dopetalk
Core Topics => Opiates & Opioids => Drugs => Methadone and Buprenorphine Maintenance => Topic started by: bignasty on April 25, 2017, 10:05:50 PM
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A new clinic just opened near my current clinic but in a different state. I've been at my current clinic for 6 months so I'm eligible for 3 take homes a week.
BUT the new clinic that just opened said I could transfer my time over from my current clinic and I'd be eligible for TWO WEEKS of take homes! I've never heard of 2 weeks of take homes after only 6 months and I've been to clinics in 5 different states.
Anybody get that many take homes after such a short period of time? If not, how does your clinic's take home policy work? Just sum it up, you don't have to give me the long version of successful drug tests, etc.... I just want to know how long you have to go there before you get X amount of take homes.
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Sounds like one of those "too good to be true" situations. I am pretty sure that clinics have to follow the federal guidelines when it comes to take homes. I know that there are clinics out there that do not follow the guidelines, but after a while, they tend to be either shut-down or forced to follow the guidelines.
The clinics I've gone to near me followed the exact same pathway when it came to take homes. When you first start you get one take home on Sundays. After consecutive clean UA's you're given another take home. IIRC, after a year of clean UA's you are at 2 weeks of take homes. That's where I'd gotten to.
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I ripped this from a website, but I'm pretty sure this is SAMHSA's federal guidelines.
Days 1-90 – A maximum of one scheduled take-home dose per week, as well as a take-home dose for one day if the clinic closes on Sunday.
Days 90-180 – A maximum of two scheduled take-home doses per week as well as a take-home dose for the one day a week the clinic will close.
Days 180-270 – A maximum of three scheduled take-home doses per week and one for days that the clinic is closed
Days 270-365 – Up to six take-home doses per week.
Year Two - Twice a month reporting.
Year Three – Once a month reporting.
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) During the first 90 days of treatment, the take-home supply (beyond that of paragraph (i)(1) of this section) is limited to a single dose each week and the patient shall ingest all other doses under appropriate supervision as provided for under the regulations in this subpart.
(ii) In the second 90 days of treatment, the take-home supply (beyond that of paragraph (i)(1) of this section) are two doses per week.
(iii) In the third 90 days of treatment, the take-home supply (beyond that of paragraph (i)(1) of this section) are three doses per week.
(iv) In the remaining months of the first year, a patient may be given a maximum 6-day supply of take-home medication.
(v) After 1 year of continuous treatment, a patient may be given a maximum 2-week supply of take-home medication.
(vi) After 2 years of continuous treatment, a patient may be given a maximum one-month supply of take-home medication, but must make monthly visits.
(4) No medications shall be dispensed to patients in short-term detoxification treatment or interim maintenance treatment for unsupervised use.
This was copied from the federal guidelines. Clinics are required by law to follow these guidelines....their rules for takehomes may be stricter than these (my clinic gives takehomes much slower than federal guidelines) but they can not be given faster than the recommended guidelines.
I agree with Wanderingmind! Too good to be true. I personally would call back to get clarification. If you get the same response, I would ask why they are able to give takehomes faster than federal guidelines. I would love to hear their answer.
Perhaps the person who answered was just misinformed, but unfortunately there are unscrupulous clinics that will say anything to get you in the door. Then you sign on the dotted line and all of a sudden, the rules have changed!
Places like this usually get shut down leaving clients scrambling for treatment. I would stick with your current clinic. Unfortunately, federal guidelines are what they are.
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I didn't get take homes for the first three months, then I got one day a month up to a week at a time. So, 9 months for once a week I guess. Technically Quebec has a limit on total amount or once a week. I think the limit is 600mg of methadone taken home per visit to the pharmacy, but I've only heard of one doctor applying that.
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I concur with the other sentiments above....
here's the thing. The federal guidelines are MINIMUMS. Clinics are allowed to impose more strict policies at their discretion, but they can NOT be LESS strict than those those mentioned above.
What will (likely) happen is you'll transfer over, you'll get your carries, they'll get found out, then you'll either lose that clinic altogether and have to go back to the other one and fight it out for a spot. (if that clinic closes everyone will be scrambling to go back to the other one, availability may become low)
Or, they won't get found out, and you'll keep getting them, until someone notices, then they'll pull them from you until you meet the fed guidelines.
