How do u find the perfect clinic for you?

Wow You know me and my long posts I just typed up a new topic and hit some key and it was gone all of it just gone and it was such a fact filled post I am so pissed but I am now typing it in word first. I should have listened when someone told another poster the same thing ALWAYS TYPE IN WORD FIRST.

I want some feedback on this: Does anyone know a good approach/method to find a good clinic for themselves. I recently encountered this as I was in dire need to leave my old clinic and find a new one. So after several post and advice received, I called all the local clinics in effort of asking some questions to alleviate some of my fears etc…before I made the move. I tried to ask the questions we all came up with but each person I talked to was as evasive as they could be and when I seemed to push for answers they became very generic in their answers the most common one being ”Well we would decide that at the appropriate time” or “That would totally be taken on as an individual basis and without having all your info here in front of me I cannot answer that” The one I chose that did seem to answer a few more of my questions etc…lied. I have already encounter problems that I was told I wouldn’t encounter. Wow I don’t know why I am so surprised but I am. If shopping for the best clinic who would be the one person you would ask to talk to? Should you just lay it all out on the line and tell them your fears and hesitations from past clinic experiences to find out how their clinic would operate if in that position?

Why is there no accountability system for these clinics? A way to check filed grievances etc…? Clinics operate on the prefaces that we are junkies and deserve to be treated like junkies even if we are seeking help. I just want to find a clinic that treats me like a patient. A paying client. I want the truth from the beginning. I was told that I had made the right decision walking into the clinic. I was told that I was going to get stabilized on methadone and when that happened, I would not be sick anymore and better yet, I would not crave opiates. I was told that I decide how much I need to take to be stable, that numbers didn’t matter. I would not be criticized for what or how much I needed. AND THE WORSE LIES I WAS TOLD WAS that I would not have to worry about not getting help or being disqualified. As long as I didn’t abuse clients or staff, divert my medicine or use benzos I could get treatment as long as I decide I need it. In fact I was encouraged to stay in as long as I can the better success. I was also told not to listen to the rumors low doses were optimal so you don’t have to detox so hard etc… higher doses were more effective. I swear yall I was told all this. But…….. Within 90 days of treatment

LIE ONE I was told I may not be able to stay on methadone because I had elevated QTC’s from an EKG they did (540) I was told in 90 days from then they would re-do my EKG and determine what they were going to do. I was able to dodge the EKG for almost two years so for almost two years I came in to the clinic worried that today would be the day they were going to do another EKG because about every month or so they would remind me I needed to do an EKG but no one ever stopped what they were doing to give me one and I by no means was going to push them to Lie One even though I was told nothing would disqualify me from treatment QTC’s could involve a medical taper FEARED THIS DAILY/WEEKLY FOR TWO YEARS.

LIE TWO After about a year of being at 160 and still suffering cravings and withdrawals I was told I must take a P&T to go any higher. I was denied increases for the whole next year because they the nurses were unable to draw my blood (3 attempts at 11 sticks, 9 sticks, and 6 sticks) for a P&T. No P&T no Increase. Lie two even though I was told that I decide how much I need to take to be stable, that numbers didn’t matter. I would not be criticized for what or how much I needed.
LIE THREE I was told that the people that worked there were there to help me and all believed in MMT and I would not be discriminated against if I ever relapsed or struggled with my addiction. I relapsed one time these two nurses began to hackle me about everything, accusing me of changing from liquid to wafers so I could make my rent, Asking me these off the wall questions trying to trip me up etc… this is a whole other post so I will keep it limited just trust me when I say they hackled me when I ask them why, one of the two nurses told me that if we felt discriminated against or treated unfairly at her window we were free to go somewhere else because Asheville was full of drug addicts needing MMT and she had great job security as she hasn’t seen any decline in business.

I am only mentioning/counting the lies that affected me personally to extreme. So I left the old clinic and I recently have posted some of the new clinics ordeal not lies yet but rogue dealings. I have been there two weeks and….I only go in once a week. I know it must look like I can’t be satisfied or I am a whiney ass, or I am hyper critical, but GOOD GOD these are health professionals and not just that they are in the therapeutic field of health. Not dentist or chiropractor etc… Mental Health/Substance Abuse. I cannot help but think that when you work in a therapeutic field of medicine/.Science etc…. You must be accountable if you a behaving
Un-therapeutically. In fact there should be some type of malpractice involved when and if clients resort back to drugs and die because the dope man was more therapeutic. I STAND MY CASE.

