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Opiate addiction Support for coping with Opiate addiction and Opiate addiction treatment.

 
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  #1  
Old 22-11-2009, 21:44
GutterPhenomenon69 GutterPhenomenon69 is offline
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Methadone pumps and additives question

hi swimz on methadone main. 75mg a day. the problem is at swims clinic they use the pumps hooked up to the computers to dispence the meds. well swim noticed that when he goes to a particular pump lets call it pump 2, the methadone is always lighter colored. swims clinic uses the cherry colored/flavored methadose. as opposed to the other pump where it is always dark and strong tasting. Is the cherry color just an additive or food dye or is it the actual methadone. is the methadone watered down on one pump? does anyone know how acurate those pumps are because one of the pumps it always looks like less fluid. if anybody knows anything about this please write back. because swim is constantly upset and worried that his precious cherry nectar is being diluted.
  #2  
Old 22-11-2009, 21:54
LiquidHandcuffs LiquidHandcuffs is offline
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Re: Metadone pumps and additives question

Swim also had the exact same setup for his MMT.

The cherry flavor is, as far as Swim knows, just a flavoring additive.

The purpose of the water? Swim believes it is so that nobody has any idea how much anyone else is dosing, as well as for drinking consistency.

As far as differences between pumps with regards to taste and color (etc)?

Swim also noticed this too, on occasion.

He decided that it was probably just cherry flavoring running low. Similar to fountain machines running low on syrup.

Swim forgot to mention that he finds the bitter taste to be the Methadone itself. Otherwise, it would just be cherry water.

Last edited by LiquidHandcuffs; 22-11-2009 at 21:57. Reason: Bitterness
  #3  
Old 23-11-2009, 05:45
jloops jloops is offline
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Re: Metadone pumps and additives question

SWIM doesn't doubt that one of the machines may indeed pump out less methadone than another. There may be another explanation for your perceptions as well, though.

In any case, it can't be a big difference... The obvious solution is to just stick to one machine, but it's probably better to stop worrying about it... Try moving your dose down a few milligrams every week and you'll see just how little difference there is between x miligrams and (x-x*0.1) milligrams. Don't worry, losing 10% of your dose (or even 20% max!) is not going to make you sick, it's in your head.

That said, SWIM sympathizes, but like SWIM said, move your dose down a bit and you'll get to see just how little a few milligrams on either side of things matters and this will cure you of your fears in all likelihood.

BTW, assuming you're in the US, that methadone liquid is already prepared and the flavoring, etc., is all already in there. Don't think too much about this, it's really not worth your trouble. Your dose is not varying enough -- if it varies at all -- to make any difference in the way you feel or how effective your treatment will be. You can mention it to the clinic, but after that forget about it, seriously. After you've reduced a bit, you'll see it matters not a bit.

You should definitely not be letting the hue of your morning methadone color the rest of your day!!!

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20% lost on a regular basis would be a big drop in one go!
If i reduce 10% of my dose i'll be withdrawing in about 3 to 5 days.. 20% is a lot worse.
  #4  
Old 23-11-2009, 07:02
Spucky Spucky is offline
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AW: Metadone pumps and additives question

Some People have allergic reactions because of the Colorings!

But the Color have no influence for the Methadone-Dose!

Swim don`t know the situation in the Us. but in Germany they have to follow now a standard-Recipe!
They include Stuff do make it not injectable!

ps. of course there are addicted People everywhere, but specific in the medical Field.
Many Docs. and Nurses have a Opioid-Problem.
Sometimes they fake the Books!

If swiny have a real doubt speak with the Supervisor, i am sure he/she have the possibility to calm swiny!

Last edited by Spucky; 23-11-2009 at 07:09.
  #5  
Old 23-11-2009, 12:22
Helene Gold member Helene is offline
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Re: Metadone pumps and additives question

Could someone explain a little more about this methadone pump business - swim has never heard of them before!

How does it work? Swim gets the impression it's almost a sort of self-service set-up, is this right? And how is your dose determined?

Swim isn't aware of this system in the UK, however she's never never been on daily supervised pick-up, so perhaps it passed her by...? Although in all the countless chemists across the country she's picked up her script in, she's never seen anything even resembling a methadone pump.

Any info appreciated!

