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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 Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!

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lilgirllost
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Female
Number of posts: 861
Age: 42
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: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Fri Nov 19, 2010 11:57 am

Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!

Take home doses are the salvation of a patient on methadone maintenance, and if you show a history of appropriate methadone use and avoid drug abuse you should be eligible in time for a full month of take home doses on a 30 day reporting schedule.

The regulations governing take home doses were changed in 2001 by SAMHSA, which is the federal agency governing opioid treatment programs. In 2001, SAMHSA eased regulations on take home doses, and although states and even individual clinics can enact more stringent regulations, each methadone clinic must apply for SAMHSA certification, and if SAMHSA thinks that any clinic's procedures vary too far from Federal Guidelines, it will not endorse certification renewal.

Basically, although there is a little leeway – clinics must stay close to federal suggestions if they want to keep their license to prescribe methadone (unless state regulations preclude them from following federal guidelines*).

*Most states have conformed their regulations to match Federal recommendations.


How to Get a Take Home Dose as Soon as Possible

So, if you want your take home doses as soon as possible, toe the line well on these 6 evaluatory conditions.

1.You must show (through random drug testing – a minimum of 8 instances per year) no evidence of drug abuse.
2.You must attend the clinic on your appointed schedule
3.You must show appropriate behavior
4.You must not engage in criminal activity
5.You must show a stable home and stable non drug-related relationships
6.You must promise to store take home methadone appropriately and safely
And…

1.The doctor must believe that the risks of diversion associated with giving you a take home dose of methadone are overshadowed by the benefits of easing reporting demands.
2.You must meet the minimum time in treatment regulations. (see as follows)
Essentially, you must prove to the medical staff at the clinic that you are serious about your recovery on methadone, and that you can be trusted to use methadone safely at home.

Time in Treatment Requirements

The following are mandatory minimum standards for the allowance of take home doses. You will not be allowed take home doses in excess of the following.

•Days 1-90 – A maximum of 1 scheduled take home dose per week, as well as a take home dose for one day if the clinic closes on Sunday.
•Days 90-180 – A maximum of 2 scheduled take home doses per week as wells as a take home dose for the one day a week the clinic will close.
•Days 180-270 – A maximum of 3 scheduled take home doses per week + 1 for days the clinic is closed.
•Days 270-365 – Up to 6 take home doses per week.
•Year 2 - Twice a month reporting.
•Year 3 – Once a month reporting.

Local Variations

Local regulations may call for slightly more stringent protocols, but local regulations should be basically in-line with federal regulations. No patient will be allowed take home doses unless the medical director of the clinic believes they are at low risk to divert the medication.

If You Aren’t Getting the Take Homes You Deserve?

1.If you feel that your clinic is unfairly restrictive, you can meet with your doctor to discuss your compliance with federal guidelines. These guidelines are in place to allow individual clinicians the flexibility to reward "good behavior" with take home doses.
2.If that doesn’t work, you can inquire at any other local clinics about take home regulations, and perhaps find a clinic that allows for greater flexibility.
3.You can also file a grievance at your local clinic. Your clinic is required by law to have a patient grievance mechanism in place and to respond to grievances within 5 days. (From SAMHSA's Opioid Drugs in Maintenance and Detoxification Treatment of Opiate Addiction; Final Rule (42 CFR Part 8.4.(e))

Dose Caps?
SAMHSA does not endorse dose caps. Research has found that clinics that operate with maximum capped doses are operating outside of best practices guidelines.

100mg Take Home Limit?

SAMHSA does not cap take home doses. There is no federal regulation against take home doses in excess of 100 mg per day.

original link for article

http://hubpages.com/hub/Methadone-Take-Home-Doses




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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D
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Age: 56
Location: Vermont
Registration date: 2009-03-06

PostSubject: Re: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Fri Nov 19, 2010 7:23 pm

Thanks for posting the information RuthAnn, I'm sure it will come in handy for a lot of people.
I love it that you are always thinking of ways to make things easier for everyone.


