Revoking Methadone Take home Doses

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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.

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82 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.

    Reply

    • 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.

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    • 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.

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      • 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.

  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.

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  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.

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    • Exactly, Joycelyn. Glad you commented. 🙂

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    • 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.

      Reply

      • 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?

    • 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.

      Sincerely,
      A thoughtful ex user

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      • 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.

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    • 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.

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      • 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 strict..in 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.

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  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$

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    • 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.

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      • 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.

    Reply

    • 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.

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  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.

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  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?

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  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.

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

    Can you loose your take homes for shoplifting?

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  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.

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  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 !

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

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      • 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.http://dpt2.samhsa.gov/regulations/smalist.aspx
        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 Pennsylvania..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

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  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.

    Reply

  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?

    L

    Reply

    • 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.

      Reply

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

      Dear veteran, If you only have 30day suspension just deal..it 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!

      Reply

  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.

    Reply

    • 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.

      Reply

      • 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?????)

    Reply

    • 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.

      Reply

      • 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.

    Reply

  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.

    Reply

  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?

    Reply

  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!
    Methadone was designed to get opiate users clean. HERE’S HOW IT WAS SUPPOSE TO WORK: YOU START THE USERS AT A DOSE EQUAL TO THEIR DRUG OF CHOICE MILLIGRAM THEN YOU GRADUALLY REDUCE THE DOSAGE LOWER AND LOWER UNTIL THEY ARE “CLEAN” and DRUG FREE: PERIOD!!
    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!

    Reply

    • 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.

      Reply

    • 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.

      Reply

  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

    Reply

    • 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.

      Reply

      • 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.

  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!

    Reply

  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?

    Reply

    • 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

      Reply

  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.

    Reply

  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.

    Reply

    • 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.

      Reply

  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” ..eg, 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. 🙂

    Reply

  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

    Reply

    • 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.

      Reply

  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

    Reply

    • 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.

      Reply

  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.

    Reply

    • 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.

      Reply

  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.

    Reply

  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!

    Reply

    • 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.

      Reply

  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?

    Reply

  33. Reblogged this on My Sharing Blog.

    Reply

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