Thanks,

H

Last edited by Helene; 23-11-2009 at 12:28.
  #6  
Old 23-11-2009, 12:54
missparkles missparkles is offline
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Re: Metadone pumps and additives question

Actually in the chemist Sparkles used to pick up from they have a pump they attach to the huge meth bottle, set the amount, press the plunger and it dispenses that amount into the bottle. Sparkles used to watch them do this whilst she waited for her meth.
She supposes that a nurse adjusts the pump to the designated dose and SWIY then presses a button to dispense the meth, or it could work like spirit measure in Brit pubs where the glass id pushed upwards under the bottle to dispense the shot required?

Sparkles.
  #7  
Old 23-11-2009, 14:11
Spucky Spucky is offline
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AW: Re: Metadone pumps and additives question

Quote:
Originally Posted by helene View Post
Could someone explain a little more about this methadone pump business - swim has never heard of them before!
H


VERDER PUMP CHOSEN FOR METHADONE DOSING


For several years a supervised methadone dosing service has been available to recovering drug addicts. Available in pharmacies, rehabilitation centres and prisons, this allows the patient to receive his or her prescribed daily medication as a single dose taken in the presence of a pharmacist, therapist or prison officer. However, although this method has proved highly successful, dispensing methadone manually is a relatively high risk, costly and time-consuming procedure.

MethaMeasure addresses this issue by providing a fast and automatic method of administering methadone. The dispensing system, housed in a compact cabinet, initially identifies the patient by fingerprint. A pump then measures the appropriate dose of methadone for the patient to drink and a record of the event is automatically saved.

Needless to say, the accuracy of dosage and the reliability of system are critically important. Reducing the potential of human error is a key benefit of the system as, at worse, an incorrect dose could prove fatal to the patient. To ensure the best pump was selected for the job MethaMeasure called on the expertise of OEM pump specialists, Verder.

The model selected for this application was the Verder M500 ac. This is a robust pump with a proven track record for a variety of applications including vending, chemical dosing and condensate removal. It has a flow rate of up 730 ml/min.

No internal backflow on the Verder M500 OEM pump ensures accurate dosing without slip providing repeatability of typically ±0.2% and metering capability of ±2%. This performance meets the stipulations of both the Weights and Measures and new Medicines Act and therefore makes it the ideal choice for MethaMeasure.

Several application specific factors had to be borne in mind in choosing the pump. Avoiding contamination is of course a key point but as the Verder OEM peristaltic pumps are based on a patented, seal-less design only the tube comes into contact with the medication. The tube itself was also selected to be resistant to the acidity of the methadone and the simplicity of pump design makes it easy and quick to exchange the tube in the field.

“Customer service was the overriding factor in our choice of Verder,” explains MethaMeasure’s Stephen Dickson. “Their people have been excellent, helping us develop a completely new product that is compliant with all relevant regulations. They have pushed this project from concept to full design and implementation.”


Source: http://images.google.com/imgres?imgu...N%26start%3D54

Post Quality Evaluations:
very good!swiy was quick to provide full info for us about this method!thanks
Answers Helene's question very well, and provides specific info for those who are not familiar with dosing pumps.
Brill explaination
  #8  
Old 23-11-2009, 17:29
Electrolingus Electrolingus is offline
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Re: Metadone pumps and additives question

In SWIMs area of the US, Methadose 10mg/ml Cherry Flavored Oral Concentrate (Mallinckrodt) in 500ml tamper resistant jugs is most often clinically used. Methadose may or may not be diluted before dispensing with a computer controlled pump (standard). Although it is not unheard of for a staff member at a clinic to pilfer a fraction of Methadose from a newly opened jug, and then replace it with water (or even more water if all jugs are diluted before dispensing), but SWIM would like to think that this type of thing doesn't happen very often.

Most likely, if the Methadose is undiluted or equally diluted, the difference in color (while in the tube), comes from the tube itself. Newly replaced tubing will make the Methadose appear lighter in color. New tubing allows more light to pass through it, as it has not been stained from use. If the Methadose appears to be diluted/over diluted once it is in the dosing cup (and SWIY really feels it is incorrect), SWIY can request that the dose be sealed under the watch of a third party staff member (such as ones counselor), and sent to a lab for analysis to determine the exact dose. The clinic can call a client back to test their take-home doses prior to the labeled date for use to ensure it wasn't sold or taken ahead of time. So... What's good for the goose is good for the gander. SWIY will have to pay for the testing if the dose is found to be correct.



