JOINT CIRCULAR

ON REGULATIONS ON POWER, PROCEDURE AND PROCESS RELATED TO DRUG DEPENDENCE DIAGNOSIS

Pursuant to the Law on penalties for administrative violations 2012;

Pursuant to Decree No.63/2012/ND-CP dated August 31, 2012 of the Government on functions, missions, rights and organizational structure of the Ministry of Health;

Pursuant to Decree No.106/2012/ND-CP dated December 20, 2012 of the Government on functions, missions, rights and organizational structure of the Ministry of Labor - War Invalids and Social Affairs;

Pursuant to Decree No.106/2014/ND-CP dated November 17, 2014 of the Government on functions, missions, rights and organizational structure of the Ministry of Public Security;

Pursuant to Decree No.94/2010/ND-CP dated September 09, 2010 of the Government on home-based drug withdrawal and community-based drug withdrawal;

Pursuant to Decree No.111/2013/ND-CP dated September 30, 2013 of the Government on compulsory educational measures in community;

Pursuant to Decree No.221/2013/ND-CP dated December 30, 2013 of the Government on mandatory attendance at rehabilitation centers;

The Minister of Health, Labor-War Invalids and Social Affairs, Public Security promulgates a Joint Circular on regulations on power, procedure and process related to drug dependence diagnosis.

Chapter I

GENERAL PROVISIONS

Article 1. Scope

This Joint Circular provides for power, procedure and process related to diagnosis of dependence on Opioids (opium-type substances) and Amphetamine-type stimulants (hereinafter referred to as ATS).

Article 1. Regulated entities

1. Agencies, organizations and individuals concerning drug dependence diagnosis

2. Individuals meeting criteria for drug dependence to be diagnosed as prescribed in Decree No.94/2010/ND-CP dated September 09, 2010 of the Government on home-based drug withdrawal and community-based drug withdrawal, Decree No.111/2013/ND-CP dated September 30, 2013 of the Government on compulsory educational measures in the community and Decree No.221/2013/ND-CP dated December 30, 2013 of the Government on mandatory attendance at rehabilitation centers.

Chapter II

POWER, PROCEDURE AND PROCESS RELATED TO DRUG DEPENDENCE DIAGNOSIS

Article 3. Power to diagnose drug dependence

Drug dependence diagnostician is a physician who holds a physician’s certificate of medical examination as prescribed in the Law of Medical examination and treatment, certificate of completion of training in diagnosis and treatment of drug withdrawal which is run by Medical Services Administration affiliated to the Ministry of Health, Department of Health of provinces and centrally-affiliated cities or organizations, institutes, hospitals, training facilities eligible to run training and issue certificates, as assigned by the Ministry of Health, and has worked for one of the following medical facilities:

1. Military and people’s military medical facilities.

2. Medical examination and treatment facilities affiliated to public security department.

3. Medical clinics of compulsory drug detention and rehabilitation centers.

4. The medical clinic of facilities functioning as a place of receiving and supervising drug addicts that have no fixed residence places during the making of dossier sent to People’s Court to consider whether to keep them in compulsory drug detention and rehabilitation centers.

5. Medical aid stations of commune; regional general clinics; hospitals of districts or superior hospitals and hospital affiliated with other ministries and departments.

Article 4. Proposed procedure for the diagnosis of drug dependence

1. A document requiring drug dependence diagnosis of Public Security of commune or district and province.

2. A record of administrative violations of illegal drug use or documents indicating illegal use of drugs; documents proving that drug-related administrative actions have been taken (if any) and documents proving that administrative penalties for using drugs have been imposed more than once (if any)

Article 5. Diagnostic process

Drug dependence diagnostician prescribed in Article 3 of this Joint Circular shall diagnose drug dependence following the process below:

1. Receive people to be diagnosed with drug dependence and documents regulated in Article 4 of this Joint Circular.

2. Immediately give the drug dependence diagnosis

a) Opioid dependence diagnosis criteria

Opioid dependence is diagnosed if a person:

- tested positive for Opioid drug and faced a drug-related administrative action;

- tested positive for Opioid drug and faced an administrative penalty for using drug more than once;

- tested positive for Naloxone;

- tested positive for Opioid drug and have at least 3 in 12 symptoms of the withdrawal state according to Appendix 1 issued together with this Joint Circular.

a) ATS dependence diagnosis criteria

ATS dependence is diagnosed if three or more of the 6 following symptoms have been experienced or exhibited during the previous 12 months:

- A strong desire or sense of compulsion to take stimulants;

- Difficulties in controlling stimulant-taking behavior in terms of its onset, termination or levels of use;

- A physiological withdrawal state when stimulant use has ceased or has been reduced;

- Evidence of tolerance such that increased doses of stimulants

- Progressive neglect of alternative pleasures or interests because of stimulant use;

- Persisting with stimulant use despite clear evidence of overtly harmful consequences

The following-up process intended for Opioid dependence diagnosis is recorded in the following-up note of Opioid (opium-type substances) dependence diagnosis prescribed in Appendix 1 of this Joint Circular.

The following-up process intended for ATS dependence diagnosis is recorded in the following-up note of ATS dependence diagnosis prescribed in Appendix 2 of this Joint Circular.

3. Have results of the diagnosis recorded in the result note of drug dependence diagnosis prescribed in Appendix 3 issued together with this Joint Circular and in medical report book of facilities where drug dependence is diagnosed for the purpose of storing the result of drug dependence diagnosis in accordance with regulations on retention of medical history of out-patients

4. Provide the result according to Appendix 3 issued together with this Joint Circular for public security agencies requiring the diagnosis of drug dependence.

Article 6. Referral for diagnosing drug dependence

In case drug dependence is hard to be diagnosed, the referral between medical facilities is required as follows;

1. For people to be diagnosed with Opioid dependence, they are required to be referred to medical facilities of districts or provinces managed by Department of Health or centers, facilities for social vice-related people founded in accordance with Resolution No.77/2014/QH13 dated November 10, 2014 of National Assembly thirteen session The Department of Health shall cooperate with Department of Labor-War Invalids and Social Affairs in deciding which facilities in province/city refer people to be diagnosed with drug dependence to and check actual conditions in local authority for the purpose of preparing a referral plan and network which most facilitates transportation and location and assure that the medical establishment could satisfy facility requirements such as infrastructure, equipments, human resources, professional qualifications and security-order assurance.

2. For people to be diagnosed with ATS dependence or both ATS and Opioid dependence, they are required to be referred to Psychiatry division of provincial general hospitals or psychiatric hospitals. The Department of Health shall take responsibility to discuss with People’s Committee of centrally-affiliated provinces and cities to invest in and improve infrastructure, equipments, human resources, professional qualifications and security and order conditions of the medical facility for drug dependence diagnosis in pursuit of satisfying the requirement for quantity of people to be diagnosed with drug dependence of local authority.

3. In case of referral between facilities, proposed procedure for drug dependence diagnosis shall comply with regulations in Article 4 of this Joint Circular associated to the referral form of medical facility of the person holding the power to diagnose drug dependence as prescribed in Article 3 of this Joint Circular. Referral form shall comply with the template provided in Appendix 1 issued together with Circular No.14/2014/TT-BYT dated April 14, 2014 of the Minister of Health on regulations on referral between medical facilities.

4. In case of referral between medical facilities, diagnostic process shall be carried out complying with regulations in Article 5 of this Joint Circular.

Chapter III

IMPLEMENTATION

Article 7. Place for drug dependence diagnosis

Place for drug dependence diagnosis must be separate, provided that order and security assurance as well as satisfy minimum conditions for living activities of people to be diagnosed with drug dependence.

