Revoking Methadone Take home Doses


My decisions to revoke take home doses provoke more anger and outrage from my patients than anything else I do. This is a sensitive issue.

To understand their fury at losing take home doses, I need to describe how hard it is to get those take homes in the first place. Patients don’t waltz into treatment and get take home doses right away.

For patients on methadone at opioid treatment programs, (OTPs), eight criteria must be met before the patient can get any take home doses.
1. Time in treatment
2. Urine drug screens negative for illicit drugs and alcohol
3. Ability to store medication safely
4. Stable home environment, stable social relationships
5. No recent criminal activities
6. Regular clinic attendance – doesn’t frequently miss days
7. No behavioral problems at the opioid treatment program
8. Rehabilitative benefits of take homes outweigh the risk of take homes

Of all the requirements, time in treatment limits patients the most. Many patients do very well right from the start, with no drug use, criminal activity or any other complications. Even so, they must come every day the program is open (often 7 days per week) for a minimum of three months. After that, they can be granted two additional take home doses per week, as long as all of the other seven criteria are met. After three more months, they get one more take home per week, and so on. Once they get to the take home level where they come only once per week, they have to be compliant and in good recovery for at least one year before being allowed to get take homes every two weeks.

Patients expend time, money, and effort to get these take home doses.

That’s for methadone. For buprenorphine (Suboxone, Subutex, Zubsolv, etc.) there is no federal requirement saying how long a patient has to be in treatment to get a take home dose. So long as buprenorphine patients meet the other seven criteria, they can get take homes from the start, as far as the federal standard is concerned. However, state requirements may be stricter than federal requirements. For example, my state didn’t drop the time in treatment criteria for patients in opioid treatment programs on buprenorphine, but is willing to grant exceptions on a case-by-case basis, as long as the request is reasonable.

Most patients manage their take home doses perfectly. This fact gets lost in the hoopla over the few patients who don’t take their take home medication as prescribed. The actions of a few rogue patients, when made public, taint the reputations of all our patients. Their actions unfairly perpetuate stigma and bias against medication assisted treatment.

At any given time, you can google “methadone overdose on take home” or something similar and read news stories about patients who sold or gave their dose to someone who died as a result. It makes big splashy headlines and causes people in the community to wring their hands and lambaste opioid treatment programs for allowing people to get take home doses at all. In reality, many more people have died from methadone diverted from pain medicine clinics.

Part of my job as an OTP medical director is to decide, with the help and input of all staff, when a patient is taking the medication I prescribe as I prescribe it, and when it’s being misused.

Now obviously most people won’t tell OTP staff if they plan to misuse their medication, or divert it to someone for whom it was not intended, so OTPs have to have ways to assure patient compliance. One of those ways is called a “bottle recall.”

In a bottle recall, a staff person, usually the patient’s counselor, calls the patient at the given contact number and asks them to return to the facility within 24 hours so we can see that they have all their bottles and that bottles to be taken later in the week are still sealed and full of medication.

Yes, there are ways to falsify bottle recalls. In the past, patients would pull the plastic bottles apart at the seams, remove the methadone, fill the bottle with red Kool-Aid or similar, and glue the bottles back together. Some patients’ efforts were easily detected, and some do a slick job.

Now that we have pressurized seals on the take home bottles, we think it’s more difficult to get into the bottle without being detected, but some clever patient will invent a way to thwart the pressure seals…or already has done so.

If the patient fails a bottle recall, we must eliminate all take homes, at least temporarily. Sometimes patients don’t give us a working phone number, sometimes they say they never got the call, they just dropped their phone in a mud puddle and it wasn’t working, they got the message but forgot to return to the clinic, they just went out of town and only got the message when they got back, are out of town and can’t make it back for a bottle recall…we hear many reasons for a failed recall. Many are legitimate, and it’s nearly impossible to sort reality from lies.

According to patients, take home medication has been lost, stolen, left in hotel rooms, spilled in the sink, run over by cars, eaten by family pets, black bears, and other animals, burnt up house fires, and dumped out by angry spouses and highway patrolmen. In one creative story, the patient said a tree fell on her house during a storm. The great wind that felled the tree also created a sort of vacuum in her house, and a whirlwind sucked her medication bottle up, up into the sky as she watched helplessly.

Another patient said he couldn’t come in for a bottle recall because he buried his bottles in the back yard and forgot where he buried them, because he had Alzheimer’s dementia. Of course, I asked why he buried them, and he said, “So my wife wouldn’t get into them.” No, he didn’t get any more take homes.

Of course weird things can actually happen, and that’s the problem. What should I do if a patient who appears stable and who appears to be doing well, reports loss of medication? It’s a judgment call. With the help of the rest of the staff, we discuss the past stability of the patient and the believability of the report. We can’t look into the hearts of all our patients and tell who has criminal intent and who doesn’t. People can’t be perfectly assessed. I do the best I can, and with the help of the rest of the staff, make judgment calls about take home doses.

As the prescribing physician, I have a responsibility to make sure every patient who gets a take home stores it safely and takes it as directed. If a patient is unable or unwilling to do this, I have to revoke their take homes, at least for some period of time, especially if there’s evidence my patient is selling or giving away their medication.

Diversion of take home doses to someone other than the patient for whom it was prescribed is always a concern at opioid treatment programs. But we don’t want to limit freedoms for patients doing well because of the illegal activities of other patients. As with so many things relating to human behavior, it’s an issue of balance. I admit we don’t always get it right.

Some anti-methadone activists would like to change the law, and force patients on medication-assisted treatment to come daily for their doses, and eliminate take home doses. That would reduce the problem of diversion, but cause a bigger problem. It would disrupt the lives of thousands of MAT patients who take their medication as prescribed as they go about their life.

In the other extreme, some pro-MAT people say patients should be allowed to be prescribed methadone and buprenorphine a month at a time, just like medication for other chronic illnesses like diabetes and high blood pressure. But the medications I prescribe, methadone and buprenorphine, have street value, and can cause euphoria in people unaccustomed to taking opioids. Therefore, because of the properties of these medications, sound medical practice tells us we have to have some safeguards in place to detect medication misused and diversion.

173 responses to this post.

  1. Posted by dbc901028 on August 3, 2014 at 7:46 pm

    The pharmacological profile of Buprenorphine and Methadone vary so much that I hate to see them lumped together in any legislation, regulation, or law enforcement. They have much different dispensing guidelines for a reason.

    Bupe and Methadone both have street value, but Methadone is the only one people would get high on. Buprenorphine has street use only stave off withdrawals. Ironically, it comes with a heavy price to drug addicts: The inability to get ‘high’ on a full agonist for days, due to Buprenorphine’s high affinity and half-life blocking any other opiods. So, if it gets diverted, it’s not like it’s getting anyone high. It might even be saving lives! (though I don’t advocate for such diversion since it’s illegal).

    Of course, frequent readers of your blog know all this, I just have to clarify for any passing reader that needs education.


    • To say that patients can get high off methadone and not buprenorphine is simply not supported by the evidence. Methadone as well is mostly going to folks who should be in treatment that are already opioid tolerant – folks who aren’t getting high. Neither medication causes individuals to get high — unless you consider being sleepy high.


      • Posted by Kathryn Bertolino on October 21, 2017 at 9:42 pm

        To say a person does not get “high” off either is a lie and you clearly have never taken them. If you had and your being honest, than you would know that both medications cause a “high” similar to a narcotic high. I felt this “high” for the first 7 months I was on methadone. I had no choice in decreasing because I was pregnant. I am now going on 11 years sober. I have also spoken to several people that all agree that they were high during the first months of taking both medications.

      • I think your experience is most unusual. Most patients say they feel normal on methadone/buprenorphine. Data show patients on both have normal reaction times and normal perceptions. Some people can experience a euphoria after a dose increase but that always wears off.
        I’m always surprised how people assume their own experience with a medication will be the same as everyone else’s.

      • Posted by RecoveringPhil on April 7, 2018 at 1:41 pm

        If methadone causes you to feel high, you are on too high a dose. I am always flabbergasted by the huge doses people in the USA find themselves on. I had a pretty heavy drug habit, and was spending close to £1000 a week, but I am stable on just 50mg of methadone. My treatment was initiated at 20mg with a visit to the clinic each day to observe the extent of withdrawal, followed by a dose increase of between 5 and 10mg, every two days, until the correct dose, (ie, one that eliminates all withdrawal symptoms and significantly reduces cravings for additional doses), is found. In my case that was at 50mg. The majority of patients at my clinic are on dosages between 25mg and 50mg. However, I constantly see stories of people from the USA, with an addiction lasting just 1 or 2 years, being put on astronomical doses of methadone, like 150mg and above. To me, this just seems unnecessary and feels as though it is designed with the intention of having the patient addicted to methadone for a longer period of time, possibly eliminating altogether the likelihood that they will ever be off it.

      • Thanks for writing. There’s a wide range of variation in how people metabolize methadone. In the U.S., opioid treatment programs used to keep everyone on doses lower than 70mg. Then there were some large studies (Ball & Ross, I think) that showed higher doses resulted in better outcomes for some patients.
        I don’t think 150mg is astronomical for some people…their metabolism may be different from yours.
        But I do agree – we want the use the lowest effective dose.

      • Posted by William Stewart Halsted on March 15, 2019 at 5:31 pm

        On a fundamental level, all of you are implicitly assuming, without ever taking a second to examine it, that the act of getting “high” in and of itself is bad, wrong, or some sort of moral failing. Why is that the case? On a physiological level, getting high is nothing more than inducing a dopamanergic response by performing a certain action….when viewed on that level, getting high is identicle (in the way your body responds to it) to shopping for some people, or sex, or gambling, or even knitting if they like it that much. So, based on that and in the spirit of not being hypocritical, Im assuming that just as you are passing negative moral judgement on getting high, then you also view any act that produces a “high” or dopamanergic response in humans negatively? If that’s not the case, explain to me why getting high by using a chemical to alter your neurotransmitter modulation and consciousness, in and of itself, is bad or wrong. Let me preemptively state right now, that citing other, possible (but, according to all the empirical data available, statistically far from probable) resulting actions is completely inadmissible. The crimes commited by an addict in the support of their habit, like shoplifting, is caused by inducing the release of dopamine in your own brain, and that goes for overdose, losimg your job, getting arrested, etc. Furthermore, all those “negative aspects” people like to unjustly attribute to drugs, are not caused by the drugs themselves, rather theyre entirely caused by the laws prohibiting them. Open any Merck pharmaceutical reference book or similar analog, and find the entry on Diacetylmorphine which is the real name for what people refer to aa “heroin”. I guarantee you wont find anything listed under side effects mentioning shoplifting, committing crimes, going to jail, etc because it’d be impossible for any drug to cause such behaviors, so it’s the prohibition of the drug that’s to blaim. When something humans have desired for as long as our species has existed like drugs are irrationally made illegal, it causes them to become artificially scarce and artificially expensive. Does any reasonable person believe that if marijuana wasn’t illegal, that a plant that literally can grow everywhere like weed, would be approaching a price per ounce equal to that of gold? Or, that if heroin was readily available in legitimate stores and 90% cheaper than it is now while it’s illegal, that an addict would have to steal to obtain it? Or that if an addict was guaranteed a cheap and readily available supply of the drug that they’d be able to get employment, or take care of the responsibilities associated with their families and friends since they wont have to be hustle to get money and then finding a dealer all day every day?

        So, now that we’ve established that it’s really drug prohibition that’s responsible for the negative aspects incorrectly attributed to drugs, please explain to me what’s wrong or bad about getting high in and of itself?

      • Are you serious? Are you really saying that the compulsion and obsession to use drugs doesn’t cause problems, aside from legal and financial concerns? I don’t judge the people who want to feel good; I do judge the myth that says I can feel great all of the time if only I have the right drugs, or combination of drugs. It’s a lie. Or maybe you are confusing drug use with substance use disorders. They are two very different things.

    • Posted by J.Miller on August 4, 2014 at 9:34 pm

      dbc901028, Both buprenorphine and methadone can, and do, cause a high in individuals who are not tolerant. Both medications can be used for recreational purposes. However, when used for maintenance purposes neither medication cause any kind of high. In large doses methadone will only cause drowsiness.


      • Posted by Blake Karlowicz on September 2, 2016 at 5:08 pm

        This is true. The only way to get high on bupe is to be completely clean of any opiate before taking bupe. Then one would feel very very high. It almost unbelievable how high hope will get an individual who has no opiate tolerance . just 1 mg can keep you nodding for over 24 hours. But once a person becomes opiate tolerant, and I mean like the second or third time taking bupe or any other opiate then it will only keep you well. Plus keep you from getting high on any opiate for at least 24 hours. Some people are different but this is true for the majority.

    • hard to believe but some people mainline IV even bup/nal combinations — they have told me the naloxone effect is effervescent and they can feel a high with bup. and certainly they do it with Bup alone — that is why the states restrict the mono product use in OTP’s to daily dosing or pregnant patients. So i don’t think it is true that people ‘can’t get high off buprenorphine” .