As far as any standard procedure regarding the dilution of methadone in US clinics...
Quote:
Based on a review of existing literature and a consensus of opinion among consulted pharmacists, the American Association for the Treatment of Opioid Dependence, Inc. (AATOD) issued several recommendations in June 2004:
  • Dilution of methadone products should be with distilled water only.
  • New, clean, air-tight, light-resistant containers should be used for dispensing.
  • Take-home containers should be securely refrigerated as soon as possible, and remain refrigerated until used.
However, there may be a question as to whether dilution at the time of clinic dispensing is required or necessary. Federal Regulations do not specifically require dilution. Typically, product labeling specifies, “to be diluted with water or other liquid to 30 mL (1 fluid oz.) or more before oral administration.” This could mean dilution “just before the dose is taken,” in which case the patient might be the one to add liquid for dilution. Tap water or other fluid could be used, since storage is not a concern. Dilution simply makes it easier to consume the full amount of otherwise thick, undiluted methadone that is in the take-home container.


For more on what goes on in U.S. methadone clinics, read the book...
Inside the Methadone Clinic Industry
by Lisa C. Berry

Post Quality Evaluations:
Interesting info.
excellent information & advice for OP,v.interesting post
Nice artice, cheers
Spot on analysis about the color in the tubes; good info about testing potential inconsistances!

Last edited by Electrolingus; 26-04-2010 at 19:49. Reason: To add AATOD data.
  #9  
Old 23-11-2009, 19:27
adzket adzket is offline
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Re: Metadone pumps and additives question

the pumps seam a good idea to swim in areas that have a large no of patients on mmt due to it's cost effective benefits swim would be worried that the minimum staff present though could be threatened and hole machine being stolen by junkies. swim agrees with above post saying it is not worth worrying about speak to staff they will tell you or if problem will get it looked at. as for ingredients look at thread methadone safety sheet at:
http://www.drugs-forum.com/forum/showthread.php?t=70285
has info on additives, colorings ect..
  #10  
Old 23-11-2009, 21:29
jloops jloops is offline
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Re: Metadone pumps and additives question

The pumps aren't bad necessarily, but it's a lot easier to just give people methadone pills or wafers, especially for take-homes, and SWIM believes that the operator of the pump could manually measure the stuff out and dispense it just as quickly... The whole thing is kind of weird. It's almost a bit 1984 to get your medicine in that way... Also, SWIM feels sorry for people who have to lug around tons of stupid bottles of liquid. The crap these regulations put people through is ridiculous. Why not just use the damned wafers or pills?!
  #11  
Old 24-11-2009, 12:50
davestate Gold member davestate is offline
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Re: Metadone pumps and additives question

SWIM woul think that dispensing a dose that is less either by inaccuracy on belhalf of the machine (mechanical error), an error in the concentration (so the machine dispenses the correct volume, but since the concentration is wrong the dose is low) is illegal.
These sort of things could potentially be harmful (E.G if the dose received was actually higher) so SWIM would think these thing would constantly be checked and verified. The difference in taste and consistency could be due to different batches or type of methadone solution, for example someone with a declared allergy could be advised to use a different pump. If these things are anything like a patient controlled analgesia machine (morphine pump) Then accuracy is extremely high, and many safeguards are in place.

This could all be psychosomatic, if it bothers SWIyou, use the other pump and ask the staff for the reason in difference

EDIT
http://www.worldpumps.com/view/3617/...hadone-dosing/
Quote:
The Verderflex M500 ac pump has no internal backflow which ensures accurate dosing without slip, providing repeatability of typically ±0.2% and metering capability of ±2%, meeting the stipulations of both the Weights and Measures and new Medicines Act.
This is the pump in spuckys post and picture. +-o.2% is very accurate. if there is a problem, it's seems it could be oner of the staff illegally diverting methadone and then watering it to bring it to the same volume

Post Quality Evaluations:
good point about psychological aspect & extra info/link about pumps.

Last edited by davestate; 24-11-2009 at 12:55.
  #12  
Old 25-11-2009, 04:36
LiquidHandcuffs LiquidHandcuffs is offline
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Re: Metadone pumps and additives question

Swim got to wondering...

