TX HHS Form 4008. Informed Consent for Opiate Use Disorder Individuals Seeking Treatment – Youths Ages 13 to 18

TX HHS Form 4008: Informed Consent for Opiate Use Disorder Individuals Seeking Treatment – Youths Ages 13 to 18

This form is used to obtain informed consent from youths aged 13-18 seeking treatment for opioid/opiate use disorder. The diagnosis of opioid/opiate use disorder indicates that the individual has experienced or is currently experiencing problems related to their use of prescription painkillers or heroin, and is at high risk or has severe substance use.

The form outlines four options for treatment, including medication-assisted treatment with methadone or buprenorphine, which requires a daily dose and participation in counseling. For youths under 18, two previous treatment attempts are required, as well as written consent from their parent or legal guardian. The form also highlights the benefits of medication-assisted treatment, such as eliminating cravings and reducing risks of infectious diseases, while noting potential risks including withdrawal symptoms and medication interaction.