New Policy at Clinic

[Griffin (OP)]

My clinic is implementing a new policy requiring family counseling to be able to get Phase 4 and 5(weeklies and biweeklies). The new policy requires you to bring in family and do a family counseling session to explain to them what it is, and keeping your take-homes safe. The problem for me is I haven't told my family I am back on it since I was arrested for my done DUI and had 4 months clean. I didn't tell them because no matter what my argument is they'd think I am high all the time and they'd question me about everything if I let them know.

My counselor is against it as well, and is currently looking up loopholes for me if it does get passed. It is a clinic policy not a federal or state regulation. He is hoping that I will just be able to bring in a friend or roommate for my family counseling session since the closest family I have is 700 miles away. He said they might do an over the phone session, so I may just tell my uncle since he has always been supportive, and was a drug counselor for a few years in his 20s. I brought his ex-wife pot without the family knowing when she had cancer so we have a tight bond.

My uncle doesn't want me on it but he is very understanding so he is my last resort if I can't get a 'friend" to do it. I think it is a bad policy because a lot of people are better off not telling there family. I think it is a good idea in some instances because every week I read a new article about someone else dying from a done OD that they got from someone from the clinic and it is usually a young child. So if it slows that down I am for it in certain circumstances.

I see news articles about kids dying from overdose atleast once a month if not more, which is horrible. I think a lot of it is because of people who aren't being careful and safe and not keeping their take-homes safe like they should be. I understand that accidents happen but they shouldn't happen at the rate they do and I think that is because of people abusing it and not using common sense and protecting their children the way they should be.

It isn't hard to keep your dose in a safe, and to drink it all and then put the bottle back in the safe and lock it. That is pretty much all they need to do to keep their kids from getting it. Instead people aren't locking it up, or drinking some and leaving the rest out where their kid can get to it, or they are mixing it with a larger drink in a regular cup and leaving it out and not drinking it all at once. All of these things shouldn't ever be done ESPECIALLY if you have kids around it's not that hard to do things right for the safety of your children.

Other than that, I don't like the reason just because being forced to tell my family and bring them in is going to make a lot of things worse for me. It is going to strain my relationships with my family, and they are always going to think I am high, lying, and stealing. I will no longer be able to have a conversation with them that doesn't include asking me when I am getting off of it and telling me why I need to get off immediately. They aren't going to trust me at all, I can't ask them for help because they think I need help because I am using again.

I love the idea of having a doctor and my counselor explain the facts to people and making them realize that I am not high, how its safe, gives people their life back, and all of the important things that would make them realize how MMT is a wonderful thing and not the same as me getting legal heroin and being high all the time. However I have done all of this with my family to no avail, I have shown them all of the research, studies, facts, and everything else that proves how it isn't the same as doing dope and that its a good thing and why I can stay clean.

What do you guys think about it? What should I do if they implement it? I am hoping I can get my weeklies before they implement it and just be happy with that. Do you think I should just bite the bullet and tell my family and hope that by some act of god that my doctor or counselor explaining it to them changes their opinion or deal with them knowing about it. I hope that it doesn't get implemented and I have nothing to worry about but that doesn't seem to be the case. Hopefully my family's opinion changes and its no longer a big deal.

I am also getting my med card monday if anyone has any questions about the process, cost, or anything like that associated with it. I can't get take-homes if I fail for weed even with a card which is dumb but I have a plan for that. The main reason I'm getting it is so that I can smoke weed on probation, which is a law that passed last year. I got food poisoning the other day from bad sushi and if I could of smoked my life would of been 1000x better. Plus all of the little things that weed helps with like sleep, pain, w/d's, and headaches it'd be nice to use for.

Basically the law they passed last year that allows people to smoke it says as long as you don't have a weed related charge and get your med card you can smoke. Unless your PO denies you which she has to have grounds to deny you smoking it, then you have to take it to court and the judge has to have legal grounds to bar you from smoking it. With it being medical, you basically just have to prove medical necessity and how pot > pills and is the best solution for you.