Bottom line here is they will not last. I recommend you stick it out at your current clinic because it sounds like you're in a good spot there...and not terribly far from 2 week carries soon anyway.
Also, Z, it makes sense they set a limit on the QUANTITY you can carry. I find it strange they don't do that here...
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It was the program director I talked to but she did say she wasn't positive. My current clinic gives 2 weeks after a year I believe.
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I would definitely stay far, far away from the new place! If the program director is throwing out arbitrary numbers and isn't "positive" about take-homes, then run away! Run far, run fast! THAT is her job to know! She should have that information memorized, or if she doesn't memorize it, she should have that information, ready and accurate at her finger tips!
It's amazing how different clinics are with take-homes. As I mentioned in my first post above (as did dizzle) clinics must obey the federal guideline minimums meaning they can not give take-homes faster than the federal guidelines state. However, they are totally allowed to make their guidelines stricter and slower than the federal minimums.
As an example, in my clinic it takes 18 months of clean urines, never missing counseling or doctor appointments and total program compliance (petty things such as not loitering in the lobby or parking lot, not smoking or vaping anywhere on the property-not even in the parking lot in your car...and yes, they do check! Not wearing pajama or "lounge" pants to clinic...plus a bunch of other stuff..it is a very strict place, but it is also a very nice place, so I can live with it). Most other clinic it only takes one year.
The maximum amount of take-homes we can get at the moment is 13 bottles(two weeks). They are planning to offer take-homes once a month, but when that goes into effect, it is only available to those who have five years of continuous clean urine and compliance.(federal guidelines is
For two weeks of takehomes, instead of the federal mandate, which is two years, in my clinic ir is 36 months (3 years) of continuous compliance.
I have no clue why they are so difficult when it comes to take-home bottles. I think many more people would try methadone as a treatment modality if there was more freedom (meaning less time to earn bottles).
I personally think that there is reason to go slow in the beginning of treatment, especially when still at the stabilization phase of treatment. For people who are very motivated, successful and compliant, I think after 18 months you should be able to get the maximum amount of takehomes. I completely understand at clinics that take forever to dole out the take-homes why those people who attend start yapping about "liquid handcuffs".
Hopefully as MAT becomes more and more an accepted, and a less stigmatized option, maybe there will be relaxation in the take-home requirements.
Of course, as long as stupid, irresponsible assholes keep allowing their young children access to their methadone, by improper storage and keeping it in the fridge or mixed with juice in a non descript mug or drinking glass, there will continue to be stricter than strict guidelines. Just this week, I read about three children under the age of five who died after ingesting methadone in my surrounding area. Scary as fuck and completely avoidable with a safe or lockbox and a little supervision! Ok-Rant over Now!!!!!!!!
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Instead of starting my own thread I'll post here
My clinic is just like dizzle and other said.
My question is does anyone know of a clinic that does not test for THC and give carries if your positive. I'm in WI and can smoke with no take homes. I want to move to OR or WA and just wondering if I can get take homes.
Any help is appreciated. Even clinics not in legal states that do not test for pot would be an option also. Dizzle does your clinic test for pot.
Thanks
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Instead of starting my own thread I'll post here
My clinic is just like dizzle and other said.
My question is does anyone know of a clinic that does not test for THC and give carries if your positive. I'm in WI and can smoke with no take homes. I want to move to OR or WA and just wondering if I can get take homes.
Any help is appreciated. Even clinics not in legal states that do not test for pot would be an option also. Dizzle does your clinic test for pot.
Thanks
You know where I'm at (TC). The two main clinics here used to let you get carries even if you smoked. I am pretty sure it's still the same now, though I've been off MMT for almost three years now so I'm not really "in the loop" at the moment.
Speaking of smoking, is anyone else like this? So, from age 13 until 19 or 20 I smoked daily. I fucking LOVED weed and was kind of snobby about it in that I only smoked high-grade. During that time, I didn't go a day without smoking. When I started shooting dope at 19, I just kind of lost interest in marijuana. Even if someone is smoking some really good weed right next to me I have no desire to smoke. Is that weird?