Why do the Methadone Clinics make addicts/dependents "pump" so much money out of their wallets, yet still force them to jump through hoops to get past the other "additives" such as the stringent take home policy, and the counseling (Swim counseled more than he received any counseling).

He understands that it is a private business, and a lucrative one at that, but seriously, the average daily Methadone dose costs around $1.00 to manufacture. Folks at Swim's old Clinic were forced to pay $90+/week due every Monday.

Hmmm... $7.00 to manufacture a weeks worth of doses (per person), but $90.00+ to get the weeks worth of doses.

^^That is withholding the cost of gas!

Perhaps a bit of exploitation of the vulnerable and needy going on?

.....or.... are the clinics possibly being strong armed by the government for extra taxes etc.?

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veering off-topic a little!Interesting thought though!
  #13  
Old 25-11-2009, 06:20
jloops jloops is offline
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Re: Metadone pumps and additives question

It's because most of them are for-profit enterprises. They can charge as much as they want!

There are some good clinics, non-profit ones, that charge high amounts but go out of their way to prove a quality service, but it seems they are few and far between. Swim cannot even conceive of the stuff he reads people going through at these clinics.

Swim especially cannot understand why some clinics are forcing people to INCREASE their dose and refusing to decrease their dose. This is the most disgusting thing swim has ever heard of. *That* should be illegal.

A lot of clinics are just crap, pure crap. People do steal the methadone and water it down, but who knows how often. The machines are maintained and verified the bare minimum at some places, no doubt. They get clogged, busted, etc. The ones swim has seen looked like pieces of trash that someone had nailed together in their garage. That said, it's not going to make a difference if your dose is off by 10%, seriously. You would never know. How can you go into withdrawal from dropping from 100 mg to 90 mg? Or from 50 to 45? The answer -- you can't, except that thinking makes it so. Swim was afraid to drop a mg off of his high dose at first. Once swim saw that it didn't do anything, he dropped 20% and 25% or more on several occasions with no trouble.
  #14  
Old 25-11-2009, 08:05
Spucky Spucky is offline
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AW: Re: Metadone pumps and additives question

Quote:
Originally Posted by LiquidHandcuffs View Post
Swim got to wondering...

Why do the Methadone Clinics make addicts/dependents "pump" so much money out of their wallets, yet still force them to jump through hoops to get past the other "additives" such as the stringent take home policy, and the counseling (Swim counseled more than he received any counseling).


Hmmm... $7.00 to manufacture a weeks worth of doses (per person), but $90.00+ to get the weeks worth of doses.

^^That is withholding the cost of gas!
Office Work need a lot of Time, don`t know how ot works in the US.
but in Europe each Dose have to be written in a special Book in a daily Base, also for each Person they need a new Application where they have to justify the need of Methadone for this Person!

Will look later how much it is in Germany!

Quote:
Originally Posted by jloops View Post

Swim especially cannot understand why some clinics are forcing people to INCREASE their dose and refusing to decrease their dose. This is the most disgusting thing swim has ever heard of. *That* should be illegal.

Swim is not a big Fan of Orrrrrrrrderrrrs but a medical Program need to follow some Rules,
this Rules made by experience.
A big Experience is that People who don`t take enough Substitutes tend to consume more of the Substance they have to avoid!
Many Times the Situation of a Client get worse if he/she consume Heroin and a Substitute like Methadone!
  #15  
Old 26-11-2009, 06:50
jloops jloops is offline
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Re: AW: Re: Metadone pumps and additives question

Quote:
Originally Posted by Spucky View Post
Office Work need a lot of Time, don`t know how ot works in the US.
but in Europe each Dose have to be written in a special Book in a daily Base, also for each Person they need a new Application where they have to justify the need of Methadone for this Person!

Will look later how much it is in Germany!




Swim is not a big Fan of Orrrrrrrrderrrrs but a medical Program need to follow some Rules,
this Rules made by experience.
A big Experience is that People who don`t take enough Substitutes tend to consume more of the Substance they have to avoid!
Many Times the Situation of a Client get worse if he/she consume Heroin and a Substitute like Methadone!
Whether or not "rules" are needed for any given undertaking is not the question -- the problem is that rules are not interchangeable. You can't just add arbitrary "rules" and expect good results! Isn't it wrong to force someone to stay on methadone (or go cold turkey) rather than allowing them to taper?