      • What you say is true – some patients will inject even the combo product. THe naloxone wears off first.
        Generally speaking, using buprenorphine as prescribed, daily, to a person with a tolerance to opioids does not produce a high feeling.
        I’ve also had patients experience a high from injecting salt water – their brains associate injecting with euphoria, so that’s also a possibility.

      • Posted by William Stewart Halsted on March 15, 2019 at 5:45 pm

        Having been on buprenorphine, both monoformulations like subutex and buprenorphine and naloxone like suboxone, and currently being a doctorate student in molecular neuropharmacology (specifically focused on the role of endogenous opioid modulation in depression and the use of mu opioid receptor agonism to treat it), i can state that the naloxone in suboxone does absolutely nothing, that it does not prevent injection (it’s actually the high affinity that buprenorphine has for the mu receptor that causes withdrawal when coadministered with another mu agonist. Furthermore, anyone sustained on buprenorphine can inject it as much as they want and it even gives a nice rush without ever worrying about the naloxone. In fact, I honestly do not understand how suboxone received FDA approval when it offers no advantage (in reality, not what is claimed by Reckitt Benckiser Pharmaceutical) over monoformulations of buprenorphine such as subutex. They most have bribed the FDA, which isnt unbelievable considering Reckitt benckiser sales representatives were caught incorrectly telling doctors that it was now illegal to prescribe subutex.

        FYI, naloxone is not a panacea, it, like all other opiates, is bound by the same rules and properties, and when it encounters another opiate that has a higher affinity for the receptor sites than it does, it does nothing…thats why you can find numerous examples in the news of individuals overdosing on fentanyl and how EMT’s can administer up to three doses of naloxone without effect. This is also demonstrated with the fact that buprenorphine isn’t an insurmountable blockade, and for example, fentanyl can easily breakthrough buprenorphine blockades even at the buprenorphine plateau dosage of 32mg.

    • Posted by RecoveringPhil on April 7, 2018 at 1:31 pm

      I am a methadone patient and my medication has never ever made me feel high. I can tell you with absolute certainty however, that in the local prisons, people are going absolutely bananas and throwing big money around to insufflate lines of crushed up buprenorphine tablets, and I have also been told by a long-time abstinent associate, that intravenous administration of buprenorphine is indistinguishable from that of heroin to a user with experience of both but without an active dependency. Conversely, in my experience, the methadone patients, myself included, are much less willing to ‘miss out’ on a day’s dose for the purpose of any potential diversion because, technically, these patients are maintained at a theoretically higher level of dependence to opioids. The street value of my daily dose of methadone, js insufficient, by quite some distance, to cover the dosage of illicit opiates that I would have to take instead of said methadone dose, in order to avoid going into withdrawal. So despite the comparitively different chemical profiles of the two substitution medicines, and contrary to expectations, it appears, at least in my experience and observations, that buprenorphine has the higher abuse potential as a result of diversion.

      I live just outside of Liverpool, England, in case this is relevant to anybody.


    • I am only repeating what I’ve heard from the streets, and the seems I have witnessed in my mother’s house as well as mine with regard to Suboxone and the ability to separate the naloxone and get the buprenorphine which would make a person intoxicated.
      My son is unfortunately on the streets now and he and a couple other people that although they are using, I care about them as my son’s friends. they have educated me to all of this new stuff that was never there when I was using thank God. It’s amazing in 15 years how much things have changed for the worst.
      A lot of people (including physicians, nurses, social workers excetera)don’t realize that Suboxone can be broken down much the same way that heroin can. Somehow where is the pill and cotton and a spoon, I’m not well-versed in this,naloxone comes out, the buprenorphine stays. I won’t say how because obviously I don’t want to encourage this sort of thing, but my son used to do this everyday all day.
      I would find paraphernalia that was pinkish because of the pills.the spoons in the house were missing, and he would be in the bathroom slumped over for an hour or more. I would find the paraphernalia and the Suboxone pills both broken down and in the bottle. When I had him sectioned Iold the psychiatrist that I spoke to that day in court about what he was doing. He said “that’s not possible”. I said” it is possible, and you should really start talking to some of these addicts rather than just pushing them down the line to the next hell hole.” (When I sectioned my son they promised me he would not go to Bridgewater which is a hospital for the criminally insane, but they broke their word.)
      There are no real counselors or advocates-no real detox, pretty much the same “so-called” detox you would get in jail, which is a joke. but rather the corrections officers run the so-called program. They are treated as criminals.
      At any rate, I have pictures if you’d like to see them but suffice it to say, it definitely can be separated. They are doing that now with crack. They are breaking it down and somehow using it IV.
      The vans that have free hypodermic syringes and other items to help people not overdose such as narcan also now have a white powder that is labeled “vitamin c” I believe. I might be wrong about the name of the vitamin, but it’s definitely a vitamin they break down into powder. I asked my son what this was, because to be honest it looks like a giant bag of heroin or cocaine, and he said that it’s for people that are taking crack and melting it down to use it IV.
      . They are taking a huge risk though and that’s why if they add the vitamin powder, it takes MOST of the impurities that could kill them out. I always say that if one wants to learn about what’s going on in the streets, we should go to the streets. ( of course where it’s safe like a van that provides these harm reduction products.)
      It frightens me that I’m an addict with 15 years plus clean time, my son is on the streets right down the street from me, and I thought I knew everything about drugs and recovery. But that is the disease of addiction that can grab out and pull someone in that has so much clean time. The clean time lulls you into a sense that you know so much, and I have learned a valuable lesson. thank you for allowing me to comment especially such a long comment LOL this is a great topic and blog.


    • Posted by Candace Smithers on June 28, 2020 at 7:31 am

      I’ve been on methadone for 11 years..I have just graduated to 2 weeks take home..I could have got them sooner but I wasn’t ready..I wanted to be honest to my self, my counselor and infuriates me when a few bad apples make us all look bad..we have the foil seal on our take home and there’s no way you can get to the medicine without it can’t glue glad because I don’t have to worry about being tempted…most of us really want to do well.


    • Posted by Brittany lail on August 7, 2020 at 1:58 am

      If I got my two week bottles and the last three the nurse didnt shut them right so I ended up losing half of my last 3 bottles whay can I do


      • Yes that’s an awful problem when the bottles don’t seal. I don’t know what else you can do except take your bottles and lock box back and explain what happened.

  2. You can get two weeks takehomes with 1 year in treatment under the federal regs and in most states and 1 month of takehomes after 2 years in treatment… North Carolina is one of the minority states with more stringent restrictions on takehomes. Restricting takehomes prevents patients from being able to live a normal life and get a good job, be able to travel and other things their treatment shouldn’t restrict. And even with a majority of state having large numbers of methadone patients with monthly takehome status the statistics still show the VAST majority of diverted methadone comes from prescriptions from private physicians for “pain” — NOT from opioid treatment programs. It’s unfortunate the 10% or so of patients who aren’t compliant with treatment or otherwise involved in diversion, etc. make up 99% of the headlines and cause an amount of hysteria surrounding takehome medication that harms patients in recovery more than anything else. Let’s talk about how to decrease the TRUE source of illicit methadone: pill mills and pain clinics.


  3. Actually wrong you do not get high from methadone and any patient will tell you it is pretty piddling. Some naïve individuals may misinterpret the sedation of methadone with being high but no one ever had an opium dream on methadone. Buprenorphine on the other hand does have a high and individuals are starting to enter methadone treatment giving buprenorphine as their drug of choice. It is rare to see methadone as a drug of choice. Both France and Scotland resisted methadone preferring buprenorphine and ended up with a serious buprenorphine problem with users preferring it to other opiates. When heroin is not available buprenorphine becomes a great second choice.


    • Exactly, Joycelyn. Glad you commented. 🙂


    • Posted by Matt on August 14, 2014 at 6:22 pm

      You are sadly mistaken if you think methadone is safer than bupe.
      What a pathetic comment. Methadone is for people who don’t want to get clean. PERIOD.


      • Well now, let’s remember the evidence. Methadone – clearly – is a life-saving medication when used correctly.

      • Last I checked I am clean after I take a shower… I’m not sure what hygiene has to do with the medical treatment of opioid addiction, but like Dr. Burson makes clear, methadone treatment is evidence solid.

      • Posted by Mark on July 31, 2015 at 10:39 am

        That’s the dumbest thing I ever heard

      • Posted by Maxine Antin on April 26, 2017 at 8:06 pm

        This is not true. Some people need longer than others to feel ready. I quite honestly why is it really matter? If a person has any other disease that needed life long medication, people wouldn’t bat an eyelid. Well this too is a disease

      • Posted by 3 years clean now on May 15, 2017 at 10:23 am

        Methadone 100% saved my life. I have lost 4 close friends to heroin, and a young family member (22yo). I was doing 15 bags in a shot and was almost dead.I have a week take homes now, i have not used dope for almost 3 years. So, i not only want to be clean, i am clean, and healthy, and not stripping houses of copper for my daily fix anymore. My court cases are finished for my possesion charges, and my life is back to normal thanks to treatment. Should i have just died since you dont understand methadone treatment?

      • Posted by Max on May 18, 2017 at 5:25 am

        It really infuriates me when people say that taking methadone is just switching from one opioid to another. It was the only thing that truly made me straighten up my life but that aside, the point I would like to make is this; I was once told by this by a very eminent Dr in this field based in the UK. He said that if there is someone that suffers from a disease i.e. diabetes and they need to take a drug to ensure that they can live a normal life then why is it so absurd to think that an addict with the disease of addiction should not be given the same opportunity?
        That’s exactly how I feel. I was sick and needed help to recover does it really matter how long I need to take it? I did take it and for over 20 years in the UK (without a problem) with a monthly take home which included injectable methadone (I digress). I came here and was clean for about 8 years and now I’m in a program here and the rules can sometimes be so ridiculous that I can understand people failing. It has taken me so long to get to a miniscule amount of take home in comparison and I’ve an absolute clean record! Why should we be dealt with differently to any other diseases?

      • Matt is just plain ignorant.

      • Posted by matrix on January 30, 2018 at 3:29 pm

        ur wrong there pal I take methadone and been clean since the day I started the program so ur entitled to your opinion but it is not a fact!

      • Posted by Blueberry on January 31, 2018 at 3:39 am

        Matrix, conrats – I’ve also been clean since the day I started the program. Methadone helped me stabilize; rather than spending my days (and all of my money) trying to find some way, any way, to avoid being sick, I was able to take a single dose of medication once a day in a safe environment. I was on the verge of homelessness and suicidal before I entered this program. Now I work full time, have close and trusting relationships with my family, and have a lovely home of my own again. Those who think methadone is just a transference of addiction don’t understand the inconsistency, volatility, difficulty, and danger of needing to find something on the street every single day, not to mention never knowing exactly what you’re getting. The stability and safety of this program saved my life in myriad ways, and I’m personally grateful for the strict guidelines. I had to build and earn trust with my clinic. Had they tossed a month’s worth of meds at me from the start I don’t know if I would have succeeded, but they forced me to make a commitment and to be accountable – no excuses! And because I knew that was the case, I made my decisions carefully, and now I’ve tapered down to 25 mg/day and only need to go in twice a month. I know these types of programs don’t work for everybody; all I can say is that I don’t even want to think about where I’d be now if I hadn’t made the decision to enter mine.

    • Posted by ActuallyHad aProblem on May 24, 2017 at 2:02 am

      Ma’am, you are mistaken. There are two types of people that use opiods. Those who get a sedated effect and those who get an extremely euphoric energy boost prior to receiving the sedated effect. Methadone is no exception to that. I, unfortunately, am one that got the “boost”. The focus, energy, and euphoria it gave me was unparalleled. Suboxone did the same but on a less noticable scale. When I entered treatment, I continued to get that high every day. After a month passed it was gone, the tolerance my body developed saw to that. I have been in treatment for over a year and have used for much longer and while I love the truth that science and medicine provides, it is not always fact. You can get a non sedated high from both drugs. Sorry I am late to the show.

      A thoughtful ex user


      • You do realize you are responding to someone who has been in methadone treatment for more than THIRTY years compared to your one year? Who also has a graduate degree in neuroscience… right? The “abnormal normality” you are referring to is not common across the board after induction and stabilization, and even for those in whom it persists it is no where near the “high” from short acting opioids. Perhaps you are on too high of a dose if you continue to experience ANY euphoria. The goal of maintenance is normal. If you are communicating your euphoric experience to your clinic physician I doubt he/she would leave your dose the same. If you aren’t communicating that then that is on you – not on the treatment. There’s no fool proof way to get patients to openly and honestly communicate with their clinic physicians.

