Methadone: A Flicker Of Light In The Dark

Methadone: A Flicker Of Light In The Dark

To provide a better understanding of the very important role methadone plays in the treatment of addiction.
 
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 Indiana Clinic

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brendaelk

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Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: Indiana Clinic   Sun Feb 14, 2010 2:55 pm

I am in the process of changing clinics. I have been on this clinic 7 yrs. I transferred from an Oklahoma clinic I had been on 8 yrs with no problems. The doctor here is such a jerk to deal with. I had detoxed myself from 160mg down to 90mgs. I started feeling poorly so went to the doctor and found out I have Hep C. Obviously from the drug using days. I have tried to get my dose back up and now have managed 3 10mg. raises, so now I am 130 again. It has taken me over a year to get those 3 10mg. raises. He even dropped my phase for asking last time. I live 80 miles round trip from there. I am not a troublemaker, have had no dirty UA's at either clinc in 15 yrs. he says I am not stable because I have ask for raises and he would like to get me to come every day if he could. He argues with everything I say. I hope to get a better doctor who understands that the hep may be also interfering with my dose. I refuse to take that Peak and Trough test. It is for people on smaller doses to see if split dosing is better. It has a wide range and it can be used against us. If you have been on 15 yrs, of course it is going to show you have plenty in your system. It sure is frustrating!


Last edited by brendaelk on Thu Feb 25, 2010 1:47 pm; edited 1 time in total (Reason for editing : do not want to be too specific because of repercussions possibly)
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lilgirllost
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Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Mon Feb 15, 2010 12:32 am

You are absolutely right about the Peak and Trough test. I had a similar experience where mine was used against me to decrease my dose. I am sure you told this doc, but he does know about your Hepatitis doesn't he? That alone should tell him you may need an increase!

I too have been on methadone for many years, this Sept makes 10 yrs and it infuriates me that long timers like us who have been stable, no bad UA's, no problems at our clinic, pay on time and everything and they still act like because we ask for an increase that we are on the scam.

I was on the same dose (120) for over 5 yrs. I had gained over 60 lbs during that 5 yrs, had just moved to a new state after living near our families for 17 yrs or more and had just started a new job. I was under alot of stress and started craving and having actual w/drawals. I asked for an increase and THAT is when I had all the problem I had because they refused to go over my dose of 120. I won't go into all the drawn out story but that is also when they made me take the Peak and Trough which they didn't know how to read and used against me.

I had to change clinic as well.

You said you are changing clinics, do you know anything about the one you are changing to? Have you spoken to them at all about your Hep?

Good luck and please let us know how things go for you. Thanks for sharing your experience with us.


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
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brendaelk

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Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: Re: Indiana Clinic   Mon Feb 15, 2010 1:09 pm

lil girl lost,
hello to you, yes I think it is so frustrating when these people put us all in the same category. We are not just walking off the street, we have done methadone for many years and we know exactly how it makes our bodies feel. We are not scamming for a high or a buzz, I guess that is what they think. Why would 10 mgs do to me anyway? Just work with me here a little, is what I feel like saying. I even went to the director of the state who used to work in the same clinic. He just happened to be visiting there one day when I was there. I just go once a week. His hands are even tied because the doctor really has the last word in a clinic. He said go ahead and just take the test to appease him and we will go from there but I am afraid they will turn it against me. That test says nothing of urges to use, or being uncomfortable and not sleeping. Even the director says it is not a test for this. There is a wide range to it and they can interpet however they want. As far as the hepatitis c, yes they know and the doc says I can not get stable because of it and I am using it as an excuse. everyone dreads the physicals and to ask him for a raise. He acts like he can change the fact we are addicts and do have urges. He is trying to play like he is a medical doctor to me and I have a specialist for my hep c that is great. Oh well I will quit complaining but I have talked to another counselor at the new clinic and she seems to understand that I may not be stable on my dose. This methadone is the only way I can live a productive life in soceity, I know from experience off and on drugs for 35 years. I am 55 now. My freedom is very important to me. Some of us use this clinic for what it is made for. It is tough when we get where we we do not have a voice in our recovery. Even my counselor agrees with me. The Doc will not even listen to her, he has to always have the last word. I want to start tx for my hep c with the interferon but I am afraid of this doc will not listen if I can not metabolize my meth right. IT was great to hear from you and know that there is so many of us are trying to do the right thing and we do have a normal life outside of the clinic to live and do our best. I will keep you posted. I have to have a intake fee so I may not get to change to the end of next week but I feel it is the best thing to do. Take Care!!
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brendaelk