And about the cost -- $7.00 per week would be on the high-end if we're talking about people dosing under 100 mg per day! Methadone is well under a dollar for a usual daily dose if swim recalls.

If a clinic has 10 full-time employees (which it almost certainly doesn't), and they average $20 per hour, that's 10*20*160=200*160=32,000. If they have 300 clients, that's 100 dollars per month they need from each client, plus 30 dollars for the medicine. Where is that other $200-$300 going for a private pay individual?

And what exactly is the methadone clinic doing for anyone that's useful other than handing out the drugs and providing a convenient location for people to buy and sell drugs to one another? All the evidence indicates that the less people attend the clinic, the better off they are, and this includes scientific studies. Most people make no use of the counseling -- those who want it can pay for it, those who don't shouldn't shoulder the cost for others.

So, why have the clinic at all? It sounds like the best results would come from a free market for drugs and psychologists.
  #16  
Old 26-11-2009, 07:39
Spucky Spucky is offline
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AW: Methadone pumps and additives question

It will be really Cheap if the Patients are responsible and can live with a monthly Take Home
but the majority is not because they are addicted+ Polytox.!

MMT-Programs for "Nam-Veterans" of the US-Army are much cheaper
because they spend already some decades in their addiction
and have mostly Take-Home for a whole Month!

Edit: Here are the Prices for Germany:
Methadone: 6.500 Euro a Year
Diamorphine: 18.000 Euro a Year

Source: http://www.aerzteblatt.de/v4/archiv/...l.asp?id=53503
(German)

Last edited by Spucky; 26-11-2009 at 07:49.
  #17  
Old 26-11-2009, 16:19
Helene Gold member Helene is offline
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Re: Metadone pumps and additives question

Quote:
Originally Posted by LiquidHandcuffs View Post
$90.00+ to get the weeks worth of doses.
Blimey! Is this really representative of the average cost of a methadone script in the US? Swim had no idea it was so much. Are you required to pay daily, or weekly? In arrears or in advance? And what happens if you can't pay for a particular week/ day? Do they withhold your dose until you come up with the goods?

Before swim started posting here on DF, she had very limited knowledge of the drugs culture in the US. The more swim reads about the state of the addiction services over there, the more upset she gets.

Can't anything be done to change things, to bring the system into the 21st century? It really riles up a revolutionary fire inside of swim, if she was in the US, she'd be sorely tempted to take to the streets and start protesting for junkie's rights...

H
  #18  
Old 26-11-2009, 16:25
missparkles missparkles is offline
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Re: Metadone pumps and additives question

helene,

We pay here just the same, only difference is we pay it at source. In the US they pay health insurance separately. Same difference really.

Sparkles.

Last edited by Dickon; 26-11-2009 at 19:57. Reason: The quotes are coming - run for the hills!
  #19  
Old 26-11-2009, 18:23
adzket adzket is offline
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Re: Methadone pumps and additives question

yes but swiymisssparkles we don't pay as much as that if we pay at all. as a lot of people on mmt are not fit for work so get benifits which means free perscriptions. yes when we work we pay tax which is what we get back when getting benifits but still even if paying it is not that much even on daily pick up you only pay for one item price wether that script is for a week or a month. swim has had monthly scrips issued but on a daily pic up from chemist and only pays for one item when they where working as the item is total amount of methadone on script not just the daily amount. an item is £7.20 and if working or on some benifits where you have to pay for perscriptions you get a discount card if on a lot of medicine which is prepaid and a lows for as many items as needed are 12-month prepayment certificate (PPC): £104.00
3-month PPC: £28.25
so it is way cheeper for us if we pay at all. in some situwations in the usa it must be cheaper & easyer to stay on the gear. which is not good in any way. swim knows a lot of people in the uk that use there scripts to cut down on amount of gear they use and would be spending way more money plus getting involved in crime to pay for it if they did not get the script free. it is the only resion people jump threw all the hoops to stay on it. otherwise it would just those that 100% wanted to be clean that would do it.

sorry went off topic was in reply to post's by jloop's, spucky, helene & misssparkles

Last edited by adzket; 30-11-2009 at 18:03.
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Old 26-11-2009, 19:08
missparkles missparkles is offline
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Re: Methadone pumps and additives question

The point I was making is that in the UK we pay for it just the same, just in a different way. People on benefit have their (what used to be NHS stamp) paid for them if they were unable to work.