  4. I should have added that the reason for the difference in the 2 medication is their pharmacological profiles — but it is not because you get high on one. It is more related to the risk of diversion — realize that the name of the game for most regulations that interfere with treatment has to do with risk of diversion and overdose. It is pretty hard to overdose on buprenorphine because of the ceiling effect and methadone in comparison is a powerful narcotic and it can last up to 36 hours or longer until tolerance is build up. For this reason methadone can be very unforgiving if a person takes too much and they may not even realize it — even the sedation is not that great and comes on slow so it is real easy to pop another pill when the user is not experienced. Nearly all the methadone overdoses (and lets remember that most of the methadone came from pain clinics) have another drug – usually benzodiazepines on board. Methadone by itself is not a fun drug and our state agency did some studies on methadone that was diverted. They found that the vast majority went to heroin addicts who for whatever reason could not enter treatment or were using it for a few days because they had to work and methadone lasts longer.


    • I think denying that some people do misuse methadone for an opioid high – even though relatively few and usually early in their addiction – puts one at risk for losing credibility altogether. I am a super-supporter of methadone, but only when used in the right way in the right patient. It can be misused.


      • Posted by Dave on December 16, 2016 at 4:04 am

        Hello,I have been reading your posts for about a year now & sent my counselor at BHG Recovery Clinic in midtown Memphis,your link etc……I like your attitude regarding methadone & the positive aspects you give your readers & clients….Im a big huge advocate of Methadone but I think some of the “punishments” are a little too other words the punishment doesnt fit the “crime”…..testing dirty etc..Ive been in the program 13 years & have not stuck a needle in my arm in 13 years…I am 60 years old ,married,three grown girls all college grads & married…My wife and I live in north Mississippi about100 miles due east of Memphis..Anyway,could you send me a link regarding revocation of take homes in Tennessee…laws & policies of diversion program etc.etc…..I would appreciate it and I surely wish I was in your area….I take the wafers which are much stronger than liquid and that is gospel fact…I take 130 mg, for last 13 years…..Love your site !! Thank you,Dave

    • Posted by Alan Clark on August 9, 2014 at 2:18 pm

      I totally disagree with the statement that you can’t get high on methadone. I used to get a wonderful, long lasting typical opiod high. I felt the same euphoria, the warm fuzzy feeling caused by opiods, and the energy some opiods cause. I know many people that buy methadone for that reason specifically. They get a very long lasting high. This is not to say that everyone does. It is mainly opiod naive individuals that get the buzz. Eventually, (in my experience as an addict) the ability to “feel” the methadone goes away and one will have to take an increasing amount dlfor the desired effect and tben one starts to experience sedation. I have been an opiod addict for almost 15 years and have been on methadone for 10 of those years. I started pain killers at the age of 14 and was a full blown addict by 15. I was able to hide this from family for almost 4 years. I was eventually taking a very highdose of oxycodone daily and could no longer afford the habit. I got introduced to methadone and fell in love immediately because i could take 200mgs of methadone and it would last for almost three days, at first. I then got in trouble and could no longer get it on the street so I started attending a clinic. For the first two years i was on 200mgs daily and was highly sedated. I then switched to Suboxoneand after a while, started to “feel” the suboxone. Now, I’m on 90mgs of methadone at a clinic and my life is stable, and wouldn’t be without MAT. In closing, I felt the need to address the comment that one doesn’t get high on methadone. If one is on the correct dose, they won’t feel the medication, but if they are on too much, it is entirely possible to get a buzz. MAT has saved me since I started taking the actual dose I need instead of telling staff I needed a higher dose. Now that I’m actually in recovery and am not trying to get high, I can tell you that you can get high on either medication, especially when not tolerant to opiods or either medication. This may not be the case for everyone, but in my long history of addiction, I have met many people that have taken methadone as their DOC because of the long lasting effects.

      I apologize for this being so long. Thank you so much for the time you dedicate to this blog, Dr. Burson. Your knowledge and desire to help addicts seems unmatched by many other medical professionals, sadly.


      • Posted by J Bo on April 13, 2020 at 2:49 am

        How can a person stay clean if their Docs not raise ing their methadone high enough? Even when I take my dose it doesn’t work in getting me comfortable i.e. I’m still hurting physically,my nose & eyes still runcraveings are unreal and by 2:30p.m. it’s ov I’m usually on 90mg. to 120mg I’m in amess. He’s left me at 60mg not allowed a raise 100 bucks a week

      • I don’t understand by what you mean about 100 bucks?

  5. Posted by Clever Leigh on August 4, 2014 at 10:17 pm

    talking about taking take homes, when there is so much wrong about methadone in general. there’s a fine line between green$


    • yeah i don’t know what this means either – probably trying to be a sly reference that opioid treatment programs charge for medical care. As I’ve said before on this blog…medical in this country is not free. It is not a right. Patients, even if through their insurance companies, have to pay for medical care. Addiction treatment isn’t any different.


      • Posted by Dave on December 16, 2016 at 3:33 am

        Methadone saved my life…period…I have been using off and on since I was 15 years old (1969)….without it I would be divorced,broke & most likely six feet under….

  6. Posted by hgr on August 8, 2014 at 5:35 am

    I am at a treatment center in Charlotte on mmt and I randomly found your blog but I’m glad I did. I have been in treatment since July 8th 2013. I was prescribed methadone first in rehab at the life center of galax in VA. I transferred to a cLinic here and slowly increased my dosage until I got to 90msg. I felt entirely too sedated and quickly went down to 80 where I was stable and remained on 80 for 8 months. I just recently decided I wanted to start decreasing and trying to get off methadone all together. I went down to 75 and I was fine. Then I dropped 10 mgs down to 65 mg which is where I’m at now. I feel horrible and have been feeling like this for 3 going on four days. I really don’t want to go back down bc I want to eventually come off methadone all together. My question to you is do you think my body will eventually stabilize on the 65? Or will I feel like crap forever on this dose? My doctor is an idiot at my clinic which is why I’m asking your opinion. I know you cannot give medical advice but can you speak hypothetically on the body adjusting to dose when someone decreases their medicine.


    • You’re right, I can’t give advice to you, but in general, if a patient comes down 10mg and feels bad, I’d encourage that patient to go back up. Maybe not the full 10mg; he or she could try going up by 5mg.
      because why feel miserable when you don’t have to? Why risk a relapse while you feel lousy?
      I also encourage patients to listen to what their bodies tell them. If a 10mg drop is too much, don’t drop by that much again. Make it slower in the future. Unless there’s some sort of deadline you have to meet, it’s better to take your time to give your body time to adjust. You asked if you will eventually stabilize at the lower dose, and I don’t know what to tell you. Many patients do stabilize but some don’t; it can take only a short while or much longer. I’ve been impressed by how much patients differ when it comes to tolerating tapers.
      But I do know you’re at higher risk for a relapse if you’re in withdrawal.
      Please go talk to your doctor – don’t give up on him/her just yet.


  7. Posted by hgr on August 8, 2014 at 5:37 am

    I meant to say that I don’t want to go back up*because I eventually went to come off of the methadone.


  8. Posted by Anna Sams on March 26, 2015 at 7:15 pm

    Just wondering if methadone would keep good longer in the refrigerator or if u can freeze it? And what are the floaties that appear in the bottom of the bottle after so long?


  9. Posted by Brandon on May 11, 2015 at 11:38 am

    Ok so I had a uncle steal my take homes. I filed a police report right after. I had the people at my clinic tell me that it was my fault and that this time they are taking my take homes and they don’t know when they are giving them back. I’ve been talking to my counselor and she seems to think If I keep doing good I should get it back and so does her boss. The only one that has been blocking me from getting the back is the doctor. I went to go talk to my doctor today and went into dose and on my paper work it says that he’s taking my take homes for good. Of course it really pissed me off because I have tried everything to get them back even though it wasn’t my fault they were taken in the first place. I’ve bought a bigger lock box to put my little box in. I’ve bought a lock on my door and have moved out of the house where they were stolen. I know of 4 people that have had their take homes stolen but did not lose their take homes not even for a little bit. When I tell the people at my clinic they act like its BS and its just hearsay. At this point I feel like I have no other move than to go over the doctors head if I can. Its bull that he can do what ever he wants and theirs nothing I can do about it. What makes me upset is I have never been In any trouble up their. I mean none and the first time something happens their ready to take my take homes for good. If I could get someone advice on what to do I would really appreciate it.


  10. Posted by Dan on June 5, 2015 at 1:15 pm

    Can you loose your take homes for shoplifting?


  11. Posted by Benjamin Kehler on November 26, 2015 at 4:43 am

    Revocation of 6 after 3yrs of compliance and nearly 30 clean urinalysis due to trace metabolite after e.r. visit with Valium administered and prescribed. Urinalysis indicated positive but not flag level. This is the total truth. How can I get fair treatment. I’m so distraught and discouraged. Its a personal vendetta by a director.


  12. Posted by Rose on January 22, 2016 at 11:59 am

    Hello Doctor! Thank you for explaining the take home process w methadone. I don’t know what state you are in but I am in Pennsylvania.I have a problem I am dealing with and thought you may offer insight or opinion.I am on methadone, have had privs 1 time a week (seems to be most they give out in p.a.) for 4 yrs. In Nov. my urinalysis came back positive for opiates(6Mam was done). Therefore, my privs were revoked for 60days. The next month my u.a. was fine, then as I was to get my privs back this month I asked to do my paperwork.At that time my counselor informed me my u.a. was positive for opiates. I asked if a confirmation was done because in no way should that have been positive and was told no but they hold the urine at the lab for 2wks n will ask for one. The following week I was told morphine 90ml/nl ? was in it so I would not get my privs back.Usually when a u.a.comes bavk positive they have a hold on you and speak w you immediately that was not done. Then, I know this was a mistake of some sort lets face it, we know what we do and don’t do. I worked hard for my privs and the head nurse is now saying I must begin all over with 1take home at a time as if I was a new patient! I’ve not ever had this issue of dirty urines and I meet all criteria for take home. I have a job and kids, no vehicle at moment and can’t have to go every day for that long! Today I heard the employees talking regarding privs and realized they have taken other ppl backwards example, Sarah goes 3times a week and was dirty in her u.a. so they now took her to only weekend privs. Or Jack goes 2times a week and had benzos in u.a. so they took Jack down to 3times a week for 60days. Why I a stable patient with no history of dirty urines, no problems at all! Never miss a day, never miss counseling, no problem ever! I am having trouble as to where to find the regulations for P.A. and I am just wondering your opinion. The head nurse not anyone else said I need to start over phase 1. I was at phase 3! I feel I am being unjustly done. Why others get to go backwards while my privs were removed makes no sense! I always pass my callbacks and they must know mistakes happen because no way is that result correct anyway. If I did it, I’d take the consequences. I am not guilty here and feel I have nowhere to turn! Thank you !


    • I’d advise trying to meet with your program manager, your doctor, and maybe filing a grievance if you don’t get satisfaction.


      • Posted by Rose on January 22, 2016 at 3:15 pm

        Hello! In response, I have met with my counselor, and the program director is out due to personal reasons for an extended ammt. of time. I feel like filing a grievance doesn’t do much for others’ who have done so previously therefore, I have got the number of a very high up person in charge whom I plan on meeting with. I do however, need to be educated (I feel many of us on methadone are grouped together as ppl who are uneducated) regarding the laws federal, state, as well as program policies. I can’t seem to find the policies for my state regulating methadone? I’ve googled and lots of things pop up but not what I am searching for. I am in P.A. There has to be a way to find info that I am searching for… I feel so helpless in my battle on methadone and thank people like you educating others . Thank you!

      • Here’s the SAMHSA link to all the SOTAs (state opioid treatment authorities). Just go down to the PA link.
        I don’t know if regulations will help you. The regulations are mostly about what OTPs can’t do – limits on things like how many take homes can be given, etc. The regulations do not say OTPs must give take homes, or give dose increases. I still think you need to talk with your doctor, because I doubt a state opioid treatment authority would contradict the treating physician, who knows (hopefully!) the patient.

      • Posted by Rose on January 23, 2016 at 10:21 pm

        Thank you for the link. I see that you are a proactive and seem extremely involved with your patients and I applaud that to the fullest extent. I could only wish the doctor at the methadone clinic I attend would even know my face, let alone my name or file. Usually we see the nurses daily and yearly we see a physician assistant for their form of physical at the clinic. Therefore, I again express my lost in the dark trying to find help with my situation. I could request to speak to him but he does not know me and my past treatment history; which is to many impressive. It is unlike me for a “dirty” u.a. to ever come up in over 5yrs..Therefore I wish they could realize the lab they use (which they have had plenty of issues with results being wrong) is wrong on this one. The turnover rate of counselors is high and we the patients are left with no advocate. I’ve often heard “Past behavior is the best predictor of future behavior.” If that help their arguments (clinic) it should also help mine. Again, thank you for all you are doing!