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Instead of starting my own thread I'll post here
My clinic is just like dizzle and other said.
My question is does anyone know of a clinic that does not test for THC and give carries if your positive. I'm in WI and can smoke with no take homes. I want to move to OR or WA and just wondering if I can get take homes.
Any help is appreciated. Even clinics not in legal states that do not test for pot would be an option also. Dizzle does your clinic test for pot.
Thanks
The one clinic in Jackson, MS doesn't test for pot unless you miss two or more days at the clinic. How I miss that clinic 'cause smoking good weed actually helps me stay away from the H
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Speaking of smoking, is anyone else like this? So, from age 13 until 19 or 20 I smoked daily. I fucking LOVED weed and was kind of snobby about it in that I only smoked high-grade. During that time, I didn't go a day without smoking. When I started shooting dope at 19, I just kind of lost interest in marijuana. Even if someone is smoking some really good weed right next to me I have no desire to smoke. Is that weird?
I think that's pretty normal. I was growing weed only for myself when i caught my last h habit & just lost interest in smoking. I kept on growing & used it to supplement my habit but totally stopped smoking pot myself. Since getting clean I've resumed smoking pot but can't really tolerate sativas anymore as they set off my anxiety.
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^Im the same way Moe when it comes to Sativas these days.... even hybrids with as much as a 20/80 sat/ind ratio and I'm just floored with anxiety. Fuckin sux.
Far as using and smoking hand in hand.... I never felt the desire monetarily to delve into MJ when I'm into using again (2.5 yrs needle clean, yay). But it's been awhile. My behavior changes radically when I'm using.
I wouldn't pass the shit up if it were next to me, I'd just be hard pressed to spend the jack on a 1/8 of MJ. Knowing (then) that $45-50 could have gotten me more dope, and that MJ I invested in ain't gonna fix SHIT when the dope runs out.
It's just gonna sit there and mock my decision making process.
Nowadays I like me a good heavy Indica with a high CBD/CBG count. But tolerance seems to rise more rapidly with daily use. Goooooo figure.
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New clinics are the shit. Enjoy the newness while it lasts! Once the freshness wears off, they become like every other place, for the most part. I'm up to 4 takehomes, last I checked (but that was before my little 7 day involuntary hospitalization/detox, so we'll see)...
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When I first started at a clinic, I got a week's worth of takehomes after my first 60 days, but that's only because I got a travel hardship exemption (which had to be approved by the DEA, I think). In my experience, clinics have become more strict since then (about ten years ago). My clinic now only allows for weekly takehomes, if you were on monthlies you're grandfathered in, but if you fuck up, you lose them. I would say it's probably too good to be true, or the receptionist just didn't know what they were talking about (or it could be you misunderstood them), or it's a sales pitch/bait and switch. I guess it wouldn't hurt to see, though, there are clinics out there that are lax with the regulations. It's pretty stupid to go to such a clinic because you never know if or when they'll get shut down, but if you have the option of more than one clinic, you could try it out.
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actually the change that many clinics made regarding no longer allowing monthly take homes was due to changes in Medical assistance where they made it so that they can't get paid if the nurse or counselor or someone does not lay eyes on you at least once a week that happened several years ago i think around 2011 i am not positive on the year
My clinic used to give monthlies but when that was put into effect they made it so you could only get a weeks worth.
I started my clinic end of Jan 2017 i now have 3 take homes plus Sunday (they are closed) i started getting them in August because i turned in a dirty UA in May 2017 been clean since.
I get another in April or May forget which cause our clinic screwed up my dates one month i should have gotten them but the doctor drug his feet on it. I always love how we have to abide by all these rules but they get paid and can screw up s they see fit with no repercussions.
My clinic goes by federal guidelines It should be in the handbook that is or should be handed to you when you get there ask them for a new one if needed.
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Okay, um at six months there were 3 or four I’m not sure. At a year I think they fucked up but they gave me and Andi two weeks. Those are splits so I’m assuming he number of bottles don’t really mater, or at least they get around it somehow. I think they were able to do a tad extra for us because we live an hour away and have some other issues. They have also dropped us to two councilor sessions a month rather than four so that’s cool too.