The methadone clinic I attend has a new policy that started a few weeks ago. They are doing what is called the 5 in 5 Program.
The first day is geared specifically around getting the patient dosed.
Before this new policy started, on your first time to the clinic,or the 5th, the usual wait is from 6-9 hours for paperwork, and ultimately, just to be dosed.(I know when I tried my first 21 day detox the wait was so long to be dosed and I was sick, that I left the clinic,went to my connection,got loaded and went back,feeling a bit better,and continued my wait.) When you have made the decision to go on maintenance you are usually at the bottom, feeling defeated and wanting help. You feel like SHIIT and just want the craziness and the being sick to stop. You don't want to fill out tons of papers,talk to 10 different people or answer a ton of questions....not today...not while you're sick, but what choice do you have??
For those of you who have been there and done that you will recognize how cool this is. No one who makes the decision to go on methadone decided it on the spot. It is something I would think takes a little thought and some research. As we all know there are good clinics and there are bad clinics. Unfortunately where you live and your access to transportation can cause problems with which clinics you can attend compared to which clinic you want to attend.
With this new program,on day 1, the patient does their admission with the Doctor and meets with the Supervision Counselor. With the most important paperwork out of the way the patient is given their dose,usually within 2-3 hours. Once they feel a bit better and the staff know they are doing ok with regards to their dose the first session is over.
Over the next 4 days the patient meets with the counselor, allowing them to tell their story, begin building a relationship & discussing a treatment plan.
On Day 5 the patient meets with the patient once again,does a follow-up and finalizes all treatment plans and documents.
After completion of the 5 in 5 Program the patient is given a certificate of completion and then scheduled to weekly groups and the once a month counseling. Medi-cal patients are required to counsel weekly.
Another change the clinic made was to make it mandatory for all patients to attend a weekly meeting of their choice,over and above the mandatory monthly meeting with their counselor. Mandatory weekly meetings met with some resistance from the patients. Everyone,regardless of clean time,medi-cal or cash payers alike have to attend a meeting once a week. There are 9 meetings to choose from beginning as early as 5AM. One of those meetings is the the Keys to Recovery meeting my husband and I lead on Wed morning. Ours is the only meeting run by patients so it is popular which is great for us.
The clinics policy on not following the rules? Kick you off the program. I think it's a good thing all the way around.
Does anyone attend a clinic with any rules like these??
Yeah Granny- Similar rules here -
Usually a 2 or 3 hour process of paperwork and medical check-ups before you get dosed -(30-40 mgs)- -and a treatment plan is drawn up, and gone over by counselor and patient
You just cant get on maintenance right from the start- you must try a 14 detox - then a 30 day detox-( then usually STM- Short term mat)- >which is 6 months-
If all this fails, and you,re still using , you are offered MMT. On all the detoxes, you must go to counseling, and stay at the klinic at least an hour ,so they can monitor how it effects you, if it gets you sick ..etc..
Some go on to MMT-- most do not- Now with subs, addicts have choices that we didn't yrs ago-
They wont put you on a higher dose than ,I think 60 mgs if your on STM- but that is a pretty good holding dose if you dont use.
Only when all else has failed, will they recommend MMT-then you can go up to a dose you feel comfortable on-
14day detox is a flat fee- 120 bucks- -30day is 60 bucks a week- 50 to get on- -and STM- is 50 to get on and then 65 a week till your built up, brought down, and detoxed off-
Long ago ,(when it was much,much cheaper) I went thru the whole gamete of detoxes more than once before I committed to MMT- some can make it work, some just cant- but all patients are encouraged, and counseled to make the commitment to stop the using, are helped with legal issues,and are offered family counseling.
As far as mandatory meetings go> only if your on the detoxes of 14 or 30 days are they mandatory. STM & MMT patients are encourged but not required to attend any meetings
Any continued use of benzo,s (which has become a problem at many klinics)- will get you administratively detoxed- - unless you have a script from a psychiatrist -Its a good idea to ask for the "klinic policies"- they are suppossed to give them to you when you begin any detox- but most of the time they dont- -and patients dont ask for them-
BEST
jack
Usually a 2 or 3 hour process of paperwork and medical check-ups before you get dosed -(30-40 mgs)- -and a treatment plan is drawn up, and gone over by counselor and patient
You just cant get on maintenance right from the start- you must try a 14 detox - then a 30 day detox-( then usually STM- Short term mat)- >which is 6 months-
If all this fails, and you,re still using , you are offered MMT. On all the detoxes, you must go to counseling, and stay at the klinic at least an hour ,so they can monitor how it effects you, if it gets you sick ..etc..
Some go on to MMT-- most do not- Now with subs, addicts have choices that we didn't yrs ago-
They wont put you on a higher dose than ,I think 60 mgs if your on STM- but that is a pretty good holding dose if you dont use.