    • Posted by Dave on December 16, 2016 at 3:47 am

      To the man in Tennessee where I get my methadone (Memphis) is no “in between” or “maybe”…Its black and white……I have been in program for 13 years & have been clean….I tested positive twice due to my 90 year old father in law giving me an aspirin in his glove compartment..The bottle of aspirin was about half full and he had a few generic Lortabs in there which looked exactly the same….Needless to say I took 2 and tested positive a few days later at the clinic..I know this sounds far-fetched but its the truth….You know,if Im gonna go out & get high it sure isnt gonna be a few Lortabs..Ya know ? …of course the clinic..BHG Recovery out of Dallas,Tx didnt believe me..and I lost take homes for 90 days…I live on a farm in north Mississippi and it takes 2 hours each way to get to the clinic…..They dont give a rats ass how long you have been there or how far you live from the clinic….It means nothing….My clinic cares…cares about the $400.00 I pay them each month and thats it……Surviving in Mississippi..Dave


  13. Posted by Christine Ramsey on April 7, 2016 at 10:43 am

    The reasoning for not giving monthly prescriptions of methadone to stable patients is not logical. There are many other medications prescribed to millions of patients worldwide that can cause euphoria or death if taken incorrectly. Waiting years to be able to have a normal life is a burden which prohibits many from fully benefitting from MAT.


  14. Hello, I have been in my clinic for almost 2 years now and I get 6 take homes. Currently I do not have an assigned counselor and have not had one for 3 months now. I was given my 6 th take home by the director putting it through. I am a combat veteran of Iraq and after extensive therapy and appointment after appointment after appointment things were finally getting good again. Here is my problem, they did a callback on me and I never even knew about these call backs, was never told, nothing, nada, when I asked the nurse she said my counselor should have told me well, I don’t have a counselor, been without for three months now, why I didn’t get the call is my fault kind of but I’m sure they heard em all, I purchased the Samsung watch phone and it was activating the blue tooth feature when in close proximity. I have never been a disciplinary problem, never missed a meeting and pay 1 month advance every time. They were going to take my take homes for 90 days and decided 30. I just spent my morning reading all the federal regulations, the call backs are the clinics discretion not federally mandated. They told me its federal rules number 1, but I feel they took nothing into consideration and also, if they want to get all federal on me, it is their responsibility to periodically update patients of the rules and regs especially after 2 years, I feel like I’m just going backwards Who is the highest rank at a clinic?



    • The doctor who is medical director at your opioid treatment program has the final decision. It’s her name on your take home bottle, and if she’s not certain what she prescribes is going to you, she may decide to revoke your take homes.
      At all the programs where I’ve worked, before a patient gets any take home doses, he signs a form saying he understands the rules around getting take homes…this includes storing the medication safely, not selling or giving it to anyone, and about call backs.
      All OTPs are asked to have diversion controls in place, and periodic call backs are expected to be a part of that.


    • Posted by Roman on August 30, 2016 at 5:51 am

      Dear veteran, If you only have 30day suspension just goes fast. I understand that it was not your fault but its more hassle than it is worth..the director can give you her bosses number if you want to go down that road but personally I think it will just be b.s. n by the time u r thru the 30days will be over..good luck. Keep us posted!


  15. Posted by Janis on August 24, 2016 at 12:09 am

    I have 2 week (13 bottles) take-home privileges. I’m a full time student (3.5 GPA) with two children and a busy schedule. I got my first call back today, and I went in as requested, but apparently I am missing a full bottle. Before I went in, I didn’t count anything, because I take my medication as prescribed and I just assumed they would all be in there. My lockbox doesn’t lock; it hasn’t since I first started bringing it to the clinic for pick-up nearly a year ago. The nursing staff either didn’t notice I never locked it afterwards, or just didn’t really care. I kept meaning to get a new one, but since I was never reprimanded, it kept slipping my mind. My lockbox is kept on top of the fridge, far out of reach of the children, so that is not a concern. I was shocked when they informed me a bottle was missing. I consulted the calendar and sure enough, I was a dose short. I don’t know what happened to it. I lost my house key not long ago, and for over a month I would finagle my way into my own house by keeping the front window unlocked, and then reaching in to unlock the front door. I live with the father of my children, but he swears he didn’t take it. Several people, including not the most noble of close by relatives, are aware of the fact I am on methadone and that I have take-homes. The clinic kept my bottles, the ones that had already been dispensed to me. In fact, they kept the entire lockbox. I filed a police report for the missing bottle, because
    I cant discern what else could’ve possibly happened to it. I understand that this is in part my fault since I failed to have a properly secured lockbox, but its just so unfair and is bothering me tremendously. The medical director will be away on vacation for another week, and until then, I am to go in to the clinic daily to dose. On Wednesday, I have my appointment with him where I will bring in the police report and he will determine the status of my privileges. Since the clinic had already dispensed and distributed those bottles to me, are they really allowed to confiscate my medication like that? And then try to give me that same medication I had at my house to me at the dosing window of the clinic? I feel like that’s not right. Most pharmacies will not accept the return of medication after it has left the pharmacy. I understand revoking my bottles, but not demanding to take what they had already given me. I appreciate any input. Thank you.


    • I think since you didn’t securely store your take homes, you should lose levels, sorry. And yes, having you dose daily at the clinic is entirely reasonable. and if they want to dose you on site, it makes sense they would take your take homes.


      • Posted by Janis on August 25, 2016 at 1:19 pm

        But they are allowed to keep the methadone I had already been dispensed to Me as take-homes? The are dosing me with my methadone from my bottles. I understand losing a phase ,I understand my part in it. However, no where in their policy does it state should there be an issue with my call back (I.e. The stolen bottle) that they are allowed to hold my methadone that I bought back in. It states revoking privileges, yes, but not confiscating medication. That’s my question. If it doesn’t explicitly state that, are they allowed to do that? Your input is much appreciated.

      • Taking back medication that has already gone out the window is a big DEA no-no. OTPs are not receiving sites for prescription take backs or destruction. Dr Burson is right, and I agree, that the clinic has the right to return you to daily (almost certain my doc would do the same at my clinic), but the fact they kept already dispensed doses is a DEA violation from my reading of their rules.

      • I get different answers depending on which DEA agent gives the information. For the patient’s and the public’s safety, it would be nice if we could confiscate medication we suspected of being misused. But you’re right – some sources say no, we can’t confiscate and dispose of take homes once we issue them.

      • The Atlanta field office of the DEA are all very sure of this… they presented at the state conference (OTPG – the GA AATOD Chapter) last year, and this was a topic they covered. I’m confident at least one entire region of the DEA is all on the same page, but I can’t speak for North Carolina (yet – anyway… we have a DEA inspection coming up, and I’ll be sure to ask). I do agree, though, it’s a bad situation for us when we know there is potential abuse or diversion but our hands are tied. That’s why we have to be double sure that patients we give take-home doses to are truly eligible and TRULY meet the 8 point criteria.

      • Posted by Janis on August 26, 2016 at 2:16 pm

        Thanx Zac. Do you know where I can find a copy of the rules you read?

  16. Posted by jenniferyoung on February 10, 2017 at 4:56 am

    I forgot to mention that after I had to pour out my take homes this afternoon, I was told I had to attend the clinic 7 days a week; EVERY day!!!! (I’ve had weekly take homes for many years….as I previously stated) I have not had to show up to my clinic on weekends for ….many years. ( p.s. I’m clean!!!!) (What’s going ON here?????)


    • I don’t know. So you can’t have take homes if you don’t have a job?? I don’t think having a job is one of the 8 criteria for take homes, so it might be a thing just in your program.


      • We require proof of income for a week or more at my clinic…simply because we won’t be a part of take-homes BECOMING income if we can help it. Doesn’t mean someone has to have a job, necessarily, though. A homemaker can provide proof of cinome from husband or wife. Disabled can provide proof of income from the SSA. But we do require proof of household income. ….for what it’s worth I think that’s a good practice.

  17. For people wondering.
    U do get hie off of methadone.
    My fiance was addicted to it for 6 years.
    And Suboxone saved him.
    He couldn’t go threw the with drawls anymore. And let’s be honest his ass could not resist the pills.
    Suboxone helped him with bolth of those problems and now has been clean and perfect for years.


  18. Posted by Lizzy on February 15, 2017 at 7:19 pm

    I am only a lil over 3 months into going to the methadone clinic. I was on methadone for 6 yrs before this for pain but due to many ppl becoming addicted and selling their meds my dr was shut down and being investigated by the DEA. I am a nurse with 3 herniated discs and after all these years my brain and body just dont function without methadone. I was forced to go to the clinic bc i waited 21 days on nothing after the whole dr chaos and i was still completely unable to even move off the couch. I went to my family dr telling them i was in a huge pickle. Lol. The only advise they had was and i quote ” dont take anything to make yourself feel better” and ” with PAWS and all you might be better in about 4 to 6 months”. Ummm i have kids and jobs. So i went over to clinic. I can not wait until i get take homes bc it is very hard to work and go to clinic every day. Nursing hrs are 5 am to 6 pm 3 days a week. That means 3 days a week i cant go to the clinic. But i cant do that. Its just a mess. At least when i earn my way and get take homes i can work and have a more stable life. It seems very hard to get take homes where i go. A man told me hes had 6 months of clean urines and his counselour will not give him not 1. The other counselour told him to file a grievance. It seems to depend on the counselour. My clinic is only about 25 miles away so at least i dont have to travel as far as some ppl. N now that i am stable on my 80 mgs a day there is absolutely no high. I just feel normal. I think its sad that i have to take a medicine to feel normal n then the count down begins hour by hour until my brain starts needing it again. I dont know how ppl could sell their bottles. I need my medicine. In group they asked what would make you stop coming here? They could tie me up n torture me and id still think it was worth it to feel normal and cook dinner n do hw with kids and just be normal. Thats priceless. I see some ppl come in with their lock boxes and get tons of take homes. I want to succeed in getting to that point to stabilize my life even further. I do have a question. I go at 9 am after i put my daughter on bus. By 7 in evening i feel crappy and by morning im already sneezing and eyes watering with difficulty having energy. Is this normal? Should i uncrease? I really dont wanna go over 90. Im at 80 now. Sorry it was long it was my 1st post so an introduction to me. Thank you.


  19. Posted by Julia Whited on February 19, 2017 at 8:17 pm

    I have a question.
    If two people from the same family go to a clinic. They get 2 weeks of take home mess. The clinic calls for you to come bring them in for a count. They say that both people have to come in at the same time. These two people don’t even live in the same house together. One of them are out of town at a funeral and the other is 175 miles from each other at the time they ask. One has left for the clinic and was told to go get your relative and come together. Is this right and is it leagal?


  20. First of all, STOP Acting so naive! I worked in jail with hundreds of thousands of addicts for 25 years, trust me ALL ADDICTS are Liars, Manipulators, schemers & gamers! That’s a fact & that is something they learn real fast living the street life. All my inmates use to tell me how they regularly lied & gamed the dope clinics! What is the most disgusting and pathetic thing to me is rhe fact that methadone clinics are notging more than “LEGAL DRUG PUSHERS IE: PHYSICANS GETTING RICH OFF OF THE MISERY & THOUSANDS OF DEATHS EVERY YEAR” from their DRUG PUSHING!!! You know EXACTLY what I’m talking about too and YOU KNOW IT!
    BUT…Over the years a bunch of unscrupilous very very dirty & EXTREMELY GREEDY PEOPLE discovered how very, very,VERY profitable peoples misery was for them so what did these (criminals disguised in doctors clothing) do? Why they did waahat ALL GREEDY SCUMBAGS DO, THEY CHANGED THE METHADONE PROGRAM COMPLETELY AND DECIDED TO RUN IT BACKWARDS! Meaning they NO LONGER WISH TO “HELP” people get clean! So now if you get on THEIR LEGAL DRUG THEY PUSH IT IS NOW ~IN THEIR WORDS AND REQUIREMENTS~ A LIFELONG DRUG “MAINTENANCE PROGRAM”. THEY DOSE YOU UP INSTEAD OF DOWN, TO THE HIGHEST DOSE ALLOWED BY LAW AND KEEP YOU HOOKED FOR LIFE. IF SOMEONE ASKS TO HAVE THEIR DOSES LOWERED SO THEY CAN GET CLEAN, REMEMBER THAT WORD? CLEAN! So if they request that…WHAT HAPPENS? YOU KICK THEM OUT OF THE METHADONE LEGAL DRUG PUSHING PROGRAM! Here’s another gross fact; I can’t even tell you how many doctors..cardiolgist, surgeons and the like quit their million dollar plus pratices to open methadone clinics! Peoples misery pays hat well now! They should be in prision and all the dope pushing clinics making all those uncaring wonderful OATH TAKING DOCTORS WHO TAKE AN OATH TO BE ETHICAL AND TO PRESERVE LIFE, RICH AS WELL AS THE FILTHY POLITIONS THAT ARE ALSO BENIFITING AND GETTING RICH FROM THIS HUMAN SUFFERAGE, THEY SHOULD ALL BE JAILED FOR THE CRIMINALS THAT THEY ARE!! And all at US THE TAX PAYERS EXPENSE! Nice huh? We. Are paying all those dirty thieving criminals billions and billions and BILLIONS A YEAR TO DO IT! How do you all lke that DOSE OF TRUTH AND REALITY? DISCUSTING ISN’T IT AND VERY SAD INDEED!


