Max methadone patients per clinic

[Z]

In the US there are stringent requirements for methadone clinics.  Dated requirements.  For suboxone, most doctors could easily do a data 2000 course and dispense it.

Here they are both governed by a 1 day, 6 hour course.  They are both treated the same with earning carries and going to the pharmacy.

I wonder if some of you who are on subs would be on methadone if you had to get your subs every day and earn privileges.  Here they stream pill users onto subs and heroin users onto methadone for the most part.  That is the experience in the circles I run in at least.

I would call and say you are on probation, and your PO wants you on methadone.  Just be aware they might want to talk to the PO, so don't spread lies.  Can't hurt right?

Edit:  my doctor is expanding his practice right now.  If anyone from Montreal/Québec needs a referral drop me a line.  I'm pretty sure I'm the only one though.

[clinton]

Yes that's why they have wait lists backed up for months ,..

My clinic is 50 patients per counselor, nothing more..we have
Five counselors ,250 patients ..people are literally waiting weeks to get in

[AllNightLong]

In the US there are stringent requirements for methadone clinics.  Dated requirements.  For suboxone, most doctors could easily do a data 2000 course and dispense it.

Here they are both governed by a 1 day, 6 hour course.  They are both treated the same with earning carries and going to the pharmacy.

I wonder if some of you who are on subs would be on methadone if you had to get your subs every day and earn privileges.  Here they stream pill users onto subs and heroin users onto methadone for the most part.  That is the experience in the circles I run in at least.

I would call and say you are on probation, and your PO wants you on methadone.  Just be aware they might want to talk to the PO, so don't spread lies.  Can't hurt right?

Edit:  my doctor is expanding his practice right now.  If anyone from Montreal/Québec needs a referral drop me a line.  I'm pretty sure I'm the only one though.

To answer your question yes I would be on methadone over suboxone if the regulations and rules for dispensing it were the same. Cost would play a factor and anyone that accepts insurance would still be considered over another.

There is actually a clinic here where I am at that despenses suboxone just like methadone and is $22 a fucking day to go to. Fuck that noise, gimme the juice.

[Wildcat]

I was wondering-

So your on the mmt to get and stay off other opiates/opioids, to get your life back on track and such, a lot of folks on probation.  From what most are saying, you must pay in advance, unless you have Medicaid?  Well, what happens, say you've become stable at a certain dose, and you get laid off from your job or something like that?  Do they give some leeway to find other employment, or do they just cut you off ct, or at least taper you down?

Then what? How do they expect folks to get and stay clean when they can't pay their bills, because they are out of a job due to no fault of their own?

[Pullmyhair.]

I was wondering-

So your on the mmt to get and stay off other opiates/opioids, to get your life back on track and such, a lot of folks on probation.  From what most are saying, you must pay in advance, unless you have Medicaid?  Well, what happens, say you've become stable at a certain dose, and you get laid off from your job or something like that?  Do they give some leeway to find other employment, or do they just cut you off ct, or at least taper you down?

Then what? How do they expect folks to get and stay clean when they can't pay their bills, because they are out of a job due to no fault of their own?

It depends on the clinic. It's referred to as a 'feetox' policy. Some clinics will give you up to a 21 day detox, some clinics, such as the one I go to, will not dose you if you're not paid up (no exceptions). My clinic won't even give you ANY of your takehomes unless you've paid for all of the takehomes you're supposed to get, so say for example if it's a holiday weekend and you forget to bring money for the dose for Monday, they won't give you your takehomes for Sat and Sun until you've paid for Monday as well, even though you've already paid for them. It's bullshit, I think it's incredibly unethical to not have some sort of detox policy in place for non-payment. You'd think they'd want to do it, because it only looks bad on them, if you don't get dosed, and have no money, I would imagine most people would do what they had to to come up with it, including breaking the law. It just seems counter-productive to the whole point of having methadone clinics.

[Wildcat]

That's just down right CRUEL. and tells me they are not interested in anyone's well being, let alone recovery- just the all mighty dollar, would understand how easy it would be to just say "FUCKIT".  2 steps forward and $15 back or whatever it is a day these clinics charge.

