2. Subjects of application

This Circular applies to agencies, organizations and individuals involved in the determination of state of drug addiction.

Article 3. Standards for diagnosis of state of drug addiction

1. Standards for diagnosis of state of drug addiction include the following 06 standards:

a) Standard No. 1: Have strong desire or sense of compulsion to use drugs;

b) Standard No. 2: Have difficulty in controlling drug use behaviors on start time, end time or usage;

c) Standard No. 3: Have phenomenon of tolerance to the narcotic substances;

d) Standard No. 4: Become increasingly indifferent to other hobbies or interests due to drug use;

dd) Standard No. 5: Continue to use drug despite knowledge of its harmful effects;

e) Standard No. 6: Have state of drug addiction treatment (syndromes upon drug addiction treatment) when drug use is stopped or reduced.

2. The determination of the characteristic state of drug addiction treatment shall be carried out according to the Guidance for determination of the characteristic state of drug addiction treatment specified in Appendix 01 issued with this Circular. The determination of standards No. 2, 3, 4 and 6 for diagnosis of state of drug addiction shall comply with the guidance specified in Appendix 02 issued with this Circular.

3. The determination of standards for diagnosis of state of drug addiction is based on the results of clinical monitoring, collection of information from the persons to be determined state of drug addiction or the accompanying person (if any) and the records provided by the public security offices.

4. The diagnosed persons are identified as drug addicts if at least 03 of the 06 standards specified in Clause 1, Article 3 of this Circular occur at the same time within at least 01 month or if they persist for less than 01 month, and are repeated simultaneously within 12 months.

Article 4. Professional process for determination of state of drug addiction

1. Step 1. Receive persons and collect relevant information of persons to be determined state of drug addiction.

2. Step 2: Perform medical examination, clinical monitoring, information recording in medical records and general log sheet on determination of state of drug addiction specified in Appendix 03 issued together with this Circular.

3. Step 3: Write the conclusions

a) In case they meet only 1 standard for state of drug addiction or 02 standards for state of drug addiction, including standard No. 6, write the conclusion as "without drug addiction" on summary sheet on determination of state of drug addiction and promptly return results of determination of state of drug addiction in accordance with Article 5 of this Circular.

b) In case they meet at least 03 standards for state of drug addiction, write the conclusion "with drug addiction" on summary sheet on determination of state of drug addiction and promptly return results of determination of state of drug addiction in accordance with Article 5 of this Circular.

c) In case they meet 02 standards for state of drug addiction, excluding standard No. 6 or with the unclear signals according to the standards for state of drug addiction, it must comply with step 4 specified in Clause 4 of this Article.

4. Step 4: Perform medical examination, clinical monitoring, recording of information and conclusions in medical records and log sheets in the case specified at Point c, Clause 3 of this Article:

a) Designate and immediately conduct medical examination and clinical monitoring to determine the state of drug addiction;

b) Perform medical examination and record medical records;

c) Monitor and record summary sheets on determination of state of drug addiction and log sheets on determination of state of drug addiction treatment corresponding to each narcotic substance, including: Log sheets on determination of state of treatment of opioid addiction according to the form specified in Appendix 04; Log sheets on determination of state of treatment of psychostimulants (amphetamines, cocaine or other psychostimulants) according to the form specified in Appendix 05 and Log sheets on determination of state of treatment of cannabis addiction according to the form specified in Appendix No. 06 issued together with this Circular;

d) Write the conclusion as "with state of drug addiction treatment" or "without state of drug addiction treatment" on Log sheets on determination of state of drug addiction treatment corresponding to each narcotic substance. Conclusions on state of drug addiction treatment are compiled into summary sheet on determination of state of drug addiction;

dd) Write conclusions on state of drug addiction on the summary sheet on determination of state of drug addiction and medical records. In case they meet at least 03 standards for state of drug addiction, the given conclusion is "with drug addiction". If the three standards for state of drug addiction are not met or the standards for diagnosis are not clearly demonstrated due to the lack of time, the given conclusion is "without drug addiction". Immediately return results of determination of state of drug addiction in accordance with Article 5 of this Circular.