    • OK readers, I usually just delete comments like this, but occasionally I publish them as examples of the vitriol and lack of knowledge that some people hold towards patients with opioid use disorders and the medical professionals who treat them.
      Ironically enough, as most of my readers know, medication-assisted treatment is among the most evidence-based medical treatments of all – yet we still see these attitudes and hostilities.


      • Posted by Logan on August 29, 2017 at 6:46 pm


        Although much of what you say is a distortion of reality, parts of your comment are correct. As a methadone patient for seven years, there have been many instances where I was discouraged from tapering. The rotating door of counselors and medical staff makes it difficult to establish procedure with regard to short and long-term planning for completion of the methadone program. I heavily desire ending my time in the methadone treatment program. Support is few and far between- not just in one clinic, but in all 5 of the clinics I have patronized over the past seven years.

        With regard to take homes, specifically, I have been a recipient since the three month mark of treatment. I have never had a positive urine or blood test in seven years of treatment. I have not used since February 18th, 2010. I transferred from a Florida clinic to a Maine clinic only two months ago. I was able to continue receiving take homes, albeit not two weeks worth. Up until last week I picked up once a week. When I returned to my clinic last Monday, my take homes were revoked due to one of my six bottles missing the cap. I now have to await the verdict of treatment team, who will consider restoring take home rights only after I complete an orientation program (again), write a letter of contrition, complete and 8-step remedial form, and meet with my counselor to discuss my plan on how I can prevent this from occurring again. I am now traveling two hours round trip everyday.

        This type of punishment is demotivating and discouraging, to say the least. I am committed to tapering off of methadone and have dropped 10 mgs. over the past month. I can only say how very disappointed I am in this process of revocation for not bringing the lid for one bottle. Truly, how does this level of punishment fit the supposed crime? I understand the fine line of empathy vs. enforcement. This seems the ultimate pettiness, that least of all deserved a warning.

        I am not alone in this circumstance. Many methadone seekers have experienced unwarranted punishment. For those who do not have a network of supporters, an episode such as this could push them into relapse. Common sense and compassion should certainly pertain to decision-making, enforcement, and policy in general.

    • Posted by Zac Talbott on February 21, 2017 at 12:16 pm

      Very sad to see such stigma. From the beginning Drs Dole & Nyswander recognized longer term maintenance would likely be necessary. There’s never been such a treatment approach. Where do folks come up with this stuff? Just whatever sounds good to their uneducated minds? And most clinics are not owned by physicians.


    • Posted by I'm expired on June 24, 2017 at 1:44 pm

      You obviously had a bitter experience I get it. Just don’t bring it here it’s pointless. Write your congressman.


    • Posted by Ann on July 13, 2017 at 8:08 pm

      If this rant had been 140 characters I’d have sworn it was written by Trump. SAD!


    • Posted by Memphis Dave on January 8, 2018 at 7:17 pm

      Dee…I hope your note in any hospital,rehab or any clinic working with recovering addicts……You are a negative factor…….all addicts are liars etc etc….You are the one that needs help…Dave


  21. Posted by jennifer on February 24, 2017 at 1:40 am

    I need help. I’ve had take homes for 8 years now. I’ve been clean the whole time. I adher to all federal guidelines. 2 weeks ago ALL of my take homes were revoked: I’m still in state of shock… The take homes were revoked because I DON’T HAVE A JOB. I now have to attend this clinic daily. Not ONE day off to relax. It takes me 2 hours to get there, 2 hours back. Sat. 1 1/2 hours. Sun. 2 hours(buses only run every hour on Sun.) The last time I had to go every day was 8 years ago. I am the end of my rope. Can anyone respond to this? And, is the clinic being fair? (Also, many other people I know who have take home priveleges do not have jobs…but nobody’s revoked their take homes!) Jennifer


    • This is a new one. To my knowledge, having a job isn’t a requirement for take homes. However, an OTP could make that a requirement. I’d suggest you ask to talk to the program manager and ask about their policy, to find out exactly why your take homes were revoked.


      • We require proof of income to have a week or more of take-homes … reasoning behind that is that we do not want take-homes to BECOME the income. If at a patient’s annual assessment they weren’t able to provide proof of income, we would do the same thing. It is our medical director’s opinion that the benefits don’t outweigh the risks of diversion at that point.

      • Posted by Lindsey on August 18, 2018 at 3:59 am

        you’re a tool, a drone…the petty rules are used to drive the screws into patients who for years have done all the right things and then one minor slipup causes it all to be taken away…people stable on methadone for years shouldnt be required to visit the clinic daily where they are forced to mingle with other drug users who ive seen compromise other patient’s recovery….do you counselors understand that being able to take your medication at home promotes stability, having to come in everyday and fight traffic etc and have possible 1 hour wait times to be dosed causing lateness to a job is literally frustrating and de-stabilizing to the patient? the takehome program is very convoluted and can be compared to a slavery camp

      • Thanks for your viewpoint, though there’s no need to name-call. You do realize physicians don’t make the rules, right? These are state and federal regulations. Some other nations have less regulation…in some countries, patients can get their doses are community pharmacies.

  22. Posted by jennifer on February 24, 2017 at 2:00 am

    (Don’t know if first comment went through). So, as long as a patient is following and obeying ALL federal and state guidelines, they should be able have the privilege of take homes. At least it was that way until 2 weeks ago. ALL of my take homes were revoked because I do not have a job. Was this a fair decision? (By the way, other people at my clinic aren’t employed and their take homes have NOT been revoked.)I thought take homes, in part, are privilege for being clean and an upstanding patient. I might as well go back to using!


  23. Posted by Joseph wuebben on March 5, 2017 at 3:40 pm

    Awesome article I really enjoyed this I’m trying to get take homes for work I’ve been in OTP for 2 years and have 6 months of clean tests except weed and I’m hoping my doctor is willing to test me again tomorrow so he can see I’m clean for everything. Question, I’ve been at my new clinic for over 2 months but at the clinic before them I had 4 months of clean tests and my new clinic has all of the results can’t my doctor prescribe me take homes over discretion?


    • I may depend on what state you live in.
      In NC, if you are positive for marijuana, you can’t get take homes unless it’s for a death in the family or something like that.
      But yes, all the drug tests at the prior OTP count – unless you’ve had a gap in treatment


  24. Posted by JenniferYoung on March 7, 2017 at 10:37 pm

    You need to state on your site that #9.:The patient must be employed; otherwise you are misleading people.Title 9 and SAMHSA do not state this either.


  25. Posted by RB on March 10, 2017 at 9:26 am

    Methadone prescribed for pain is written for 30 days at a time and filled at the pharmacy for 1$ the only reason not to do that is to charge people with chemical dependency 20$ a day and that means these people are just profiting from the exploitation of a desperate group of sick people that could easily be managed with conviance to all involved. If drinking bleach was euforic it would be illegal. They are just profiting from the drug war. By far the most debilitating consequence of my drug problem is the actions of the government entity’s involved in persecution of the afflicted control and prohibition of substances illegal or controlled. It’s a commercial enterprise nothing more.


    • You don’t know how wrong you are. About ten years ago, Medicaid asked physicians to prescribe methadone for pain, and the overdose death rates for methadone soared. It’s a dangerous drug when not used properly and supervised.
      The extra money charged by opioid treatment programs isn’t for the medication – it’s for the counselors assigned to help patients, the dosing nurses, the doctors, drug screens and blood testing, and administrative personnel.


  26. Posted by C.M on March 16, 2017 at 7:20 am

    Googled ”Spilled methadone” and found this blog. In UK most methadone is ”supervised consumption” at a patient’s local pharmacy.
    If one is ”trusted”, clean urine tests , one can get ”weekly” takeouts.
    However..thismorning, measuring out from a 500ml bottle that had 100mls left in it.

    There was an accident, and the bottle was knocked off my bedside table, crashing to a wooden floor.
    It didn’t break, [glass] but there was a wastage of methadone that splashed everywhere.
    I managed to rescue most of the spillage, but am now down 32mls.

    This ‘loss’ I will have to bear.

    Have had [rare] spills before, [leaky bottletop when travelling] and one smash, which the pharmacist saw, and he could do nothing about.

    Methadone pills are so much more convenient than liquid, but of course pills are only given if one has to travel by air nowadays.

    Methadone deaths to children have happened in England, and locally a little child was dosed by parents to ”keep him quiet” with a fatal outcome.
    The toddler had methadone stains on his clothes and his hair showed he had been dosed with methadone at other times.

    These cases are very rare, but when they happen they provoke despair and outrage in everyone, and have done much to cause ”daily supervised” methadone consumption in most patients.

    There used to be ”DDU’s in UK [drug dependency units] attached to hospitals, and here one got scripts, not methadone itself…the waiting rooms were of course just full of ‘drug talk’..there are specialist units still, but many more addicts are treated in their communities via doctor’s surgeries with experienced staff supplied from specialist drug projects- this seems to work very well.

    People are ‘lucky’ to be able to get methadone..[double edged sword though it may be] as some poor souls in Russia cannot access methadone maintenance at all.
    Treatment there is abstinence based..and brutal.

    Stay safe…and look after your take homes..don’t spill any. 🙂


  27. Hi I have been going to a treatment center and have been on a week take home have been clean for 7years thanks to treatment plan .I have a Dr outside of the treatment center for my back problems .I was took in to the office with my counselor at the clinic and the one about her any way he prescribed me pain pills I picked up my scripts but never took them .Even tho I’m still clean they took my take homes and said I will never get them back ever again .I was treated wrong and it was in called for can u help me on this matter


    • Most opioid treatment programs ask patient to notify them if any new prescriptions have been written, and especially if they are filled. If you haven’t taken any, perhaps your program would allow you to bring in the bottle to discard in their presence, proving you didn’t actually use any medication.
      I do understand why they took your take homes – filling a controlled substance prescription while you are enrolled in an opioid use disorder program without telling anyone obviously may raise some red flags. That would bring your overall stability into question.
      The only part I’d disagree with them about is never getting take homes again. I think after a time of stability, and after talking to your OTP doctor and counselor about why you didn’t inform them about medication, you should go back up on take homes. maybe not all at once, but gradually.


  28. Posted by Lyubov S Arce on April 8, 2017 at 2:36 pm

    I am have an issue with my methadone clinic they are treating me unfair and right now I’m having medical issues and they basically cut me down from 110 milligrams to 10 milligrams right now I’m suffering from a collapsed bladder so basically every time I try to go to the bathroom it tries to fall out and because they cut me down from 110 to 10 milligrams I am suffering every single day because my body’s going through the drawers I don’t know who do I approach or how do I fight them on this because they are destroying me right now I feel like they’re setting me up to fail please give me some ideas of where I turn to get some help thank you


    • You need to speak with your prescribing physician at your opioid treatment program. It seems very odd to drop from 110mg to 10mg unless there is some concern the methadone may harm you. You have a right to know what is going on and get an explanation of the reason you were dropped by 100mg.


  29. Posted by Billy Burns on April 18, 2017 at 3:16 pm

    I have been on the Methadone Program since 2001. I have given clean UA’s and have been on time and have returned on call backs. They’ve taken one week of takeouts from me because Medicaid requires their patients to be seen once a week. I’m not on Medicaid or Medicare. I can’t afford to go to the clinic 4 times a month. I am on SSI Disability. This doesn’t seem to matter to them. What can I do to get back my two week takeouts. The clinic is 126 miles one way 252 miles round trip. That’s almost $200 a month in gas. Which I can’t afford.


    • Really? I’ve never heard of this being a Medicaid rule…what state are you in?
      And if you have Medicaid, they may be willing to give you gas vouchers or transportation to your program.
      Particularly since you are doing so well, it would seem that something reasonable could be done to offset the extra travel expense.
      Maybe you could talk to you program’s manager, or Medicaid caseworker.


  30. Posted by Mr. Parlantieri on April 20, 2017 at 10:00 am

    I have been on mmt for 2 decades. I found your article very informative and acruate. Also, (u hit home with the humorous outrageous excuses about loosing Ibottles ). A few do ruin things for the majority. When I started methadone treatment in the 80s if a client vomited a dose, they were allowed to be redosed at 1/2 the dose level. That was phased out years ago. I saw many a person fake that. A client also could get doses replaced with proper law enforcement documentation. That is also gone. A person could even be dosed in jail ( short term ) or law enforcement would transport the patient to and from the clinic. Again both situations are now gone. It also made a difference what state or country or city a person had the short term incarceration in. I wouldn’t want the responsibility of being a mmt Dr. Most of the time a Dr. and staff can tell who is being deceitful, yet not always. Again, this is why privileges are harder to get and shows how a minority do make the program more of a challenge and can inconvenience the majority who follow all the rules. Thank you Dr.