"I will let yesterday end so that today can begin"



Never take any online advice over that of a qualified healthcare provider
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Happylady5



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Registration date: 2010-06-07

PostSubject: Re: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Sun Nov 21, 2010 1:33 pm

Yeah, I read something like this when I was checking to see if I was eligible for take-homes. Thanks for the info!
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Digmon



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PostSubject: Re: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Wed Apr 06, 2011 11:32 am

I was getting 3 take homes a week and I'm on a split dose. When it was time for me start getting 4 take homes a week and dosing 3 days at the clinic my clinic Told me that they had been doing take homes for split dose ppl wrong and I would have to go back to dosing 6 days a week at the clinic. I keep asking them to show me where they was getting this from but the only thing they was giving me was the run around. So I went online and got all the federal And state reg's and I took it into the clinic and showed the Dr. , the next day myself and the other 9 ppl with split dosing was able to go back to our nor take homes. Im so glad that I looked into this and was able to get it str8. The other ppl was not happy about losing all there take homes but not one person other then me wanted to do anything about


Last edited by Digimon81 on Thu Apr 07, 2011 2:23 pm; edited 1 time in total
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lilgirllost
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Female
Number of posts: 861
Age: 42
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: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Wed Apr 06, 2011 2:10 pm

Digimon,
WAY TO GO for standing up for yourself and getting your clinic to agree with you. You don't know what a good thing it is to have a clinic that will actually listen to the patient and try to keep the patients best interest at heart.

Unfortunately, where you say there way other ppl who were in the same situation but you were the only one that actually tried to do anything is so common. In my own personal experience as well as from working with other MMT pts, I know that this happens for so many different reasons.

Number one being FEAR of being retaliated against. Even thought Fed Regs are set up to protect us if we feel we need to complain or make a formal complaint, it doesn't always work that way. I have known ppl to get their take homes taken away, get a dose decrease (as punishment) and in worse cases they were deemed "noncompliant patients" and administratively detoxed and/or forced to transfer to another clinic.

I understand the fear perfectly but it sounds like you have a pretty good clinic that will actually listen to the patient and they don't have that "God complex" that they are the only one who is right about anything and we are all just lying, untrustworthy drug addicts who are idiots.

Again, good for you for standing up for yourself and I am so glad you have such a great clinic!


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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ahatzianocl



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PostSubject: Re: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Mon Jun 27, 2011 8:44 pm

Hi, my name is Alicia Hatzianoglou I have visited numerous websites in reference to my rights as a patient in a outpatient MMT facility, and I came across a website that spoke about SAMHSA regulations and guidelines. I apoligize in advance for the email may be alittle lengthy I just want to be honest, and thorough about my situation. I have been a patient of Pine Heights Treatment Center 3455 Wilkens Avenue of Baltimore, Maryland since January 2009. In this time I have not once had a positive urine for any drugs or alcohol of any kind, I have been an ideal patient I attended groups on a weekly basis, and been through numerous couselors due to numerous reasons on the behalf of the program. Now in the 3.6 years of being clean, compliant, respectful and overly patient I did not receive my takehomes in the fashion according to the SAMHSA regulations, so I put in a Grievance stating facts and pleading my case I then was told that I finally stood up for myself and that proved I deserve to gain my takehomes with the background of all the compliance of my responsibilities of a patient of MMT. In fact I was even told by my counselor that I was actually overlooked and he apoligized on the behalf of the program but it really was not him specifically. There is Nurse at Pine Heights whom has taken her position completely out of hand, she is very unprofessional, direspectful, and outright rude which I never tag and just ignore but since I put my grievance in with the key contigancies she was making every little bit remarks and attempts to attack me, in which I had went on a trip and forgot my Takehome dose bottles in my luggage, they were empty and I returned them a few days later, I accepted my responsibility and was given a contract which is the first step for everyone on the program when they DO NOT bring them in at all, as I was signing the contract within the same five minutes of me explaining it to my couselor she called him from her office and stated I lost my take home priviledges which I only had one, which I had the grievance in just a few days before. So as time went by I had worked on a grievance about me recieving the the take home doses I deserved beings I have been a patient with not ONE dirty urine, never been in trouble, had one on one on a weekly if not bi-weekly basis, attended groups, and everything I did was done in the best interest of my recovery as well as to respect the programs responsibilities however was not recieving any of the benefits in which people who had violated numerous times had. So, as soon as they recieved my second grievance which was last week June 21, 2011. I was accepted for two takehomes and Sundays, they only gave me one of them and I was told the other one I could not get until the following week which I complied because I was happy there was some sort of result to my grievance. Now today 6/27/11 I came in and turned in my one take home and my Sunday, instantly I was taken to Cathy (The Nurse whom acts as if she owns the place) and again was told my takehomes were taken because my takehome bottles were defaced. Which I had washed in my jeans and the wording was still entacted on the one it just had alittle denim coloring on it, and the other one was not removed, you can tell it was washed but the sticker was not removed. And in a very ignorant way with a smirk on her face she says you lost your takehomes for 60 days, I told her I take responsibility for my actions, and just wanted to know how she can just make the decisions without the clinical director which is never there, or the physician, or treatment team its like what she says goes and no one can question it. So after I went out of her office, I came back to ask if I can take a picture of the bottles to show they were not removed and the information was still on them, and she told me "No, I don't have to give you anything and quiet frankly you gave me the perfect excuse." Now Almost every patient there has a problem with Cathy and the way she verdicts everything like a judge with no questions or answers. I just would like to know if you can help me in any information or Federal regulations or guidelines on this discrimination. I do not speak up for myself because I do not want to seem disrespectful, and I never complain but my sobriety and my abiding to this clinic is really getting to me, I feel I deserve as much effort as I put in. Please help me. I have put up with so much at Pine heights and would change but its close to my home. I have done been sexually harrassed by a couselor last year, and told my the following one that I deserved to be raped by my father and when I told the Director Mrs. Hunt she had the three of us sit together and I was called a liar. It is unexceptable and I asked for two years to be detoxed yet they will not put in the paperwork. I have proved time and time again through five counselors and urine tests, and coming daily, and one on ones, and groups that I take my sobriety seriously. I just don't stand up for myself and it really bothers me being taken advantage of by the people who is suppose to coach me through recovery. Please any information or help would be more then helpful, it would be priceless. I thank you for your time, I am sorry this is so long. Have a blessed day. Thank you.
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lilgirllost
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Number of posts: 861
Age: 42
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: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Mon Jun 27, 2011 10:45 pm