[Sand and Water]

I was wondering-

So your on the mmt to get and stay off other opiates/opioids, to get your life back on track and such, a lot of folks on probation.  From what most are saying, you must pay in advance, unless you have Medicaid?  Well, what happens, say you've become stable at a certain dose, and you get laid off from your job or something like that?  Do they give some leeway to find other employment, or do they just cut you off ct, or at least taper you down?

Then what? How do they expect folks to get and stay clean when they can't pay their bills, because they are out of a job due to no fault of their own?

It depends on the clinic. It's referred to as a 'feetox' policy. Some clinics will give you up to a 21 day detox, some clinics, such as the one I go to, will not dose you if you're not paid up (no exceptions). My clinic won't even give you ANY of your takehomes unless you've paid for all of the takehomes you're supposed to get, so say for example if it's a holiday weekend and you forget to bring money for the dose for Monday, they won't give you your takehomes for Sat and Sun until you've paid for Monday as well, even though you've already paid for them. It's bullshit, I think it's incredibly unethical to not have some sort of detox policy in place for non-payment. You'd think they'd want to do it, because it only looks bad on them, if you don't get dosed, and have no money, I would imagine most people would do what they had to to come up with it, including breaking the law. It just seems counter-productive to the whole point of having methadone clinics.

Repped. It IS counter-productive. And cruel. And has nothing to do with a client or patients well-being when applied in this context imo. You'd *think* it'd make these clinics look bad, but when so much we hear in the media is "abstinence is attainable if they do the work" etc, the blame for not succeeding gets placed right back on the very people who WANT help (aka recidivism).

And who in mass media gives "junkies" (hate that word in this context too) an equal voice over "Dr Drew" and his ilk?. Grr sorry for rant-it's just disgusting to me.

 I hate that for so many - not all, but enough - it seems to just be about big business (= all about the $$$).  I'm curious--does anyone have info i.e., studies/stats on whether or not there was a surge in these types of businesses by doctors immediately following crackdowns by DEA, state politics etc?  I though someone had written and posted a link to media attention. but I'm not certain so apologies if Im just not seeing it.

[Griffin]

They do a feetox at my clinic too but it is a 10 day detox no matter what dose your at. So if your on 200 your going down 20 a day regardless. It is 230-300 a month on a sliding scale or $20 a day to guest dose there. They also dispense methadone on my clinic and its more expensive and you have to go about getting take homes the exact same way.

I wouldn't be surprised if the amount of docs switching to done shot up after the crackdown. Even though not very many new ones have been able to open due to regulations and funding. I bet a lot of doctors followed the money and were able to get jobs at the ones available. I also adds on becoming drug counselors all the time.

[monkey business]

My clinic has the exact same policy as Griffin's.. If you can't pay they drop 10% of your original dose each day until you get to zero and are dropped entirely. The fucked up thing too is, say you're on 120 mg and get fee-toxed for 8 days due to non-payment and then on day 9 you're finally able to pay your debt. Well now you're stuck at 12 mg and will have to do a slow and steady increase instead of just having your original 120 mg dose re-instated. This means an additional 1-2 weeks of sickness and w/d until you can get back where you were all because of a week-late bill that's somewhere in the $80-100 range.


It's redic and they don't give a shit about the patients' success or stability, only getting their money every week like clockwork while every one else suffers.

[Z]

That's disgusting.  My pharmacy has given me my methadone before I go to the doctor before.  Just because the pharmacist is nice, and doesn't want me to be sick.

I couldn't pay $20 a day.  I would still be actively involved in bad ways to make money if I had to pay 500 a month for methadone.  I pay $17 a month right now.

[Tainted (OP)]

That's disgusting.  My pharmacy has given me my methadone before I go to the doctor before.  Just because the pharmacist is nice, and doesn't want me to be sick.

I couldn't pay $20 a day.  I would still be actively involved in bad ways to make money if I had to pay 500 a month for methadone.  I pay $17 a month right now.