  31. Posted by Maxine Antin on April 26, 2017 at 7:37 pm

    I find this a fascinating article especially asince I’m going thru this situation currently. I’ve been at the clinic for 2 years in June with a perfect u/a record since day 1! Been on 2 week take home for about a year with abother prescription
    Unfortunately, I’ve been diagnosed with many other illnesses since by sobriety and still with best cancer in tow and copd plus a nice oxygen tank to boot, have still never given a dirty. Even when given oxys as pain killer after surgery! I now am currently waiting for a Obgyn apt for a suspected prolapse bladder, uterus or bowel. My husband had to help me there because I’m so sick.
    So I have not changed any primary care Dr and yet only saying something after 6 months my clinic asks takes away one week and says get Dr to sign anotger form it will be ok. Which i did. The Dr has given me a copy too. Apparently, didn’t word it to their satisfaction. So I asked the dr to Fessenden it when I was at one of my many frequent visits. He did so again. Now this time they’re saying because he corrected himself they decided to not to return my dose to 2 weeks So I asked the Dr to yet again re fax that he was totally aware of my methadone Programe. Now hence all my illnesses, returning me to a weekly takeoffs had caused me no end of problems. Not only am I now being out on more medications the lower my immunity even more then it is after cancer treatment but taking steroids because my chronic bronchitis is never getting a chance to heal. I would like to know if I have any legal comeback at all. But mainly just need my take home preferably more seeing how sick I am! Why would a clinic do this? Perfect attendance not 1 dirty evert!


    • Posted by Maxine Antin on April 26, 2017 at 7:59 pm

      I just thought I’d add that I was one of the first ever people worldwide and definitely in the uk to have received the first Naltrexone detox under anesthetic back in the early 80 but I found a maintenance program suited me better and got a monthly take home including injectables of over 250ml daily! I find with this knowledge to my problem additionally frustrating when I was stable for 20 years at least.


  32. Posted by Kenzie on June 1, 2017 at 2:40 am

    I had to leave California on very short term notice. I have been in treatment for 3 years. I have 13 take homes that I’ve earned with flying colors. I’m courtesy dosing at this clinic and they want to revoke my take homes and make me dose every single day again. I don’t know if they want the money, or if it’s a policy thing….but I think it’s rediculious. What do I do? There’s another clinic down the street…should I see what they say there?


  33. Reblogged this on My Sharing Blog.


  34. Posted by Dana on August 21, 2017 at 11:31 am

    I have a question more than a comment. My son he was addicted to opiods for 8 yrs .He was injured when he was 13 from a bike wreck but didn’t complain about it years later. now he goes to a methadone clinic to help his cravings go away and he said it helps his pain. But if he misses his dose they take the dosage down. My son isn’t always honost with me. He’s 31 and has a hard job.but I think he is still using pain meds. What would cause him to go from 125 down to 30? A dirty test or just missing a dose?


    • I can’t speak to his specific situation, but yes, if a patient misses more than a day or two, the dose is generally reduced by 50-75%, depending on how many days missed. For my own program, if a patient misses more than 4 days, they have to see me again before they are re-started on methadone.
      If a patient presents to a program with impairment, that’s another reason his doctor may order that the dose be reduced.


  35. Posted by Melissa Gun on September 5, 2017 at 8:40 pm

    I have a question. Today someone from the clinic called and told me I need to come in tomorrow for a med check. I get prescribed xanax. I get them counted every time I get them filled. This is the first time I’ve had a callback. I have 10 less than I should have.I normally take them as prescribed but I took a cpl extra due to stressful events (getting eviction notice, possible hurricane ). Does anyone know what they will do if I come up 10 short? Take away my take homes? Or worse will they call my doctor? Thank you!


    • you are lucky you are allowed to take xanax and methadone — it is a potentially fatal combination. I would educate yourself about the dangers xanax and ANY opiate — there is an FDA black box warning against the use of ANY BZO and ANY opioid — for good reason. Short acting BZO’s cause the anxiety they were first started for because of BZO withdrawal symptoms between doses. ][ so called “benzo backbit’] If you MUST be on a BZO and few really do need to be, klonopin is much safer and you can do an ASHTON BZO DETOX using smaller and smaller doses of Klonopin over months . and get off the physical dependence of the benzodiazepines. — slowly


    • Posted by Mel Gun on September 9, 2017 at 8:23 pm

      Of course my Dr knows. Both my shrink & my primary care Dr knows. I told them plus the clinic faxed them a release of info. I am knowledgeable about taking both meds and take them responsibly. I’ve been under a lot of stress so I took a few extra over a several day period. My methadone dose is just 60mg & only take two 1mg xanax a day. It’s irresponsible people who just wants to get fu*+ed up and take a handful of x’s with who knows how much methadone that overdose.
      Oh, btw thanks for answering my question, which of course you did not. It worked out well anyway, they checked my bottles and I had what I was supposed to have
      This is out of context, but I don’t see how or why a person needs to be on 300mg or higher on methadone. Shit at my highest dose of 130mg made me nod out, I can’t imagine being at 300. The cutoff amount at all methadone clinics should be no more than 250mg, which I believe is still to high.


      • You have a lot of strong medical opinions? do you have a degree or just opinions?
        educate yourself regarding the problems with benzodiazepines and substance abuse patients. Not a good combination. But you seem to be stuck there.

  36. PS: you xanax prescriber should know about this. Does he/ she know you are on methadone????


  37. Posted by Breezylicious on September 13, 2017 at 4:53 pm

    Nice article – and lots of good information within all these replies as well; thanks for taking the time to still respond! 🙂

    That being said, I have my own story:

    Been on methadone for 5 1/2 years, and have never failed a U.A. or bottle check, though I have had bottles taken before, then given back, after the clinic realized they were at fault (not saving the updated phone# I gave them, in their computers… they later found it in their paper files & gave back my 13 takeouts).

    Anyways, last week I was called in for a bottle check. While in w/ the nurse, I noticed she was taking more time than usual, and she asked if I had put something in the bottles..? I had no idea what she meant, until afterwards when she relented & said I could go ahead and dose, and I felt a ‘gravelly’ texture in my mouth. When I got home & looked at the other bottle she was questioning, and noticed there was some sort of stringy-stuff floating near the bottom. I had never saw this before, and now understood why the nurse was concerned.

    Fast-forward a week later, and I get a call from my counselor saying that I failed that bottle check. Although apparently the nurse reported that, “the consistency & color wasn’t the same in 2 bottles.” Now obviously this came way out of left-field for me, as I have no clue what would have caused the stringy-substance in the bottle’s bottom, but even more-so, why the nurse didn’t mention any of what she told the Director/staff while I was in having the bottle check done w/ a counselor right there too.

    Having been through similar situations, I feel like I’m basically getting railroaded; A patient is never taken at their word, which I do understand in most cases, while the nurse’s view is gospel. Aside from never being an issue, I’ve always been truthful, even when at my own expense (have come out n admitted I took Tramadol for a toothache, and Gabapentin on occasion, but was told they aren’t narcotics & I was fine)

    So I’ve been told that I have to come in everyday for a month before I can get back to 2 takehomes. From there , who knows.. and who’s to say this doesn’t happen again? I mean, I understand that ‘takehomes are a privilege, not a right,’ but this whole situation isn’t right at all, and I feel like there’s nothing I can do despite having done nothing wrong.



  38. Posted by C.M on January 2, 2018 at 2:48 am

    Oh gawd, leaky methadone bottles…
    My son, his wife and I were visiting an old family friend out in the country, there had been a little snow, and as this is England, a ”little snow” can mean the entire country grinds to a halt.
    Twas 28th December, and because of the snow, I grabbed a 100mg bottle of methadone just in case we should be stranded in the Country for the night.

    We all went on a walk, crunching through the snow, the scenery looking beautiful, the old oak trees and dry stone walls sheltering sheep, and an orange sunset making the sky pink against the blue white snow.
    Crunch, crunch through the snow, and I felt a stickiness on my right hand..I dismissed it , but 20 mins later felt it again, more surely, in fact, my right hand was hugely sticky.
    I looked down, and my handbag was leaking green syrup through the bottom of it onto my coat, and down into the snow below.

    I panicked, grappled in my bag, sodden emerald tissues greeted me, and my 100mgs was almost gone.

    My panic was son began to to record the sorry spectacle with his iPhone, and I had to hope and trust things would be ok.
    Back at my friend’s house, I phoned the pharmacist in a panic..luckily he has known me for years, and suggested phoning the Bank Holiday time, this was a challenge, as it meant getting an appointment via the Dragons, the receptionists.
    Mercifully the receptionist got a doctor to phone me back, and as he was a Locum, and didn’t know me, he had to check with the Pharmacist.
    Since a crazy doctor, Harold Shipman gave heroin injections to old ladies to kill them, all Controlled drug dispensing has been tightened up a lot here,
    but luckily the Pharmacist vouched for me.
    I was luckily able to get a replacement script.
    The reason for the leak was a cross threaded bottle, the bottles here are brown glass with a safety cap..they don’t usually leak, as have travelled through Europe with methadone in my luggage without the dreaded leaks.
    Washing out my bag/money/keys in the bathroom sink turned the water green..the methadone was unsalvageable..had I not had a new script, I think I’d have drunk the rinse water, but most had leaked into the snow on our walk.
    Interestingly, the landowner had a son [a lord] who is no stranger to addiction..he has spent years in prison for wife beating and drug use [heroin/crack]…lives in a beautiful part of the country, wealthy, but acts like an inner city desperado despite daddy’s millions.

    Happy New Year!


  39. Posted by lostasa on January 3, 2018 at 4:05 pm

    Hi I have some questions and can’t find any places to get answers so hopefully someone here can help. I am trying to get details about the diversion program, in depth, like time lines on for revocation, what ions can be taken for abuse, etc. Thank you for taking the time read this and hopefully someone can help .


    • I’m sorry but I don’t understand your questions. What time lines do you mean? Time it takes for reduction of levels? TIme on reduced levels before they are increased again? And what are ions?


  40. I have a question about the clinic I go to in Alabama. Here is my issue I drive 50 miles 1 way 1 time a week I pick up 6 takehomes .I get home put my box in the safe til next day.Next day I get my medicine out to take and realize it has been double label is on top of another label where u can clearly see the other name marked out and number marked out.If I get stopped by a cop or something on my way home could I have possibly been arrested for this because it was clearly the clinics doing not mine


  41. Posted by Rhonda on January 13, 2018 at 8:41 pm

    I would just like to say that I have been on methadone for close to four years now. The entire time I have been on 40 mg and it is held me the entire time. I personally feel that your argument about methadone having street value unlike high blood pressure medication is invalid because so does Xanax and oxycodone and they get prescribed those things 30 days at a time as well. I feel that taking all of the earned take homes away all at once because of one mistake is a little overboard. I also think that having patients come in every single day to dose would interfere with getting a job or having a normal life especially if the individual doesn’t have a car. It’s obvious that there is a lot of misunderstanding when it comes to medication assisted treatment. I will say that this was a very eye-opening an interesting article coming from the point of view of the director or doctor which ever one you are.


  42. Posted by Stephen Welden on August 12, 2018 at 2:29 pm

    What happens when u abuse your take homes and then u get call back then u don’t have them they take your take homes away but will the still get dosed even tho there all gone ?


    • It depends on all the circumstances, but if you’ve already had medication dispensed to you, it’s unlikely the opioid treatment program can – or should – replace them.


      • Posted by steven welden on August 13, 2018 at 11:56 am

        Thank u for the response I think I’m just going to detox my self just tired living like this been on this stuff for 2 1/2 yrs first time I’ve had this happen my dose doesn’t last long anymore and I don’t believe going up is the answer I’m on a 100 mg for 2 yr I call this stuff liquid hand cuffs !! Thank u for your response tho !

        On Sun, Aug 12, 2018 at 6:19 PM Janaburson’s Blog wrote:

        > janaburson commented: “It depends on all the circumstances, but if you’ve > already had medication dispensed to you, it’s unlikely the opioid treatment > program can – or should – replace them.” >

  43. What do you do with people who say their take-home bottles were “stolen”?
    like 3 bottles of 120 mg??


    • It’s a tough one. I hate for the patient to go without medication, but we can’t replace the stolen doses. The patient would have to resume dosing on the day due to return. I’d also address the way the bottles were stored – how did they get stolen? Did the whole lockbox get stolen? Does the patient have any idea who stole them? If it could have been friend or family, they may need referred to some sort of help, and that much methadone could kill a person with no tolerance. If it was a home break-in by stranger there’s not much to be done except notify the police. That’s to protect the patient, in case the bottle with the patient’s name on it turns up at the scene of an overdose.


      • If there is a police report and an otherwise compliant patient there is no reason the patient can not be dosed at the window those days. This is up to the individual physician, but to just outright deny to medicate them after a true event that could not have likely been prevented is cruel and unethical in my opinion. We had no issues from the state or DEA, and we had a couple documented cases. We have never replaced the take-homes, but to not even allow the patient to window dose when there is a police report? Nah. That’s wrong. And the one overdosing might be the stable patient who is forced to go back to the streets.

  44. Two bits of strong evidence against this patient are he has missed two call backs for bottle counts in the past. After the first one he was warned. After the second one, he lost his take homes. He earned them back and now “three bottles were stolen”. Not a good pattern. That was all taken into consideration. His bottles were not replaced.