Only when all else has failed, will they recommend MMT-then you can go up to a dose you feel comfortable on-
14day detox is a flat fee- 120 bucks- -30day is 60 bucks a week- 50 to get on- -and STM- is 50 to get on and then 65 a week till your built up, brought down, and detoxed off-
Long ago ,(when it was much,much cheaper) I went thru the whole gamete of detoxes more than once before I committed to MMT- some can make it work, some just cant- but all patients are encouraged, and counseled to make the commitment to stop the using, are helped with legal issues,and are offered family counseling.
As far as mandatory meetings go> only if your on the detoxes of 14 or 30 days are they mandatory. STM & MMT patients are encourged but not required to attend any meetings
Any continued use of benzo,s (which has become a problem at many klinics)- will get you administratively detoxed- - unless you have a script from a psychiatrist -Its a good idea to ask for the "klinic policies"- they are suppossed to give them to you when you begin any detox- but most of the time they dont- -and patients dont ask for them-
BEST
jack
Hi Jack,
From what I know you have only to prove you failed 2 detoxes from whenever and whereever and you can get on maintenance.
California clinics dont require you do anything else,except the mandatory once a month counseling with your counselor and pay your bill and pee on command.
I believe they are hoping this will help with the folks who do nothing to assist themselves in staying clean. In our particular group of clinics, evidently the cash paying patients are the ones who are using on top on MMT and failing the whole idea of the program.
From what I know you have only to prove you failed 2 detoxes from whenever and whereever and you can get on maintenance.
California clinics dont require you do anything else,except the mandatory once a month counseling with your counselor and pay your bill and pee on command.
I believe they are hoping this will help with the folks who do nothing to assist themselves in staying clean. In our particular group of clinics, evidently the cash paying patients are the ones who are using on top on MMT and failing the whole idea of the program.
I am very surprised to hear about all of the rules that other methadone clinics require you to follow and it also makes me kind of nervous bc I feel like I might be at one of the "bad" clinics, although I don't really have A choice where I live. My clinic never mentioned that you had to have 2 failed tx's before MMT, but I already had 2 in my using anyway so maybe that's why. I've also noticed that they don't ever approach any pt about maybe tapering no matter how long they've been there and only Very recently have they announced the new rule made mandatory by the at of ks that if a pt tests pos 3 months in a row for the same sub then the pt will be required to pay for and provide us samples 15$ each time every week until they're clean from that sub. After that idk I'm guessing you
over.
over.
Well Troops...
Thank God I live in the good old U.K....
there ARE RULES INVolved wi yer scripts but its down to whatever area you live in and the Dr who runs the clinic,,he or she decides what the rules are,n,over the years diferrent Drs have came in and turned the system on its head then left for it to be turned on its head again..Some don't let you go over a certain dose where others differ,,i think by what ive seen wi other people over the last few years that they have quite a good system just now bcoz for the first time ive witnessed people not using wi their meth,n,coming down then swapping to the subs for their tapering off..ECK
Thank God I live in the good old U.K....
there ARE RULES INVolved wi yer scripts but its down to whatever area you live in and the Dr who runs the clinic,,he or she decides what the rules are,n,over the years diferrent Drs have came in and turned the system on its head then left for it to be turned on its head again..Some don't let you go over a certain dose where others differ,,i think by what ive seen wi other people over the last few years that they have quite a good system just now bcoz for the first time ive witnessed people not using wi their meth,n,coming down then swapping to the subs for their tapering off..ECK
So far I am able to get a little work done. I have the new tower,Just dont have it up and running yet so this may or may not go thru.
For anyone that is in a clinic that doesnt at least "challenge" you a little to stay clean may be one that doesnt really give a rats a** if you clean up or not.
21 day detoxes were created for patients to fail because addicts who have used for years cannot possibly get clean and stay clean with only 21 days to tackle their addiction. It can take that long to get on a dose that holds you so the urge to use is gone.
As far as I know, a reputable clinic will require testing monthly,observed or not, monthly counseling,minimum of 50 min. each time and listen to what YOU say and how YOU feel.
Gotta go I'm losing my connection.
Granny
For anyone that is in a clinic that doesnt at least "challenge" you a little to stay clean may be one that doesnt really give a rats a** if you clean up or not.
21 day detoxes were created for patients to fail because addicts who have used for years cannot possibly get clean and stay clean with only 21 days to tackle their addiction. It can take that long to get on a dose that holds you so the urge to use is gone.
As far as I know, a reputable clinic will require testing monthly,observed or not, monthly counseling,minimum of 50 min. each time and listen to what YOU say and how YOU feel.
Gotta go I'm losing my connection.
Granny