Alicia, I answered your post under the other topic you posted under. Please head over there for my reply.

Here is the link

http://methadone.forumotion.net/t875-help-my-program-is-disriminating-against-me


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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sckofclinicbs



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Number of posts: 7
Location: reno
Registration date: 2011-10-03

PostSubject: Re: Methadone Take Home Doses. Federal Regulations on Clinic Reporting; Get the Take Home Doses You Deserve!   Tue Oct 04, 2011 1:14 pm

lilgirllost wrote:
Digimon,
WAY TO GO for standing up for yourself and getting your clinic to agree with you. You don't know what a good thing it is to have a clinic that will actually listen to the patient and try to keep the patients best interest at heart.

Unfortunately, where you say there way other ppl who were in the same situation but you were the only one that actually tried to do anything is so common. In my own personal experience as well as from working with other MMT pts, I know that this happens for so many different reasons.

Number one being FEAR of being retaliated against. Even thought Fed Regs are set up to protect us if we feel we need to complain or make a formal complaint, it doesn't always work that way. I have known ppl to get their take homes taken away, get a dose decrease (as punishment) and in worse cases they were deemed "noncompliant patients" and administratively detoxed and/or forced to transfer to another clinic.

I understand the fear perfectly but it sounds like you have a pretty good clinic that will actually listen to the patient and they don't have that "God complex" that they are the only one who is right about anything and we are all just lying, untrustworthy drug addicts who are idiots.

Again, good for you for standing up for yourself and I am so glad you have such a great clinic!


I called our state methadone regulatory board and spoke with a registered nurse who visits the two clinics in our town to make sure they are in compliance. She told me that the clinics CAN deviate from the federal guidelines. In that call i didn't mention SAMSHA. I asked my clinic who to complain to on Friday and was given CARP, our state's board and the board of director of the clinic's non-profit board of director. She did not list SAMSHA. I looked up our clinic's info online on Friday and it said their SAMSHA license was through 2010. Does anyone know if that means they aren't licensed with SAMSHA? Maybe this is the year where they are reviewed by them. Does anyone know if a complaint to SAMSHA helps? I wouldn't file it now though. The director would retaliate in the ways Dee described. I doubt they could be in operation without being licensed by SAMSHA. I wonder why she left that off the list. She also didn't offer an internal greivance procedure. I only learned that their must be one on this site. Any thoughts?
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