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Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: update on changing clinics   Sat Feb 20, 2010 11:44 am

I have got to talk to the director of the state clinics. He is a very nice and knowledgeable man. He understands the frustration of not being on a stable dose. Of course the doctor is the one I have to convince. I have not came up with my intake fee for the new clinic so I am still waiting to transfer. I would take the peak and trough test if it was a little closer to me. It is 70 miles and I just do not have the money to buy gas due to my husbands unemployment. and then I have to hang around 4 hours to complete the test. I feel I should not have to do this, I know how my body feels and where I am at and I do not feel stable. Maybe it is the hep C? I do hate to have to change clinics because I have been at this one 7 yrs. I am used to my weekly routine and the long drive. I am sure I will never just go down on my dosage again without doing it more slowly. It makes me so mad that this is my fault. But I am known for not making good decisions. I am glad that it did not drive me back to using, I would hate to see the progression after 15 yrs that I would pick up at. Being on the methadone clinic has been the happiest and safest time of my life. I felt like the dopefiend in me was dead and gone. I was so far removed from the dope house and the hustling of a habit that any thought of returning is terrifying to me. I do hope the doctors will not lump the ones that use the methadone for what is meant to do with the ones who abuse the priveledge. Thank God for the right to redeem what goodness truly is within us.
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lilgirllost
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Female
Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Sat Feb 20, 2010 12:56 pm

Brenda,
Are you changing clinics because they won't give you the increase? If so, have you talked to anyone at the new clinic to "get a feel" if they are going to feel any differently?

One thing you need to keep in mind, if you are going to persue getting an increase, at some point you will have to take a peak and trough test. Most clinics are going to require one if you are requesting a dose over a certain amount and if you decide to take it over their heads and take the steps I mentioned in the email about contacting the person at the Methadone Authority that may be able to help you, a Peak and Trough test is going to probably be necessary for that too.

BEFORE you fork out the money and the time to have it done, I would speak with the clinic and/or the doctor and ask them how they interpret the P & T and at what "levels" do they base an increase on or consider you properly medicated. That way you can get an idea of if they know how to read one or not properly.

Here is the info/link to P & T levels and info
http://methadone.forumotion.net/is-your-dose-holding-you-f4/how-to-interpret-a-peak-and-trough-test-t162.htm


Interpreting Methadone Serum Methadone Levels


Trough level < 200ng/ml Subtherapeutic; withdrawal likely.

> 200-400ng/ml Sometimes little or no withdrawal,but opioid
blockade probably incomplete.

> 400-500ng/ml Optimal, usually no withdrawal and opioid
blockade achieved.

>500-700ng/ml Withdrawal unlikely, but possible monitor
clinically for overmedication.

>700ng/ml Withdrawal unlikely, examine other reasons for
any discomfort (and monitor for overmedication).

I know the test is expensive and you may not have the time to do it, but I am afraid if you are going to continue to "fight" for your increase, there is going to come a point in time where you will have to take one.

Hang in there and let us know what happens.

RuthAnn


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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brendaelk

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Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: Re: Indiana Clinic   Sat Feb 20, 2010 3:30 pm

Yes Ruth Ann, I have discussed my situation the best I can at the new clinic. They too have to get a blood test she said before they go over 120, but they seem like it is not the end all to getting stabilized. I do not mind taking the PEAK and TROUGH test. I am just hoping it is read correctly and not used against like I heard people speak of in the forums. My regular clinic wants the test, I just do not see having to take it if I transfer. Though I will take it at one clinic or the other if need be. This is something I have been dealing with awhile at my clinic. I have been doing some tests with my hep c doctor trying to get interferon tx started soon so I have not got anything done about my methadone. I do intend to decide this next week and get something done. I need to make sure my methadone is not going to be a problem because It is very important to me I stay in a clinic that will listen to me when I am not feeling well. I never want to use again.
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lilgirllost
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Female
Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Sat Feb 20, 2010 3:47 pm

I agree with you totally that your treatment is VERY important, if you aren't able to keep it under control then everything else is out of sync too, including your Hep treatment. So keep hanging in there no matter how hard it may get!