My PO said I'd be fine I just have to get the card, unfortunately that is not how the MMT clinics in colorado are. Even with a card you can't smoke and get take homes. My plan is I am getting my 4th phase which is weeklies next month and I am going to smoke every other month so when I fail my UA I will go from weeklies and be moved down to 3 days a week and then that month if I have a clean UA they will move me back to weeklies and I will just keep doing that

Ideally I'd be at phase 5 getting bi-weeklies and get moved down to weeklies when I fail my test and go back and forth between those two phases. Basically they take you down one phase each month if you fail your UA for the month. If you pass your UA the month after you've failed, and been moved down, you go back up to where you were. Ideally i'd do this with biweeklies and weeklies and just smoke every other month. It's not ideal but its better than nothing and when I have my UA within the first 2 weeks I can smoke for a week on my off months.

There aren't any plans to change this and I am not sure if it is a state, federal, or just a clinic policy but it seems to be the norm and I haven't heard of any clinics here who let you smoke with a card and get take homes. You'd think with it being legal it'd be fine but I can't see how they can legally stop you from smoking it if its medical. It shouldn't be treated any different than any other prescribed medication. At worst they should do what they do with benzos, which is inform the dr who prescribes the benzos that you take methadone and that's it.

I think it will come in handy big time when or if I start tapering for all the w/d symptoms. Does anyone's clinic allow weed and take homes? If they do s your state a med or recreational state? Hopefully they let me off probation early in july after its been a year instead of 18 months and then I probably won't care as much about getting my take homes but it is definitely a pain in the ass to go every day. If I move to Oklahoma after I get off probation I won't smoke weed at all because I can't afford another charge, so I'd like to do it while I can.

[Pullmyhair.]

It seems to me like this policy would be in violation of your HIPAA rights, your family members aren't medical professionals coordinating your care, so I don't see how they could force you to sign a waiver to communicate with them (and again, since they're not medical professionals, they can't communicate with them without a waiver). It's an incredibly foolish and unethical policy. Nevermind the fact that not everyone has family, or doesn't live with family. Expecting you to have your family from 700 miles away come in (or even call) is the stupidest fucking thing I've ever heard. I could understand making everyone take a takehome safety class (maybe an extra one for people with kids), but this policy is just plain stupid (and likely violates your rights). I would contact their accrediting agency and your state methadone authority (both should be easy to find contact info for), I would also file a grievance at your clinic and let them know it's unethical and violates your rights. It also doesn't make sense to only require this for weeklies and biweeklies, the people on lower phases are just as likely to divert or not properly store their takehomes as anyone else. I know a lot of clinics pull some shit, but the more I think about it, this takes the cake, this is some next level stupid.

As far as test for weed, my clinic doesn't test for it (and my state doesn't even have medical marijuana). I don't think your plan of smoking every other month will work for more than a few months, if you're continuously testing dirty every other month, they'll eventually stop letting you get your phase back after just one clean UA, they'll want 3 months (or more). Remember that the regulations and clinic policies are the most lenient they'll be, it doesn't mean they can't or won't be more strict if they want to. In my experience, consecutive or regularly failed UAs, will result in you going daily, even if technically on paper you should be able to fail every other month and still stay above a certain phase. I'm guessing based on all that you've posted about how ridiculous your clinic is, your plan won't pan out.

[Sand and Water]

^^^ everything Pullmyhair hair said x100. How stupid is it to screw w/ADULTS who are choosing to make a change in their lives by involving family members?  what a can of worms to open if family doesnt "believe in mmt". Hmm--so if mom or dad *doesn't* "get it" about someone not being high on MMT, the purposes etc., this opens the door for all kinds of negative crap. Like...child custody cases, forcing an ADULT to answer to another "authority" besides the clinic about what should be confidential info.

So if they're actually available, and willing to come, what happens if they disagree w/the clinic even being an option; "just say no" is the "only real way", & use that info against the ADULT?

Sorry for the rant, but this chaps my hide--it's medical treatment. Period. There's no justification (except money) w/out the client saying they WANT family "counseling" for this.  Too many already judge those on MMT *despite* being given info on it, why on earth make it compulsory to disclose private medical and tangential information? 

The only thing I can think of is they think they've found a way to get a lot of extra $$$ for these "counseling sessions"?  What's their plan when "issues" cone out during the session(s)? Oh, lemme guess, making *more* sessions compulsory??

I really hope you can use that loophole, (if not find a different clinic). Honest to Pete, if I were you, I'd immediately (anonymously) report them to your State licensure board and Mental Health Dept for what Pullmyhair already said. This is so over the top that a complaint and investigation would hopefully put a very quick  stop to it.

[Jega]

I'll echo what those above me said.

