Max methadone patients per clinic

[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.

[Tainted (OP)]

I realize all clinics will have diff policies, but what's the general UA policy? Fail two or three ua and your out or what? I'm figuring methadone will get my tolerance so high that opiates will be pointless, but I wouldn't mind rolling now and then or doing some coke. Am I gonna have to pee in a cup before I dose and keep it in the fridge for safe keeping in case they test me

[Smacky-Doodle 2.0]

At my clinic, fail or come up 'non-therapeutic' as they put it, and you will have your step-level decreased.  This means if you are on monthly take-homes, then you go back to bi-monthly.  If you are on the weekly phase, as I am, then you will be reverted back to 3x week.

If you are daily, and fail a UA, nothing really happens except it'll take longer to progress.  You have to have 3 'therapeutic' UA's, and some classes completed to increase or phase up your step-level.

If you aren't accruing any clean UA's, then you're gonna be daily for the foresee-able future.  For some people this is no big deal.....I know some who have been daily for years....they piss dirty, and just keep showing up they keep getting dosed.

Benzos are the only thing that if you piss dirty for them, you'll get kicked the fuck out.  And it still takes a while of them saying 'hey, don't do that' before you are up for termination.

I think for the most part clinics are pretty tolerable of people cross-using, as long as it's not benzos.

That's MY experience....Florida could be entirely different.

[Z]

A single payer system would make a huge difference for you guys.  I forget the exact numbers, but medicare and the va costs a similar amount per capita as the Canadian system that covers our entire population.

A single payer system makes the difference.  Instead of the hospitals setting their prices, the government assigns a value and pays that.  There is no need for hmo's to get rich at the expense of the citizens.  It's too bad that the aca was watered down to its present state, but it is a good start.

Sorry if it seems like I turned this into a USA vs Canada thing.  Not trying to offend anyone.  I was just trying to add my experience from the other side of the border.

In Alberta the experience was similar to what you guys describe.  It cost me 400 per month, and I had three times a week urine and alcohol tests.  We had to blow a 0.00, and they were strict about it.  Fail three times and you're out.

One woman I knew there was still prostituting to afford the clinic.  Tragic.

It isn't all rainbows and lollipops here.

In Vancouver it was the opposite.  You could get a same day appointment, welfare covered prescription costs even if you were not eligible for welfare, and I dosed at a pharmacy that only did methadone.  They mixed up 1 gallon water jugs full of 1mg/ml, and dispensed with graduated cylinders into Styrofoam cups.  No bottles available.  If you had tskehomes they sent you to a different pharmacy.

[Griffin]

My clinic is the same as smacky-doodles when it comes to UAs except they don't care if you fail for benzos or anything. I know a guy whose been there 18 years and hasn't had a clean UA most of them are for pot or benzos. I think you have to have 12 clean UAs in a row to get weeklies here along with all of the other stuff smacky said.

My clinic started a new policy last month that if you fail your breathalyzer on Saturday you can't get your Sunday take-home either. They only give breathalyzers to the people who have alcohol issues. Luckily they didn't start me on them when I got the DUI even though it wasn't for drinking. They are required to take them everyday and to get off I think you have to have 6-12 months of no hot breathalyzers and no alcohol in your UAs after you've been put on them.

The workers dose first policy is still in effect as well if you guys remember reading about that in the other MMT thread. Basically everyone who works early gets to dose first the first 30 minutes of each day including Saturdays where they are only open 6-930.

I am not sure if you even have to work early or if their is a cut off time. It may just be for anyone who has a job and brings in their schedule every 2 weeks gets put on the workers list. No one else can dose the first 30 minutes unless there is no one in there. If someone on the list shows up they are moved to the front of the line. It pissed off a lot of people at first but now I don't hear many complaints about it.

No worries about adding your input about Canada Z. I think most of us are very interested in how things are done there and everywhere else. I think it is interesting to read how other countries are doing things. It seems Canada has a leg up on the US when it comes to addiction treatment.

 I have a lot of respect for the woman who started the Heroin maintenance stuff in Canada. My counselor is a huge fan of her and went to a class she did here in Denver about her findings and research of Heroin Maintenance. From what I understand she lobbied for almost 10 years to get the regulations put in place to be able to do research on it and start up a clinic to do so. I love reading about it, it gives me hope.