I know I am asking some of the same questions but I just want to make sure I understand everything right.......... I know you said you spoke w/your clinic about the situation, but did you ask the clinic how they interpret the P & T? What level do they deem adequate and what level do they think justifies and increase? If so, what did they say.

If you can find out how they interpret them, then you may find that you have nothing to worry about as far as the clinic misinterpreting the results and that would take a big load off your sholders.


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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brendaelk

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Female
Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: Re: Indiana Clinic   Sat Feb 20, 2010 4:43 pm

No RuthAnn,
I have not asked how they interpet the P&K test. I doubt if they would tell me. The nurses and doc stick together. I talked to my counselor about it last week but she did not know much about the test or results. I will definitely find out next week. DO you think they could read it wrong and try to bring me down even more? That is my only scare about it. I will ask both places next week that question. Thks so much for pointing that out. I know if it is read right it should show I am not holding at this dose well. It seems like there is so much left out in testing that way. It is a broad range and not very accurate about urges or withdrawals.
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lilgirllost
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Female
Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Sat Feb 20, 2010 9:39 pm

Brenda,

it is a possibility that they will misinterpret and decrease your dose, that is what they did to me at my old clinic. They said according to the test results, I was OVER medicated and they decreased my dose, so yes, it can happen. Even though I showed them they were misreading the results and gave them info that I got from SAMSHA and other reliable sources, they still refused my increase and told me they were decreasing me.

I hope that isn't what happens to you, but it will come down to you having to take the test I am afraid.

Anyhow, do keep us posted on how things go and if you decide you want to "go over" their heads, I can give you the contact info for the contact person I have who may can help you.

take care and HANG IN THERE!


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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brendaelk

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Female
Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: peak and trough got me decreased   Sat Mar 20, 2010 12:47 pm

Yes RuthAnn, I finally did what the doctor asked me to do after a year of jumping through hoops to try to get back up to my original dose of 160. I live miles away from the clinic and testing place, but I spent 5 hours waiting to do the peak part of the test. okay then next week I go in to the clinic and find out the doctor dropped me 10 more mgs. Down to 120. I have been on methadone for 15 yrs with no dirty ua's. I was up to 160 then brought myself down to 90 too quick and with the hep c it was not holding me 24 hrs. The director of the regional clinic is trying to convince the doc he should listen to the patient. He knows the test can be misleading and does not account for cravings as well. I knew this might happen because you said it could. The doc said the test was showing I was over medicated. Now he tells me to come in next tues and wait to dose in front of the nurses then hang around 3 to 4 hours so he can observe me. I have a husband who is not an addict and is on unemployment so I do not have the extra gas to drive there. I have been to the clinic 3 times this week. I should be on the max on take homes, I have clean ua's for 15 yrs! I am sorry I even asked to go up now he is making me drive 60 miles and gas is high as well as the methadone. What can I do? I feel like I am being punished for asking for a raise.
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lilgirllost
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Female
Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Sat Mar 20, 2010 5:29 pm

Brenda,
I am so sorry this has happened to you! I KNEW that was probably going to happen and it is so aggrivating to me! That is EXACTLY what happened to me and I had been on methadone for 10 years and the same dose of 120mg for 5 years. Like you I had no dirty UA's since I don't even KNOW when, and had been a "model" patient all these years.

Do you know what your test results were? The actual numbers of you peak and the numbers of you trough? They have to give you a copy of it if you request it, so I would request a copy.

Like I told you before, there is a person I can give you the contact info for that works with patients in your situation, but once you take that step to persue it, be prepared that you may start having some trouble from the clinic and/or the doctor. They are not suppose to "retaliate" but we all know they find ways around it. Just let me know what you want to do.

Other than try to "fight" this, the only other option I see is to transfer to yet another clinic or "ride it out" and try to make the most of it.

It doesn't make things any better and it sure as HELL isn't right, but we are powerless right now and it burns me up! These doctors know that and that
is why they treat us like they do.

Hang in there!