Anyways, there has to be a clinic out there that conducts business like a doctor’s office. That is in business and has people working there to deliver a service in line for the disease they are trying to arrest if not cure. And…I don’t care how far I have to drive etc….all I want to know is how the hell to find out where to start, what to ask etc… A FEW THINGS THAT HAVE TO BE GIVEN CONSIDERATION IS the only way you can see for yourself is go for the assessment and doctors appointment to ask or find out the answers to your questions and in doing this, you put your status at your current clinic in harm’s way by going this route. WHEN YOU CALL AND ASK QUESTIONS they can be lying and/or they give these generic answers and if you push with some of the questions then they assume your intentions are possibly shady.

I swear to be a good, compliant, follow the rules client if I could find a clinic that will realize that finally after 25 years of relapses I have found hope in methadone. If I lose the methadone I know what’s in store for me. History repeats. I will sign any waiver regarding EKG/QTC conflicts and they can keep their increases screw it. Just help me or tell me how to effectively find a clinic that will take me and deal with my EKG etc… and not make me feel like a junkie anymore. Or like a liar anymore. Or like a drug seeker anymore. Etc… you know what I mean.

Yip, I know what ya mean. Someone told me once to go interview clinics and this worked well for me. In my very humble opinion there is no way to tell for sure what is really going on in a clinic from just a phone call. I tried this route too and it did not work very good at all. However, it might help if you go visit your top contenders in person. I don't feel like that would jeopardize your current status with your clinic. Whenever, I need a different doctor I usually interview a few of them before I switch from the current doctor so why should this be any different.

I really do understand your frustration and part of the problem is the clinic can give you a list of their current policies and procedures in writing when you sign up and then change all or some of them 6 months later. Yes, they are suppose to abide by the State and Federal Laws but the way the Laws are written leaves the clinic director with a lot of room for interpretation. This is what drives me crazy too! Today it is one story and then next week the story changes. The one thing I really have difficulty with and I think most people find this difficult too.... SURPRISES! It seems some of these clinics thrive on surprises and it is hard to be a patient in a clinic that thinks this type of patient care is appropriate. At least it is for me.

The other idea I had for MYSELF was to write down the names of all the clinics in my area on a small piece of paper and pin them to a dart board. Then I would blindfold myself. Turn myself around 3 times. Do the Hokey Pokey.... and Pin the Tail on the Donkey!

It seemed to me at one point that solution might be equally effective... LOL

Please don't take that wrong as I am not making light of your situation. I want you to know that I completely understand the frustration your going through and I am here if you need help in trying to pick one over the others. Has the new place done something else that has worried or upset you recently?

No but I just can't get it out of my mind how my counselor seemed so confused as to why I was denied the increase. Like I said though it could be a look of wow I should have sent the P&T in with the request, but it was like he was shocked it was denied. He said the Doc doesn't really ever ask for P&T's. (Which made matters/worries worse for me) then, he began immediately accusing me of leaving a part out of my story. Like when he said Yeah but you didn't tell me the doctor wanted the P&T, nor did you tell me to attach it to your request. I told him the doctor didn't tell me he wanted it. I ask the doc if he had it. He said no but asks me if I knew my numbers. I gave him the numbers and then he wrote down on a sheet of paper it appeared to be a form for doctor orders for the nurses to increase me from 160 to 165. He did not write anything else down like pending P&T etc... Nor did he say for me to get a copy or tell my counselor to get a copy etc... I brought it in because I knew in the back of my mind that after I ask more than twice for a 5mg increase he would probably try ordering me to do another one and the nurses here would end up like the nurses there did mad at me because they can't get blood. I am afraid to ask if my last EKG they did a month ago at the old clinic is in the file or not because that's what is going to happen next I know the EKG will become a problem and the last one I had put me just slightly out of the danger zone of high QTC's 454 instead of 540 like in the beginning when the nurse made me feel like I would be discharged if my QRC's were elevated at the next EKG so I ran undetected for the next year and half but every week waiting to be caught. I have asked in a new topic exactly what paperwork would I need from my chart if I wanted to find a clinic and have all my necessary paperwork with me at a clinic interview. Whereas I can show the doc my test results and tell him I stay in fear of being medically detoxed but I need to be on methadone etc.... It will be a for sure relapse if I get discharged for any reason at all. I walk a chalk line not to do anything wrong but I cannot change my body and the way it metabolizes methadone and/or whether I have high QTC's but I will sign anything holding them not liable, because I will relapse and be back out there on dope if I lose this option. All I have gotten back, my family, my husband, my life will be gone etc... Anyways beside my last EKG and P&T what records would a clinic want to have regarding my dose, my take homes etc...