It MAY BE the policy of your clinic to do this. Federal law trumps Business Policy and Practices.

Rights are only rights if you insert and stand up for your rights.

[Z]

Do you live with family?  Not having them around your methadone might be enough of an argument to not approach your unknowing family.

[Griffin (OP)]

Thanks guys for the info, I hadn't even thought about that aspect of it and more than likely there has to some hoops they'd have to jump through to put this in to effect. They do hold the carrot though, so I don't know if they can get around regulations by saying some shit that they'll only give phase 4 and 5 to clients that the clinic feels are ready for it. They'd probably just say that the family counseling isn't a requirement but in reality that is what they are going to use as the requirement.

I really hope this blows over, and luckily my counselor is completely against it so maybe he'll help me out. I don't really have any friends that I'd take to a session there and if I did I'd probably never talk to them again. I like my clinic, the staff is nice for the most part, it's close, and my counselor is really cool. They have continued to make things harder there this last year, I am not sure if that has to do with medicaid covering it 100% or not but it came around at the same time.

They changed the time it takes to get the first phase to 4 months after you start instead of 30 days, but that doesn't bother me. Then they made everyone on dailies do 3 groups and a counseling session a month and phase 1-3 do one counseling session and one group a month. That is a main reason I want weeklies because the only group I can goto is at 6 AM. I am sure that some studies show that it helps lower relapse rates but I have been clean since I got on mmt in nov. 2013 so I'm good with one session or group a month not 2.

The last thing they did has pissed the most people off and is annoying to me but it's not that big of a deal. The first 30 minutes of every day only people on the "working" list can dose, so only people who work early and brought their schedule to their counselors and were put on the list before hand can dose from 530-6 everyone else has to wait. It's really annoying around holidays when everyones getting 2-4 take homes and it takes 30 minutes to an hour to dose.

Last time everyone was freaking out because it was taking a long time and since everyone who is not on the "list" has to wait until 6. There was like 45 people in line waiting to dose at 6. A lot of people were leaving without their dose or complaining about getting fired if they are late. There were a few counselors who moved people to the front of the line for this reason but they only did it for a few people and were definitely playing favorites.

I thought some of the people were going to lose it because they were having the same problem but they were going to have to wait it out while someone else went to the front of the line. I think no matter what I am going to have to deal with it at this clinic, when I tried to get back on after getting arrested last year and having a few months of clean time not one clinic in Denver was accepting patients it would of taken 4-6 months to get back on at my clinic if my counselor hadn't asked for a personal favor from the doctor to do an intake for me.

I don't think things have gotten much better I think there is one more clinic now but they are probably already full. I am just hoping that because of counselors disagreeing with it and it seemingly being a violation of quite a few regulations that this blows over and doesn't pass. I will find out more on Tuesday, I'll ask my counselor and see what happened at their weekly meeting and pass along what I've found out through hippa and what you guys have said.

Thanks for all the info everyone, you guys are awesome as always and I will keep you up to date on what happens. I am hoping I can find a way to smoke weed, maybe I can take it to the supreme court and win is Johnny Cochran still alive? I guess when I get off probation I won't have anymore observed UAs so i could always just store some clean piss and use it the times I smoke even though I wont be off until January, i can start sending appeals for early termination In April. Maybe in July they'll let me off. I haven't had much luck in the past but it'd be nice.

[dizzle]

Hey I'm just putting this out there but there's an app for the iPhone called voxox and if u dl it and put like $2.00 on it u can set ur caller id to anything u want. So, for example, if the clinic has ur family's phone number because u gave it to them when signed up, u can have a friend call the clinic using voxox app with the caller id spoofed to show ur family's number, that way the clinic will see it and believe it. Just saying.....


On top of that, I agree it's a serious hippa violation if I were u id contact ur local aclu chapter and get them involved with all their lawyering and whatnot, tell them what is happening and that ur rights are being violated. Maybe one call from the acle Lawyer would be enough to scare them off from making that gay ass rule.


Also, donate to ur local aclu, everyone!!!

[whiteheat]

Dizz got all the good tricks love it!

[Chip]

<snip>
The new policy requires you to bring in family and do a family counseling session to explain to them what it is
<snip>

that's not right; that shit is private. brother, that's a hell of an ask.

i don't agree with that policy at all.