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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brendaelk

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Number of posts : 22
Age : 63
Location : NW Indiana
Registration date : 2009-04-17

PostSubject: another hoop to jump through   Tue Mar 23, 2010 11:36 am

Hi Ruth Ann,
Just wanted to let you know what is going on with the clinic doc on my raise issue. Now he wants me to spend extra gas money and time to come to the clinic and drink my dose in front of the nurse (a dose I already have at home) first he will observe me before I dose then after 2 to 3 hrs have passed. Now how crazy is that? I am not going to show any withdraw in that time span! He needs to observe me at midnight at my home to see that. Besides the fact I have been there twice this week, he wants me drive another 70 miles there and back and spend my money on gas in a jeep that does not get good gas milage, while my husband is on unemployment, and I can not work at this time due to hep c, a fallen bladder, and fibromyalgia. I would love to change clinics and have your friend check into the situation, but I do not have the intake fee for a different clinic and I may have to go every day for a few weeks to get started. I hate whining but this is so uncalled for, I have never broken any rules at the clinic, 15 yrs of clean UA's. I appreciate you listening to me and relating. I am so afraid he might say to mandatory detox me. I should be on monthly take homes according to rules. I will keep you posted and maybe we come decide what is best. I am sure you are more up to date on the consequences than I am. I also do not want to burn bridges with this clinic before I check another one out and get blacklisted! It is so wrong they have so much control over our lives, The ones that follow the rules should be appreciated. Thks! brenda
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lilgirllost
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Female
Number of posts : 863
Age : 44
Location : live in Louisiana but attend MMT clinic in Tx
Job/hobbies : COUPONING & GEOCACHING are my favorite past times but I also love reading and spending time with my husband and kids
Humor : I don't have a sense of humor.............
Registration date : 2009-05-25

PostSubject: Re: Indiana Clinic   Tue Mar 23, 2010 4:05 pm

OMG! Are you kidding me???!!!??

I absolutely agree with you! What does he hope to see 2-3 hrs after your dose??? COME ON! I might could understand it if he had you dose in front of the nurse and then come back the next morning for him to see what symptoms you are showing but 2-3 HOURS AFTER YOUR DOSE???? That will show NOTHING!

If you haven't already, I think you should start keeping a journal of what is going on. What time you take your dose, what time you start having symptoms each day and what they are, what happens at the clinic........all of it. Also, start making the nurse write down in your chart your symptoms each time you point them out to her. (that is something I learned the HARD WAY!) just because they "acknowledge" your symptoms when you point them out to them doesn't mean ANYTHING! It needs to be written down in your chart so that it is there in black and white. Otherwise if push comes to shove and you do file a complaint or whatever, there is the notes IN YOUR CHART and it doesn't end up just being nothing but your word that you have been having problems all this time.

You don't have to change clinics to contact the person I have in mind for you to speak with. Of course, once he starts talking to them at your clinic, they may start making things harder for you, even though they aren't suppose to. But if you want to get this ball rolling, you do not have to change clinics to do so.

Your comment about me being more up to date on consequences and all, I appreciate the compliment, but each clinic is different and each clinic can have different rules in addition to FED REGS that they inforce. For example, FED REGS say that after a certain amount of time in treatment, you should be able to have once a month clinic visits. Well, all the clinics in Louisiana, they most take outs they will ever let you have is 2 weeks at a time. You will NEVER be able to go once a month as long as you attend a clinic in LA. Now, just across the border in Texas, they allow once a month visits. That is why I will drive the xtra 14 miles to go to a clinic in Tx versus the closer one in LA because I have earned once a month take homes and by gosh I want to be able to get them!

So again, I try to stay as up to date as I possible can, but each clinic can have additional rules and regulations that are more strict, just so long as they follow the FED REGS as well.

Please do keep me posted. If you want to speak privately w/me, you can private message me through the forum. Regardless, just know that I am here for you as well as all our buds on the forum so if you need us, just let us know.

Hang in there!
RuthAnn


RuthAnn
aka lilgirllost

We are not bad people trying to become good, we are sick people trying to become well.

Methadone; A Flicker Of Light In The Dark
www.medicalassistedtreatment.org
www.suboxoneassistedtreatment.org
We are available 24 hours a day, 7 days a week.
If you cannot afford to call us, send us an email and
we will call you at our expense.
Office: 1-770-334-3655~ Cell: 1-770-527-9119
Email: mrdeanv@aol.com
ALL INFORMATION IS KEPT STRICKLY CONFIDENTIAL
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