Article 8. Responsibilities of the Ministry of Health

1. Preside over and cooperate with the Ministry of Labor-War Invalids and Social Affairs and Public Security in achieving, supervising, preliminarily and officially reviewing the implementation of provisions in this Joint Circular.

2. Instruct the Department of Health to cooperate with the Department of Labor-War Invalids and Social Affairs, Public Security of centrally-affiliated provinces and cities to implement this Joint Circular.

3. Assign entities to follow-up and provide guidelines for the implementation of the Circular

a) Medical Services Administration:

- Instruct the Departments of Health, hospitals affiliated with the Ministry of Health to implement this Joint Circular;

- Organize training and issue certificate of completion of training in drug dependence diagnosis and treatment to managers and people holding power to diagnose drug dependence;

- Instruct Departments of Health to organize training and issue certificate of completion of training in drug dependence diagnosis and treatment to people holding power to diagnose drug dependence prescribed in Article 3 of this Joint Circular (except those who received certificate of training completion from the Ministry of Health);

- Preside over and cooperate with relevant agencies to supervise the implementation of this Joint Circular.

b) Health Ministry Inspectorate

- Cooperate with the Medical Services Administration in providing guidelines for, achieving, monitoring the implementation of this Joint Circular;

- Provide the Department of Health with guidelines for medical function-based supervision and inspection of the implementation of this Joint Circular;

- Preside over and cooperate with relevant agencies to directly inspect and supervise the implementation of this Joint Circular.

Article 9. Responsibilities of the Ministry of Labor-War Invalids and Social Affairs

1. Instruct the Department for Social Vices Prevention to achieve, supervise the implementation and urge agencies, entities affiliated with the Ministry of Labor-War Invalids and Social Affairs to implement this Joint Circular; cooperate with entities affiliated with the Ministry of Health and Public Security to provide guidelines for and supervise the implementation of this Joint Circular.

2. Instruct the Department of Labor-War Invalids and Social Affairs, agencies and entities affiliated with the Department of Labor-War Invalids and Social Affairs to implement this Joint Circular.

Article 10. Responsibilities of the Ministry of Public Security

1. Instruct the General Department of Public Security to cooperate with entities affiliated with the Department of Labor-War Invalids and Social Affairs to organize the implementation of the Joint Circular; provide guidelines for, supervise and urge entities in People’s Public Security to implement this Joint Circular.

2. Instruct the Public Security of centrally-affiliated provinces and cities to implement the Joint Circular and provide order and security assurance of the facility or place where the drug dependence is diagnosed.

Article 11. Responsibilities of People’s Committee of centrally-affiliated provinces and cities

1. Instruct People’s Committees, relevant professional agencies to choose a place eligible for requirements prescribed in Article 7 for the purpose of diagnosing drug dependence.

2. Instruct the Department of Health to cooperate with the Department of Labor-War Invalids and Social Affairs in developing a referral network for local drug dependence diagnosis as prescribed in Article 6 of this Joint Circular.

3. Instruct the Department of Labor-War Invalids and Social Affairs, Public Security of centrally-affiliated provinces and cities and relevant agencies to cooperate with the Department of Health in organizing the implementation of this Joint Circular.

4. Provide funding for implementation of the Joint Circular in local authority which is allocated from local budget and other sources in accordance with regulations of the Law on budget and legal documents in force.

5. Examine, monitor, preliminarily and officially review the implementation of this Joint Circular.

Article 12. Effect

1. This Joint Circular comes into force from August 23, 2015.

2. Chapter III of Circular No.03/2012/TTLT-BLDTBXH-BYT-BCA dated February 10, 2012 of inter-Ministry of Labor-War Invalids and Social Affairs-Health and Public Security providing for details and guidelines for some articles of Decree No.94/2010/ND-CP dated September 09, 2010 of the Government on home-based drug withdrawal and community-based drug withdrawal will be abolished from the day on which this Joint Circular comes into force.