  45. What happens if the person is double dosing, not selling nor giving away but taking a dose at 6am then another at 3pm and they decided to tell the staff cause one they ran out and want to stop what happens will they be kicked out or just have to go daily again and will it be permanently??


    • It would depend on a whole lot of factors. Sorry, I can’t speak for what your doctor would decided.


    • Posted by Maxine Antin on November 9, 2018 at 11:11 am

      They’ll probably have to go to daily again until they can prove they’re worthy of take homes again. I see people at my clinic that started the same time as me and are still on dailys and don’t take home except when the clinic is shut! I’ve been with this clinic 3 years now and have never given a dirty UA. I’m just thinking about coming off all together now. It would have been earlier but I became ill with cancer and COPD and couldn’t quite face it before now.


  46. Jana, I have a question for you. I currently go 1x per month to my clinic and have been for 8 years (never with any issues). I had a bottle recall last week, and brought in 7 full bottles, as well as my 21 empties. One of the 7 bottles was a lighter color than the rest, so they revoked my take home priviledges until testing on all of the bottles is done by the lab. I was shocked by this. The levels were all fine and all of the seals were intact. In addition, no one had access to my bottles to tamper with. I do keep my bottles in my backpack in the trunk of my car, and temperature changes do occur. But I’m not sure if that can cause discoloration or color changes. In your experience, Have you seen discoloration before?
    If so, what caused it? I am nervous about losing my priviledges for something that I did not do.
    Thank you so much


    • Posted by Maxine Antin on November 13, 2018 at 8:03 pm

      My goodess I feel for you. Just the thought of any change in my take homes makes me have a panic attack almost. They come up with some crazy excuses to test us patients. Is it not stupid for an 8 year patient to lose his take home by tampering with 1 bottle? Why don’t they look at the logic of said infraction? Surely they know deep inside who the unstable patients are.

      I just think the American system compared to my old 20 yrs once monthly partly “injectable” take homes in the UK goes over the top with diversion. Why would a stable patient risk that for 1 bottle? Ridiculous. We worked the programme to the letter for over a year to get them!


      • Posted by John on November 29, 2018 at 3:14 pm

        Thanks for the response. Yeah, they do not use common sense in these situations. You are guilty, until proven innocent, which is unfair. It should be the opposite. You are treated as a convict in these places, and it makes you feel like crap. These counselors and directors rule by the letter of the law, rather than using logic and common sense to make judgements. They should take in account the individuals’ track record, and history, because every issue does not have a cookie cutter answer.
        Again, why would anyone tamper with just 1 bottle, after working for 8 years to get take home priviledges. I’m still waiting for testing to be completed. And they have me so brainwashed because of how they treat you, that I don’t know what the test will result in. I know nothing was done, but you start questioning your sanity and yourself, when people tell you that something was done.
        Jana, have you seen discoloration before??

  47. Posted by Darlene on December 2, 2018 at 1:56 am

    Is it safe for a clinic to quit providing methadone for someone, after they have been on it for over a year, without any warning. They have been clean and doing very good during this time? There was a conflict one day that they said they came before 6:30 but their phone said 6:32, this is the first time they have ever gotten in trouble while in the program!


    • Sorry, but there’s no way for me to evaluate this situation, not enough details. Patients can be asked to transfer to another program without any notice if there’s violence or threat of violence on the part of a patient.


  48. Posted by John on December 10, 2018 at 8:09 pm

    Jana,I left the comment regarding discoloration. So the test on the 9 recalled bottles came back, and now the clinic is stating that the test showed 10ml missing from the 60mg of each bottle. The test states no discoloration. I feel like i am being railroaded. I have 9 years of a perfect record, going 1x per month, and they are taking all my bottles away. All of the seals were intact, and this is so out of left field.
    Are there any rights that I have? They were testing for one thing, then that was fine, and somehow discovered another. Also, how much is 10ml from 60mg. Yhey stated all of the bottles were missing that much.
    I leave my bottles in my car, and live in new England, so I think the temperature changes caused the loss of liquid.
    Any thoughts because this is ruining my life.


    • Sorry, but I don’t know any information that could help you. Milliliters and milligrams are two different measurements, unless the methadone is 1mg per 1mL.And I don’t know what could cause discoloration.


  49. The fact of the matter is unfortunately any addict can basically find a way to get high from any prescribed or over the counter medicine. As an addict you become a “pro” at learning new methods and experimenting with new things. There is no way to control or divert this issue in any way. If one medicine is made so that a high cannot be achieved then an addict will always know a way to get around this issue with another med of equal or close ingredients. My issue is that the world needs to accept and realize that methadone is truly a life saver for many addicts who take it as directed. It eliminates the need to go “street searching” for illegal narcotics and also it’s way cheaper to be in a federal regulated clinic. Much safer as well. Methadone has gained an ill reputation as a replacement drug meaning it replaces another drug for the same effects. It may very well be that but the facts show that those in methadone clinics lead a very productive life and become productive citizens of society once again due to becoming stable and being able to function normally as a normal human being. Non- addicts and non-methadone users that have never experienced addiction just cannot seem to grasp this reality. Methadone saves lives! Pure and simple! Enough said…


  50. I’m not sure yet, but I think I lost a full bottle. 15 years on the clinic-12 in full compliance,( my husband is dying, and if I lose my take homes in screwed) . The new years holiday take homes I THINK I refused, but I might have accepted..i can’t remember if I got 3 bottles or 2 on Friday! My husband was on the clinic, dragging himself in there twice a week for even the time he could barely walk- but hospice finally prescribed the methadone so he stays at home.
    I TOLD them when they screwed up my Xmas vacation that between altering my schedule and not having my husband with me…it was going to be very difficult as we even met in the clinic in Jan of 2000( ironic that this is happening NOW!) I feel I should be owed SOME credit for 100% compliance, but it’s my fault no matter what happens. My hubby can’t be alone every day as I muddle thru the horrid winter!! IF I am missing a bottle( I’ll find out tomorrow, as I plan to be honest as that’s what’s worked in my recovery) but how long will they take them away? They love my husband…unusual to have 2 married people who met at clinic have a wonderful relationship…on transplant list 8 years. ( won’t get one die9tob” deactivation due to frailty)
    Will it be months until I get them back? I’m so scared- NOT FOR ME..but for my husband being alone every day…i pray they only gave me 2 doses…(29th and 30tg) then tomorrow I’ll get 3..but I said I didn’t want new years take homes…after Xmas…( I had to come in one day with just dosing- then next day given 2..THEN given 3. I TOLD THEM this would happen..but if there’s one thing I know about treatment, NEVER assign blame except on one’s own shoulders!
    Any advice or feedback is appreciated..even after the post date…Happy New Year!!!


  51. Posted by Hannah L Green on January 8, 2019 at 5:30 pm

    Your input here is of great importance to me. I was just a phase 5 for the last six months with no positive drug screens no illicit activity noted with my take homes always returning my bottles and always coming to call backs. Recently I took a trip to see my daughter that required me to have eight bottles of methadone with me. On my flight back I forgot to grab 6 of the empty bottles that were under lock and key in my son-in-law’s car. He sent them to the to me in the mail and when they arrived I return them to the clinic. I hope that and keeping them posted with updates for the post office as to where my package was with the empty bottles in it that there would be leniency. But no now I am back to a phase one which is done me no good at all it’s put me in a mental state of being that drug addict back then. My first reaction was to want go and grab some pills somewhere. I have never really had a good relationship with my counselor and feel that this was her decision solely. I now do not trust her or the facility. I did my part for the last 2 years go to my neighbor. Have they done their part? What are my rights here? This was a huge mental set back for me. I don’t feel that my counselor is a good advocate for me or my recovery. I have been sober for a year and a half and this is a kick in the teeth.


  52. Posted by William Stewart Halsted on March 15, 2019 at 5:04 pm

    You mentioned that a reason for NOT wanting methadone prescribed in 30 day supplies is that it has (1) street value and (2) it can cause euphoria in opioid naive individuals. Both of these “reasons” are completely outside a patient’s control, though they’re being punished and forced through a bureaucratic hurdles race becauae of them. First, the extremely inflated price of prohibited substances is caused entirely by their prohibition, there’s literally no other cause for why marijuana, for example, a plant that grows easily everywhere to be approaching the price of precious metals per ounce. Arguably, your support for further prohibitive measures only exacerbates that problem. I’m sure you’ll disagree though, as everything you have written above clearly implies that you, despite being a medical doctor and for all intents and purposes a scientist, view the issue of drug use, addiction and all that encompasses it through the lens of morality. This is perfectly demonstrated by your second objection that if methadone got in the wro mg hands, it may cause….eurphoria!!! God save us all, the world may come to an end if someone, somewhere happens to invoke a sensation of euphoria and temporary change in consciousness. Even though someone feeling euphoric has absolutely no effect any anyone elses life, but that of the user, someone feeling good is just too ghastly to imagine (the sarcasm should be evident). Jokes aside, this raises a huge contradiction and hypocrisy associates medication assisted treatment that I’ve long noticed, but have never received a legitimate and logical answer in response, namely that an individual is allowed and that a doctor will give them(in the social, political and legal sense) methadone or buprenorphine indefinitely, but will never even consider the option of prescribing other opiates, specifically Schedule II opiates e.g. hydromorphone, oxymorphone, fentanyl. If we compare schedule II opaites with methadone (also schedule II) and buprenorphine (Schedule III), the only substantive difference is that the schedule II opiates provide the euphoria desired while methadone and buprenorphine do not. Methadone and buprenorphine cause all of the negative health consequences that the schedule II opaites do (such as decreased testosterone production in men, decreased pain threshold, etc including the worst one of all, opiate withdrawal and in my direct experience which is ubiquitously corroborated by opiate users everywhere, methadone and buprenorphine cause far worse and prolonged withdrawal symptoms due to their long parent half-life (I also truly believe that in the near future it’ll be discovered that buprenorphine causes permanent Mu receptor damage due to it’s partial agonism). So, that clearly demonstrates that the reason why doctors refuse to prescibe schedule II opiates (for medication assisted treatment as well as for pain, or even depression) is NOT because they care about the patient’s health, rather it’s because they just can’t abide someone feeling “high”. Let me preempt any vapid objections based around the argument that methadone and buprenorphine have a much longer half-life and therefore don’t need persistent dosing within a 24 hour period or that it helps to “level” out the patient or stablize them. The reason why that argument doesn’t hold is because there are currently numerous pharmaceutical formulations that overcome the shorter half-life of Schedule II opiates by releasing the drug to venous circulation in a controlled and consistent manner. This has allowed a drug like fentanyl with a comparatively short half-life to be steadily released over the course of 72 hours by means of a transdermal patch. Please abstain from even mentioning the possibility of the patient bypassing this by various means. First of all, empirical data demonstrates that the most excessive forms of “criminal” addiction among those eligible for MAT is the aberration, NOT the norm and furthermore this justification effectively punishes the overwhelming majority for the actions of an exceedingly small minority and last time I checked, when someone gets a D.U.I. it’s only them that loses their driving privilege, not everyone. Secondly, the issues associated with the initial formulations of transdermal delivery as well as controlled gastrointestinal delivery have largely veen overcome, e.g. the gel contained in earlier fentanyl patches as been replaced by a “matrix” that effectively removes the incentive to alter the medication.

    So, why is the act of altering ones normal neurotransmitter modulation (aka getting “high”) so stigmatized and why are so many, including doctors, not only offended by it, but view it negatively in a moral light? When someone gets high, they literally effect noone else, but themselves, so where’s the logic and what’s the rationale for someone’s opposition to this act when it is of zero consequence to their existence (it’s been proven time and again that of all those that have used and do use recreational drugs, less than 1% become addicts, so anyone trying to use the excuse of the possibility of criminal or dangerous acts performed by addicts under the influece has absolutely no ground to stand on). What’s the big deal with getting high? Especially considering that on a physiological level, getting high with a drug is identicle to finding pleasure in shopping, sex, gambling, etc in that it illicits a dopamanergic reward response in our brains. I honestly cannot come up with a logical and rational reason for objecting to people getting high, with my best theory being that those who strongly object probably have at least some degree of Authoritarian Personality disorder and therefore voraciously object to others getting high not because it does harm, but because it challenges the current socially accepted status quo. I’m not trying to be hyperbolic, but I have to believe that an individual who thinks it’s acceptable to tell another consenting adult what they can or cannot do with or to their own body when it effects nobody else has fascist leanings. Or, it could be due to the issue of morality once again. If a doctor perceives addiction and drug use to be a moral failing or a failure of character, then it would make sense why they would prefer giving them methadone and not the opiates they seek. The doctor objects because they have construed the issue in morality and would see the prescribing of a schedule II opiate as “rewarding the patient’s failure of morality”, and that implies a strong punitive overtone and a punitive objective on behalf of the doctor. Anyone who think’s that’s not the case should ask anyone on methadone and they’ll all testify to how the implied threat of doctor initiated withdrawal as punishment is essentially the sole means of coercion and the guarantor of patient compliance at a methadone clinic. How such isn’t a violation of the hippocratic oath or at the least a serious ethical dilemma is beyond me, as I can personally testify that opiate withdrawal is the worst thing I’ve ever experienced, so bad in fact that if given the imaginative hypothetical choice between suffering though opiate withdrawal or having all my finger and toenails ripped out with pliers…I’d happily and eagerly choose the pliers and honestly consider myself lucky. This is also why I think any addiction counselor that hasn’t personally experienced it is inherently disingenuous and completely without any sense of moral authority in their interactions with addicts. I also believe that every doctor should be required to experience it as well so they’re not so cavalier and flippant when they do things such as acutely and without warning, discontinue prescribing a chronic pain patient’s medication.