[Griffin (OP)]

So my clinic coordinator is a fucking asshat, to put it nicely. He is now using me to get his stupid little rule passed about requiring everyone have a family counseling session to get weeklies. This is not a federal or state policy or requirement. The coordinator is just an idiot who wants to piss off more patients because everyone hates him, I assume he is doing it to get more money.

 I was supposed to get weeklies last week, and they haven't officially enacted this policy which comes with a bunch of other bullshit that I will put at the end of my post. However he is requiring me to do it to get weeklies, and I have to have a sit down with him about it, this is his way of getting it passed even though a few counselors and all patients are against it.

At my clinic to get moved to the next phase your counselor has to present your case in front of the entire staff, and the entire staff has to agree for you to be able to get your next phase. My counselor did this last week and everyone except for the coordinator signed off on it. Now he wants to use me as the first person to be required to do the family session since I am one of the arguments for not enacting his policy. My counselor is one of the main people against it and has used me as an example to get this policy from going into effect.

I have no family or friends in this state, i am single, I live in a community housing setup with people I don't know that well, my family doesn't know I am on it, if they did it would cause major problems with our relationship and they would nag me to get off of it in every conversation. So my counselor has used me as an example of reasons it shouldn't be passed or why they should allow some people to not have it, there is no one I know that could go, and it would cause me a lot of stress and problems if my family found out.

I could pay someone $20 to go but that is my best option, I don't want my roommates to know. They don't know and would judge me, or could potentially try to steal it if they knew I had it. I really don't want my family to know, the amount of never ending shit I would get for it is astronomical, none of them understand at all. Since I got the methadone DUI they think it is ruining my life hence why I didn't tell them I got back on it and why I went through 4 months of hell trying to stay off of it before deciding to get back on it after getting arrested.

So if anyone has any arguments I can use to get out of this, or get this dumb policy canned please let me know!! Especially any that are legal like hippa stuff. Since take-homes are a privilege I assume that would be why it wouldn't go against hippa, Since they aren't forcing me to tell my family I just wont get to have the privilege of take homes it is okay. I'm having my sitdown in the next 2 days, so I'd like as much ammo as I can to get out of this bullshit, the guy is an asshole and gets pleasure out of fucking over people, he gets joy when people can't dose.

Here is why I think it is a money ploy, it will count as another counseling session, the insurance they take only cover one counseling session and then one group a month so it's an out of pocket expense. But the big piece of it is what they are adding on to this policy. On top of the family session being required to they are adding a ton of extra mandatory groups i will post what they are later let me know if you can read the pictures.

[Taytoechip]

Last year when my girl (and myself thanks to the ridiculously over prescribing habits of most doctors) got on bupe she was in a program to help pay for everything. but there were some pretty intense requirements. Far more hours a week than a part time job in fact. But still, the hoops were jumped through until we built up enough strips to handle business on our own. In addition to daily visits to the clinic and meetings (4hrs/day) she had to attend 3 night time meetings with a family member a week (in this case, her dad) which were also 2 hours each.
But it was a real bind to make it happen. After a couple times of not being able to make the meetings each week she was put on like a probation shit. If the 3 meetings with her dad were not made each week she could and would have been terminated from the program. Because he was the one who started coming to the family meetings with her, she couldnt switch it up and bring another member if he couldnt attend. it HAD to be the same family member. How fucking ridiculous is that?

Best of luck though. Sorry, wish i had some advice.

[Lolleedee]

HOLY FUCKING GROUPS!!!  This is the most ridiculous thing I have see!  It totally looks like a money making venture for them.

They basically more than tripled the requirements!  How do they expect people to recover when they are spending that much time at the fucking clinic!???

My clinic has groups but NONE are required...they are all voluntary.  We have mandatory individual counseling.  I think for the first 30 days it is once a week, but they are only half hour sessions.  After that it is one session per month.

I do not think groups should be mandatory.  Some people, especially those with severe social anxiety, won't find much of a benefit.  Plus, I sometimes think the whole "clinic culture" can be detrimental.  For me, I go in, dose and then run far, far away!  I have a private therapist that i see and I find this woks best for me.

I think it is unfair that more goups are required, at your expense, for higher phase.  I would mention in your meeting that they are in essence, discriminating against those who can't afford the extra groups.  That is a totally unfair, discriminatory policy..  If they wave the fee for those who can't afford the extra groups, well, at least that would be a bit more fair.

If they were truly worried about the "safe storing of take-homes" and "family understanding of treatment" then that family session should be at NO COST TO CLIENTS!