So healthcare in the UK is not free, it's just paid for by those with the ability to pay. Perhaps you could look at it as a safety net to catch people on low incomes, same as free hospitals and clinics in the US?

Sparkles.

Apologies for off topic post, was answering Adzket.

Last edited by missparkles; 26-11-2009 at 20:22. Reason: Apologies.
  #21  
Old 26-11-2009, 19:59
Dickon Dickon is offline
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Re: Methadone pumps and additives question

Has anyone recently looked at the topic of this thread? Please do so before posting anything more. This is a real off-topic-fest.
  #22  
Old 27-11-2009, 03:23
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Re: Metadone pumps and additives question

Oops...
  #23  
Old 29-11-2009, 07:07
Ragnar Danneskjöld Ragnar Danneskjöld is offline
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Re: Metadone pumps and additives question

Quote:
Originally Posted by missparkles View Post
helene,

We pay here just the same, only difference is we pay it at source. In the US they pay health insurance separately. Same difference really.

Sparkles.

It is not the same in the US. After my kidneys failed I was denied government aide and told I had to work. I lopped in with my parents and thier health care and even then I owe $10,000 for the transplant.

Even on Dialysis i was given not a penny.
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Old 29-11-2009, 07:31
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Re: Methadone pumps and additives question

I am simply going to delete every off-topic post in this thread - so don't waste your time. One final time - stay on topic - and it's not on topic to apologise about being off-topic!

I'm pretty sure this subject has been done to death - but if anyone has anything new to contribute go ahead. This is not the place to discuss healthcare systems in general.

D
  #25  
Old 18-02-2010, 19:20
BakaBilly BakaBilly is offline
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Re: Methadone pumps and additives question

I know this subject is - Old - and - Beaten to death, but I stumbled on it and wanted to add my few cents should someone with the same questions stumble on this thread VIA a search engine or this site itself.

Methadone is watered down not for the reason of privacy, the difference between 50mg of liquid methadone and 150mg of liquid methadone is very small. 200mg of pure liquid methadone isnt alot of liquid (depending on where the clinic is and what they use, methadone/methadose.) its watered down because the pure liquid is VERY bad on your stomache. If a patient drank it without any water or anything else it would make their gut sour and in some cases sore and in many cases will make them throw up.

Some clinics use water, putting out some kool aide or more water to wash it down with.

The pink cherry stuff SWIY is talking about is usually a premixed liquid with flavored sugar water that is in a seperate bottle from the methadone. The pump machines pump both the cherry flavor liquid and the methadone into one dose. If this is how SWIY clinic works, its most likely the cherry water mixture having a little more/less water than last time.

The most popular however (in just about ALL California clinics) is the "methadose" which is all mixed in one bottle. Its also pink and is also cherry flavored (there are other flavors however, green mint in northern Cali. for example.) after the dose is put into the cup the dosing nurse (or even the machine in some cases) pours a small amount of water into the dosing cup. Again this cherry methadose un-watered is very bad for the stomache.

This is most likely the case and the reason for lighter looking dosages one day and darker another.

If theres paranoid people out there worried about their dosage being tampered with, think of it like this. MMTreatment has been around for a very long time. By now there are many safe gaurds protecting you and the people working behind the counter.

This isnt fast food. Its not so easy to just pinch the line and tamper with people doses like it is to spit in peoples burgers. Not to mention the people behind the counter arent like most of the people on the opposite side. They dont need/want to risk Federal Prision to get a little taste of cherry meds.

Clinic nurses are heavily screened, heavily monitored and the consequences are rediculous. Not to mention how much the clinics want to avoid anymore lawsuits. Messing with peoples medication warrants huge settlements.

Thats not to say there arent exceptions to the rule and should someone have a problem look up D.O.R.A. represntatives in the area and make a report. The suggestion of having the dosage sent to a lab for checking is AWSOME.

SWIM has been to many clinics across the U.S. and has guest dosed at many o' clinic. SWIM asks many questions and has even dated a cute clinic nurse for a year.

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