5. In the process of determination of state of drug addiction, if persons to be determined state of drug addiction have syndromes upon drug addiction treatment, mental disorders and accompanying diseases, they shall be examined and treated according to current regulations on medical examination and treatment.

Article 5. Return of results of determination of state of drug addiction

1. Record the results on the result sheet on determination of state of drug addiction according to the conclusion on state of drug addiction on summary sheet on determination of state of drug addiction.

2. Results of determination of state of drug addiction are returned to the person who voluntarily requests for determination of state of drug addiction or returned to the public security office with request to determine state of drug addiction within 5 days from the date of receipt of persons to be determined state of drug addiction.

Article 6. Implementation organization

1. Responsibilities of Medical Services Administration:

a) Direct, guide, disseminate, inspect and check the implementation of this Circular;

b) Organize professional training and further training in diagnosis and determination of state of drug addiction for the Departments of Health of centrally-affiliated cities and provinces (hereinafter referred to as the Department of Health) and health establishments.

2. Responsibilities of the Department of Health:

a) Direct, guide, disseminate, inspect and check the implementation of this Circular by health establishments in the area under their management;

b) Organize professional training, further training in diagnosis and determination of state of drug addiction for health establishments and doctors in charge of determination of state of drug addiction;

c) Report results of determination of state of drug addiction in the area under management.

3. Responsibilities of public security of centrally-affiliated cities and provinces:

a) Ensure security and safety for health establishments and clinicians during determination of state of drug addiction;

b) Direct the public security office to provide complete dossiers of request for determination of state of drug addiction according to regulations;

c) Ensure funds for the determination of state of drug addiction at the request of the public security office.

4. Responsibilities of health sector: Assume the prime responsibility for, and coordinate with relevant units in, organizing the implementation, guidance, inspection, examination and evaluation of the implementation of this Circular within the management scope of the ministry and branches.

5. Responsibilities of health establishments:

a) Organize the implementation of regulations on standards for diagnosis and professional process for determination of state of drug addiction in accordance with this Circular and relevant regulations;

b) Organize, provide training, further training, communicate and disseminate to relevant subjects on the regulations on determination of state of drug addiction;

c) Organize therapy of syndromes upon drug addiction treatment, mental disorders and accompanying diseases (if any) for persons to be determined state of drug addiction during the period of determination of state of drug addiction;

d) Maintain records of determination of state of drug addiction in accordance with the law on medical examination and treatment;

dd) Report results of the health establishments' determination of state of drug addiction.

6. Responsibilities of person whose state of drug addiction is determined:

a) Comply with internal rules and regulations on operation of health establishments and clinicians during determination of state of drug addiction;

b) Provide truthful information about history and symptoms of drug use and other expertise-related information in the process of determination of state of drug addiction.

Article 7. Effect

1. This Circular takes effect from January 01, 2022.

2.The Joint Circular No. 17/2015/TTLT-BYT-BLDTBXH-BCA dated July 9, 2015 of the Minister of Health, the Minister of Labor, Invalids and Social Affairs and the Minister of Public Security regulating the competence, procedures and processes for determining state of drug addiction shall cease to be effective from the effective date of this Circular.

Article 8. Responsibility for implementation

The Director of Medical Services Administration, Director of Vietnam Administration of HIV/AIDS Control, Chief of the Office of the Ministry of Health, Chief Inspector of the Ministry of Health, General Directors, Director, Heads of Agencies, Departments, Directorates under the Ministry of Health and relevant agencies, organizations and individuals are responsible for the implementation of this Circular.

During the implementation of this Circular, if there are difficulties or problems, agencies, organizations and individuals are requested to report them to the Ministry of Health (Medical Services Administration) for consideration and settlement./.

* All Appendices are not translated herein.