Thank you for understanding and not making me feel like a nut. I already know about myself being an over panicker reactor worrier etc... I hate it but it's me. I need to try not to be so much of these but it isn't anything I can change overnight and maybe never. So all I can do to control the panic is find solutions and my next attempt is to get all my records and go clinic shopping within 50 miles my range. I do not want to go in the clinics as a new admit but I do not know if they will let me have an open slot with a doctor if I don't so I guess I am going to call or write letters and ask if I might could take 10 minutes with their doc to ask a few questions that I have found to be concerns with clinics I have been in (2 of them) So before committing to changing my clinic I need to find out if it is going to be a problem to their doc. What do u think?

Great Picture of you Finalllyachance! It is a funny thing about being on MMT, if we happen to get into a bad clinic at some point it effects our thinking in a negative way in regard to all the other clinics we go to. Going through 2 years of worry at your last clinic has now set a pattern in the brain. For lack of a better word. After you go through something like this it seems to me that the mind is always referring back to what the bad clinic did and how they reacted to our problems and situations. Then we start to think that the next one is going to treat us the same way and we are always on the look out for more bad behavior from the staff.

You said that no one at your new clinic asked you to bring in the P/T test results but that you brought them in anyway because you just ASSUMED that they would want it just like the last clinic did.... is that correct? It could be that you confused the counselor by bringing in something that was not requested of you. Like you have found out the hard way, all of these clinics have their own set of rules. One clinic may want P/T tests and the other could care less. One might want EKG testing and the other does not even have an EKG machine.

I think you said that you are/were a paralegal and as such I bet you are very thorough and concise with your work. Always trying to anticipate what will be needed ahead of time so you can do a good job. Does that sound like you? If you are like this then perhaps you are trying to be equally concise and be a good patient who is on top of everything, anticipating what this clinic wants based on your experience with the last clinic. I know you have some concerns about telling Joe that you were in the treatment industry and that might have something to do with why you want to make sure they have everything they need even before they ask for it. I commend you for trying to do a good job and make sure they have everything needed in their files. This I am sure in a normal business would be appreciated. However, I think in a clinic situation it confuses them. I understand that the whole point is to get your increases.

I would suggest to you the following: Only give to them what they ask you for. Try not to make assumptions about what they will want, what they are going to do to you, what they will "probably" think, etc. ASK them questions about what they need from you and then only give what is asked for from you. Nothing more. You might have heard this one.... Keep It Simple.

My own example to you.... I came out of a bad clinic into a better clinic. However, I assume that they are all the same based on my past experiences in the bad clinic. I have went for 2 whole weeks with 1/3 of my dose MISSING! I thought that either the machine/Computer broke or what I was almost positive of.... One of the Employees had stolen over 400mg of my methadone. All of my take homes were short and I have been sick as an old brown dog....LOL! Sorry...could not resist that one considering my screen name... I did not call them as I was afraid they would tell me that I was the one who took the methadone and diverted it. I was scared they would then take away my privileges.

I went to the new clinic on schedule and I reported this problem. They told me that they had been at the office 2 weeks ago until the early morning trying to figure out why they had thousands of mg's of methadone TOO MUCH. They said no one called to report any shortages and they did not know who was shorted. They told me if I just would have called they would have replaced the shorted methadone! OMG!!! They apologized profusely for the mistake. You see what I am saying.... I just ASSUMED that the new clinic was going to treat me like the old clinic did. I could have saved myself 2 weeks of misery if I would have just called and communicated with them.

Hopefully, this will help you as you adjust to your new clinic too. I would have a sit down discussion with "Joe" and talk to him about these things you are feeling and see if some honest communication makes a difference. You said that he seemed to like you and you had a good feeling about him. We all have off days too. You have been around enough people in the treatment industry that you would have caught something if "Joe" was a real bad one that first day you were with him for over 4 hours I would think.

As far as your treatment records. I posted to you on what I asked for and maybe that will help you. I think it is always wise to have a back up just in case you ever need to relocate to a new clinic. I now maintain my own copy of my health records from ALL doctors, clinics, labs etc and will only give out a copy of what is in my file. If anyone needs originals then I will sign a release and they can obtain those from the source. I don't know your area but I will tell you about mine. There is no way in my area that a person would be able to see a clinic doctor unless they were transferring in as a new patient. Instead of trying to talk to a clinic doctor of all the clinics in a 50 mile range. Perhaps picking out your top 3-5 and calling for an appt with either the Clinic Director or a Head Counselor would be easier and just as effective. The doctor in my clinic has a private practice and if anyone wants to speak with him about anything it will cost a min of $100. I would save my money and the aggravation if I were you.