I would definitely tell them you feel it is discriminatory to those without the financial means to do these groups.  I know most people are afraid to speak out, but clinics will continue to fuck with us if we do not stand up!  There are policies in place that protect us from retaliation.

I put in a formal complaint against our dosing nurse.  It's a long story, but in the end she lost her job because I refused to back down.  I pay close to 100.00 a week and in no other consumer situation would people put up with the shit we put up with.  You (or your insurance) is paying for a service,,,so make damn sure you are getting the treatment you deserve.

If it was me, I would say the above and if they hem and haw ask the dickhead for the form to file a formal complaint...and if you do file one, inform them you will also be sending a copy to SAMHSA and your state methadone authority.  I have found through the years that these things make them change their tune pretty quickly!

Also, document everything!  Who you talk to, what they, say, date, time etc. on the off chance they force you to play your hand.  Complaints that are well documented are taken way more seriously then someone who gives just vague details.

Sorry you are dealing with clinic bullshit!!!!!!

[Griffin (OP)]

Thanks lolleedee, when I started you had to do one orientation group to start and then one counseling session or group a month after that. Then they switched it to one group and a counseling session a month for people who are on weeklies and above and now they are adding another one on top of that and this family counseling bullshit. I am fortunate that my counselor is really cool and completely against it, I think that is a reason they are going after me because I am a prime example of why it is bullshit.

Of course he can't see me until Thursday, the day i don't come in, at 8 am, so I will have to wait at least one more week and that is if he lets me have my phase which he should and he can come after me AFTER this is actually a policy because right now it isn't they are just proposing it. They take suggestions and they have to read them in there weekly staff meeting so I am recommending everyone I know to write one a day, that is what I am doing. I will do a formal complaint if this goes forward.

I don't see how he can require me to have it and no one else when it isn't a policy yet, they are just talking about it, and I shouldn't have to anyway. They are basing it off a study that shows clients who are more involved in their treatment do better, this study doesn't show or look into how much it alienates people, how many people dropped out or their retention rates, because its easier and cheaper to get dope than it is to go through all these hurdles, a few hours of groups a week, plus counseling, and a bunch of other shit, on top of $100 a week for your dose.

The study is so broad, and unspecific that of course they would come to that conclusion. It doesn't look into how groups or counseling affect retention and success or anything else that it should to prove that this is all bullshit that is going to cause more people to use, and drop out. I would understand if it were a fed. or state requirement, but this is bullshit I'd much rather they just come out and add $10 to everyones bill than to make us all suffer and go through this bullshit as money is the only reason this dumb ass shit makes any sense.

I'm not sure how much the groups cost yet. I haven't had a dirty UA since I started in Nov 2013, the only days I missed where when I was incarcerated, and the only reason I am not still on 2 weeks at a time is because I was arrested for driving on methadone. They didn't think it was a good idea to inform me or anyone else that driving with methadone in your system(even if its a day after you took it) can result in a DUI as it did with me, which is why I am not getting 2 weeks at a time and jumping through all these hoops again. Can I sue? (yeah i know thats what wrong with america, and it was my fault, but I need recourse for this bs)

If someone has made it 2.5 years without fucking up they shouldn't be punished with extra groups and counseling, all they are doing is forcing people off of it, and putting more stress on everyone. I don't think any studies show that if you stress someone out so much and make their treatment unaffordable that they will have more success at getting clean. More people might get off methadone but not because they are getting clean. Fucking assholes, i guess ill stop ranting and update you after I meet with captain dickhead, wish me luck and if anyone has any ideas for arguments please let me know as this is bullshit.

[10kites]

The policy is based on studies that show......bla, bla, bla.  I go ballistic when I read this "studies show" bullshit. You can conduct a study that shows the moon is made of cheese if you want to, but it still don't make it true.

If you got the money to spend, you could do a study that shows that they are full of shit, but I bet they would'nt want to quote that "study."

Studies show that they are greedy fuckin assholes.

[smalls]

If you started in Nov 2013, doesn't that put you in the third column with "No group changes"? Or even of you're considered a "re-start" after July 2014 due to your arrest, wouldn't that then put you in the second column which does not require family meetings?

To be clear, they have not initiated this as policy yet but despite that they are requiring you schedule a family meeting?

You're right. All these rules sure don't encourage one to stay in treatment.