Seems like the moral of this thread is America sucks and we should all goto canada.

[_Enduser]

That's disgusting.  My pharmacy has given me my methadone before I go to the doctor before.  Just because the pharmacist is nice, and doesn't want me to be sick.

I couldn't pay $20 a day.  I would still be actively involved in bad ways to make money if I had to pay 500 a month for methadone.  I pay $17 a month right now.

Seems like the moral of this thread is America sucks and we should all goto canada.

do you get methadone in jail in canada?

[Z]

You do get methadone in jail, but it has to be set up through a bureaucratic nightmare.

I wouldn't say America sucks, and we certainly have our problems.  The public health system is overburdened, and waiting lists are long.  I waited two months for my initial appointment.  Then a month later they moved the appointment forward yet another month.  In all it was 4 1/2 months between first call and getting my methadone.

Some people wait less long, and some wait longer.  I heard from one guy that waited a year.  To me, that is unacceptable.  People have died waiting for treatment.  That is part of the reason for relais methadone.  That is also my motivation for offering referrals to my doctor.  Someone in crisis needs help now, and not in 4 1/2 months.

[Griffin]

I hate al of the hoops you have to jump through to get treatment here it is horrible. I don't know how many people have to be addicted for them to start making getting treatment easier, cheaper, and more accessible. I couldn't imagine paying $20,000+ a month to go to in-patient treatment. I am glad that methadone is finally free with medicaid here in colorado but I know some states aren't as lucky.

They need to do studies that show how many people are dying because the treatment system in americas unavailability. There are plenty of studies that show that it is more cost-effective for people to get treatment. It is way more cost-effective for people to get meds in jail, and the crime rate goes down. The only down side to it is a politician saying he is wrong or saying another way might work which will probably be the hardest hurdle to jump.

[Opus]

I wouldn't say America sucks, and we certainly have our problems.  The public health system is overburdened, and waiting lists are long.  I waited two months for my initial appointment.  Then a month later they moved the appointment forward yet another month.  In all it was 4 1/2 months between first call and getting my methadone.

These waits are very similar to what I'm dealing with being on medi-cal. It's typical (tho admittedly a little faster lately) for me to have to wait 1.5 - 2mos for an initial appt. with my "GP" - who is about as useful as a hemorrhoid, then he makes a referral, and another 2mos. goes by before I can get an appt. with a specialist.

Ideally anyway.

I just had a small cyst removed (actually there were three of the fuckers), it took well over a year for my Quack and his Krew to get their shit together for what was ultimately a 15 minute surgery that happened in a small office with nothing more than a little Novocaine and 4 stitches; it was a joke. But at least for us in the US, this is SOMETHING -- I went >10 years without a chance in hell for health insurance simply because I've had something they didn't know how to easily deal with (pre-existing condition, for me in the form of daily un-relenting 'heartburn' that you wouldn't wish on an enemy).

Anyway. Our system is far from perfect but we've made a TON of progress on that front (THANK YOU OBAMA!). Now if we could just get a single-payer system set up, we'd be even further down the road to acting like we actually have some humanity and live in the same century as the rest of the "first" world.

/rant 

[Lolleedee]

Our "feetox" policy is you don't pay, you don't dose..at all.  If you miss three days, then you get kicked off with no detox.  It is fucking barbaric!

I'm not under the delusion that treatment should be free.  I am willing to pay a fair price for treatment. I hear people at the clinic all the time bitching about the clients who have medicaid and have their methadone paid for.  While I would love to have mine paid for, I realize (but the people bitching don't) that I am lucky to have enough income to pay for my treatment and I have private insurance.  People on medicaid do not have that wiggle room in their budget.

Believe it or not, the only time they wean you down is if you have an administative detox for noncompliance.  Soooo if you are an ass to staff and are a fuckwad, they will detox you..if money is tight, it is fuck you!

This has to change.  It never ceases to amaze me that the most effective treatment for opioid dependence is so hard to access.