Now... Help me out if you don't mind. What is the status AT THIS POINT with your dosage increases? Have they stopped all increases or are you suppose to call on Mondays to request another one or what exactly?

Well I was told that this same increase for a 5 mg increase that was denied went back in to the doc’s pile to be signed with the attached Peak and Trough. (I am sure I have said this too many times but I suffer from a disease in my veins that I am almost an impossible stick I never used IV I could not have without dying of abscesses I am sure) So the reason I really got the P&T from the old clinic quickly was I was afraid maybe in retaliation that result might come up missing as the nurse that admitted at the new clinic told me when she stuck me 3 times for admission she would never try more than three times. So I imagined her in my mind having to re-do my P&T as Like I said I had been told by the doctor an hour before say he had not received any P&T results when in fact the day before my counselor had me sign a release for my records to include the P&T. It was evident he had received some records but he said no P&T results were there.
So I left the new clinic that morning and drove straight to the old clinic to get those results or I would be in the same position I had been in for the last year and a half them trying to get blood and not able to so they all refused to try so I never got any increases for that year and half. The doctor had asked me verbally for my results since no results were there and I told him. Now maybe he forgot I was the one he had agreed that if those figures were right I did indeed need an increase my Peak was four times my Trough showing me a fast metabolizer. But anyways I had quoted results so I thought best to have them just in case because if that test came up missing and he did want it I might be screwed they might even deny ever doing one. (I am burnt by them bad.)
So I got the one 5 mg increase on my word and then I ask for another and he denied it. Then the counselor acted all confused with me about why the doctor wanted them as he was not one to require P&T normally. Plus then he blamed me for not telling him the doctor wanted them I told him the doctor never told me he wanted them I just felt I better get them since I had quoted the results and they had not been in the records the doc had when he did the admission even though we had ask for them. So it’s like what’s up the doc usually doesn’t require P&T and now he does with me? Plus Joe was so muffled about everything he ask if we could cancel and reschedule our appointment cause it wasn’t even seven a.m. and his day was hectic. It makes me think the old clinic sent some kind of bad report or something.
Now with all this being said, yes I think in the box around the box and outside the box especially when it comes to something (for the lack of a better way to say it) something near and dear to me. My MMT because I have gained back so much in these two years etc…. I have a 27 year history that makes me a firm believer in the fact if I lose my chance with methadone I will be back on dope. I can do everything right and still something can mess it all up for me like a rumor from the old clinic, or my EKG with high QTC readings or maybe asking for increases if they think I don’t need them etc…So I am scared all the time. Send me your email address and I will send you a typed version of the grievance I filed before I left the old clinic. That will explain to you that before I left the old clinic some freak things happened that started this chain reaction of doom I have.
In short I came in for my regular one time a week dosing pick up take home appointments and I was told before I could dose I needed to talk to my counselor. She told me I had been pulled/flagged for a mandatory P&T (knowing that every nurse had been unable to ever get one before) She explained it was a random pull as so I could not get out of it on the grounds of hard stick they would have to make all attempts to get one and also I had been pulled for a EKG and a physical and drug screen. The Monday I showed up had the EKG, Drug Screen even though I had one on Wednesday and went to the window so they could observe me taking my dose (Had to do this three days same exact time) When I opened my box to get my dose to take the nurse went past my hands and grabbed all my bottles out of my box (3 empties 3 full) and said I’ll be taking these. Of course the way she said it and just because I said “Why” she said “Because I can” we stood in silence for a moment then she said “Plus there isn’t anything that says I can’t is there?”
I took my dose and went to my counselor and said “Okay what the hell is up have I done something wrong has someone said something to make you all believe I am or have done something wrong?” She said “NO, Why?” I told her what happened she told me to file a grievance I told her “I will think about it but I cannot help but think something’s up” The next day the director approached me and ask me if I would be willing to file a grievance so I said ok and did. Oh I can PM it to you by copy paste so look for it and read it. So you don’t have to give me your email after all. Anyway since all this I have not been able to shake questioning everything and being so paranoid.
Thank you so much for your interest and empathy. It has been and is quite comforting to me.