    Back to the point…the unethical infusion of morality and judgement into medicine and health by medical practitioners in the United States is clearly evident and basically the status quo. Just imagine how doctors in America would instantly oppose legislation allowing for any doctor with a DEA prescribing number to engage in outpatient medication assisted treatment by prescribing the patient their opiate of choice onstead of methadone or buprenorphine…they’d be acting as though the world would end. Yet, in the United Kingdom, primary care physicians are allowed to do just that, and the U.K. isn’t collapsing into chaos, their streets are prowled by violent drug addicts gripping the country in a crime wave. We could also look at the Netherlands, Germany, Switzerland, and again the U.K. as well as some additional European countries that all engage in Heroin assited treatment in which addicts are provided pharmaceutical grade Diacetylmorphine (aka “heroin”, which is actually the brand name created by Bayer pharmaceutical in the early 20th century to market their Diacetylmorphine which could be legally purchased over the counter) instead of methadone or buprenorphine. Detailed analysis of heroin assisted treatment and the dats surrounding it clearly demonstrates that it is far superior to methodone and buprenorphine treatment in that it maintains a far greater patient retention rate, allows the patient to discontinue the use of other substances sooner, and allows patients to voluntarily end their treatment much sooner. In fact, an initial study to determine the validity of heroin assisted treatment on a national level in the U.K., took 20 addicts that had all failed to abstain from drug use while on methadone, and found that 17 of 20 were able to abstain from drug use wirhout exception after one year and that within two years 15 of 20 individuals voluntarily ended their participation and successfully transitioned to complete abstinence from drug use. In addition to all that, heroin assisted treatment has also be demonstrated to be far cheaper in cost than methadone on several levels from the cost of the program for the government to a reduction in criminal justice costs.

    Despite all this exceedingly strong evidence demonstrating the superiority in every metric of treating addicts with heroin (a drug they want) instead of methadone, and that has even recently convinced Canada to engage in heroin assisted treatment, doctors in america would still oppose it despite lacking even a single medically or health related argument. Their ownly argument would be a moral one and it’d basically say that it’s “wrong” to give addicts what they’re seeking even if, as with the case of heroin assisted treatment, it’s a clear net benefit for society as a whole.


  53. Posted by Jay on April 18, 2019 at 6:51 am

    For what it is worth, I have been a model recovery patient. Methadone saved my life, my career and my marriage. I was injured back in the early 90’s and had multiple surgeries. I ended up seeing a pain doctor that kept increasing my pain meds to the point I was taking 350 micrograms of fentanyl every 48 hours. Then in a 2 week time frame he decided to take me off it because of the new crack down on prescribing pain meds. I was never so sick. I owned my own company and made excellent money, I started buying pills on the streets. My habit got so bad I was spending $1000 a day. I lost my company, and I was going to lose my family if I didn’t do something. I checked into a methadone clinic. That
    Was 7 years ago. I have a great career, I have been working in Houston for the past 3 years. Since I started 7 years ago, I have never failed a drug test, I have appeared for every call back and I get 27 take homes every month. I travel a lot with my new career, if I did not have the 27 take homes every month, I would have advanced in my career. I am now being transferred back to New England and I can’t find a clinic that provides a full month of take homes. I could lose my job due to this issue! You should reconsider!!! I am sure there are more people like me in some of these clinics


    • for once a month pick ups you could probably fly to a clinic that does 27 take homes — do your UDS, counseling, MD visit after your intake and pickup the take homes and go back to cold and unfeeling New England where they incarcerate people in civil commitments to ‘treat their addictions’ and take them off their MAT. That New England. We have several clinics in Virginia that might accommodate you if you want to travel here for intake and then once every 27 days.


    • Posted by Dr K. on November 14, 2019 at 11:42 pm

      Thank you for sharing, because there are so many people like you, and the world needs to hear it


  54. Posted by Ashley Bingham on July 8, 2019 at 12:44 pm

    Hi my name is Ashley, I just wanted to comment about this because the clinic I currently go to took all of my levels from a level 4 to a 1 because I have a drug screen one week that failed for thc the gave me another drug screen the following week and it also failed for thc but the level was much lower. Iv talked to everyone available at my clinic about this situation and the day there is nothing that can be done but as a mom and a full time worker it’s hard for me to take the 30 min drive there and 30 minutes back everyday not to mention having to bring my daughter on occasion. I just wish something could be done I know I made a mistake but I don’t believe I should have lost all levels


  55. Posted by Reva N Brock on October 18, 2019 at 2:12 pm

    My husband recently got a day take home but because of a screen he took 2 weeks ago before take homes he got it revoked. Wasn’t because of failing it was because of creatin levels. So even though he’s been compliant he gets punished.


    • I’m sorry to hear that. He should ask to talk to the physician at his program to get further details. Part of the urine testing consists of measuring urine creatinine. This is added as a measure to insure the urine sample hasn’t been tampered with. If water is added to the urine sample, in an attempt to avoid detection of drug use, the creatnine will be lower than is physiologically possible. In the past, we thought it was impossible to get a urine creatinine lower than 10. Now, most OTPs use a cut-off of 5.


      • Posted by D Ringo on October 25, 2019 at 12:34 pm

        My clinic in Memphis loves to “punish”…Thats their protocol…..Giving out punishments

  56. Posted by Dr K. on November 14, 2019 at 11:39 pm

    Even with the vacuum sealer, make it known, everyone with take home bottles, open the bottles at the window. Staff was revoking bottles for open seals, with patients who had a long history of compliance, opening bottles to check on call backs, bottle seals popping. Even leaks inside boxes were noticed. Patient after patient losing take homes for usually very short periods of time, but when patients say, hey I didn’t do this, it just happens sometimes, i started having take home bottles opened on pick up dates at the nursing windows. Not surprising, when on average one out of every 6 bottles had a slight opening, enough to not seal and leaking. I listened, now people can stop the chance of lose before it occurs, not their faults. But rules aren’t really in place for those who comply.


  57. Posted by Michael Flynt on December 20, 2019 at 2:36 pm

    Im in a clinical recovery program(due to my inability to do without opioid based medicine(s). I have been at the same establishment for almost six(6) years. No dirty u-a”s or major violations/-0- write ups.
    A dosing nurse with a frigid and uncaring demeanor was hired and totally disrupted the environment in the clinic. With unsuitable wait times. And mismanagement of dosing room keys by her and my questions got me kicked out. I was not threatening nor out of my element in that questioning. I was made to write an apology letter. (Which was no problem. If she felt offended or anything of the like. But i was allowed to continue at the clinic in the town over. Same co. Sae nursing staff. But now i am noticing this nurse is engaged in the same “foot dragging” standoffish behavior and is influencing the entire staff to act accordingly. What do i do im a business owner and these people are intently destroying my life literally. Im up at 5-a.m. every day i have children to take to school at 8- and prefer /NEED to -TCB- before the business day starts. Customers don’t pay for Excuses.


  58. Posted by Mark Canavan on June 18, 2020 at 8:36 pm

    I have been a methadone patient at 18 clinics in 5 different states. The article, although absurd in many places, patients who lost their doses didnt need that much note. It’s called diversion by some. They hustled their stuff, simple as that. BUT your mention of it being the most contentious thing happening at a methadone clinic. The Kafkaesque like way they are given as well as taken is often far too difficult to contend with. The fact that they treat mass produced testing kits and crowded labs as infallible. The idea that a patient can lead a clean, productive life if only they can survive the capricious whims of those who make the decision of whether or not you will be tethered to that clinic 7 days a week is a lie. It is the carrot every clinic dangles above your head. Be a good boy and stay clean and you can have this privilege. It has been my experience that no matter what a patient does there will come a time where for cause or for no reason at all you will get those privileges yanked away from you. At all 18 clinics I’ve attended, in Washington, Colorado, California, Texas, Missouri and Arizona, they all engage in this. I once had a doctor tell me ion this subject, “we are not hear to help you” . At least he was honest. I really wish the author was as honest and be willing to give REAL TRUE Iinsight. Instead we got a diatribe about the funny ways patients lied about where take homes were. Maybe next time you can write about how to get your methadone clinic to operate ethically or how to bring litigation if they don’t. Even something about how to successfully write a grievance about the way handle take home privileges? No, we’ll continue to get Junkies are funny and they lie alot stories because it’s just so entertaining.


  59. Posted by Sheri Maguire on July 18, 2020 at 8:10 pm

    Hi I got two take home .I always put a bit hot water stir drink drink juice I put water in the second.bottle and do the same is it ok
    works for me yes I’m awake and ready I in am I’ll dump!!! Please let me ow someone said it’s not as strong not


    • I’m not sure I understand what you are saying.


      • Posted by frank wood on July 23, 2020 at 12:53 am

        what in the hell is she talking about….?

      • Posted by Mark William Canavan on July 26, 2020 at 2:06 pm

        She dont even know shes on methadone. She’s referring to her thorazine dose and is confused as to why her hat doesnt taste like the Turkey dinner she ordered. You didnt see her final comment as it was cut off. This restaurant bites my ass, bruh.

  60. I missed a day of picking up my weekly takehomes.Will they take them away?


  61. Posted by Lawrence Clarkson on October 5, 2020 at 11:36 am

    My take homes being in a state of probationary hyper scrutiny, I’m required to arrive at the clinic twice a week for 30 days for missing a c bottle check and today the nurse tells me through a small window after I’ve provided a urine sample that it isn’t indicating a temp because it was “too hot” so I would need to provide another specimen and then both would be sent to lab for testing! This is the second time this has happened and I am not jumping through these hoops anymore when I’m in compliance and now after paying for 3 additional urine tests and now I am not going to be given my money I just handed them because I’m leaving without giving the second urine test! I have to wait for corporate approval before being reimbursed. These are the realities of a recovering addict who is in compliance with every aspect and flaming hoop for 3 years with only one drug test failure and then successfully completing 90 day probation to be level 3 approval with weekly take homes just as coviid-19 compliance initiates two week take home procedures


  62. Posted by MadatMat on October 26, 2020 at 5:36 pm

    I had month take home doses at the start of the COVID-19 pandemic. Prior to that I was at weekly status. I’ve had consistently clean UA’s, no behavior issues, stable home environment, no criminal activity, etc… basically I’ve met all requirements fir my take homes. A fellow patient who dislikes me extremely sent an email with an assumed name stating he had found my bottle in his 15 year old daughter’s dresser. Let it be noted my kids were 19 and 22 at the time. He had also sent a picture of a bottle with a 40 mg wafer next to it. The bottle had my info on it, but the dose was incorrect. Mind you, I, as well as 2 different counsellors have asked to see the email but I was told that no one but the director had seen it. She had sent it to corporate and no longer had it. This left me scratching my head… i normally press send on an email and a copy is in my outbox. Let it Akzo be said that the patient who Iasked them to look into has openly admitted that he was responsible to several patients. He said he made the label on his computer at home (I also was able to make a label at home in less than 30 minutes, 20 of which was spent finding the font. I did this just to see if it could be done). A few patients went to counselors and told them of admission, yet nothing was said or done. Here it is nearly 6 months later and I am still having to go daily. Both my counselor and the clinic doctor have advocated for me to be given my status back to no avail. The director is very young and very immature. She has disliked me from the start. I don’t know where to go from here. It is so frustrating.


    • Posted by frank wood on November 1, 2020 at 5:15 pm

      Thats absolute bullshit……Id find another clinic……some of these people who staff these clinics think they are God himself……..Get a lawyer…


    • Posted by frank wood on November 1, 2020 at 5:18 pm

      90% of the staff and counselors are babies……young brats who know nadda……Ive had so many counselors in my 18 years on Done its not funny……All these clinics care about is money,period……New Seasons,BHG……They are all the same….


  63. Posted by Stacie on July 19, 2021 at 7:52 am

    I just got mine took cause i came in a day early I had a bottle couldn’t figure out why and told lady up front I had one I usually pick up on Fridays .so why I’m waiting for Betty to get off phone .it dawned on me I picked up sat instead of Friday and two weeks puts me coming in on Sat so I just went on home .return sat they took all mine away . they can pull camera up front cause she talking to them tommorow this isn’t rite. Now I got to explan to my family were not going to Florida


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