Opinions - Problems at the methadone clinic

[china cat]

For three or four years swim has been prescribed methadone by his local drug problems clinic.

The clinic's idea is for swim to stop using heroin by replacing it with methadone and then to gradually reduce the amount of methadone until swim is opiate free.

Swim's idea, because at the moment he can't realistically see himself being opiate free, is to use the methadone as a backup or safety net so that swim's job (which is very important to him) doesn't suffer from the inevitable.......swim being sick from time to time.

Swim takes his methadone and also uses heroin on top on a fairly regular basis. He doesn't drink much, doesn't steal/burgle/mug/rob/rape, pays his taxes , trys his best to look after his family and everybody thinks that he is in general a really fucking good guy (ok.........so I made that last bit up)

Before the clinic prescribed swim methadone he was using a fair amount of gear (about a louis a day), occasionally straying away from the path of righteousness, scraping money together however he could and not caring about the consequences........generally doing what every junkie does from time to time.........swim was being a bit of a dick and heading for trouble.

He only takes 20mls a day, he pays for his script at his chemist, he has never asked his clinic for more methadone.......From the start he told them that he just wants enough so that he can work and get by and not feel sick.

Now in swim's book he's doing okay. He's reduced from 100 odd mls down to 20 mls and his heroin use is tiny compared to what it was but does this count as success at his clinic? Does it fuck. They are constantly on his back hastling him about dirty urine samples, threatening to take away his script if he doesn't conform, they keep him on a supervised script, if he needs to go away for work/holidays with the kids etc they make it very difficult for him to get his methadone away They are constantly reminding him that they can, at any moment cancel his prescription. If he hands in any more dirty samples they will cut him off.

The consequences of cutting swim off would be disastrous and swim just doesn't understand why they would do it? It would achieve the exact opposite of what they are set up to do.

A methadone prescription improves the quality of swim's life but more importantly it improves the quality of his family's life. I can't believe they would ever put that at risk by taking swim's script away.

Abstinence is just not feasible for some people. Why does it have to be all or nothing? Has any other swiy found their prescription to be subject to draconian rules? Has any swiy ever met a key worker who actually did swiy some good rather than just waffling bullshit?

[drug-bot]

swims on methadone maitaince as well, 80 mgs, and still shoots dope like once a week sometimes twice. swims clinic is pretty good, they dont insist on a person coming off methadone if they dont want to.
as far as swims heroin use, swim knows round about the time they do their drug test (oral swab, about once a month) so he abstains for a week or so when that time comes around. so far he has all clean results, but a couple days ago they blindsided him and gave him a test only about 3 weeks since his last and he shoot about 24 hours before that.
its not a big deal though that swim most likely failed. the clinic gives a warning the first 2 failed tests, the 3rd failed and your sentenced to a once a week class on relapse prevention for about a month, 4th failed same as 3rd just longer, only after 5 failed tests can they choose to medicaly detox you (2mg every 3 days swim believes) and kick one off the clinic.

[Spyder]

swiS often does the same as swiBot...abstain till his monthly urine, then enjoy the rest of the month. It's not foolproof, and he fails every now and then, but it's do-able.

At swiS's clinic, the first dirty is a warning, then the next (if back to back), "take-home" privileges are reduced (from 3day/wk, to 5, to 7, etc. with each dirty). Each dirty reduces the privileges another level. Beyone that, it's kinda a case by case basis, they will put the client on "Contract" where they give 2 urines per month (charge extra for the 2nd). If dirtys continue for the next 4-6months, they will detox.

Bottomline, it's kinda tough to actually get kicked out, if just a little common sense is used. swiS still likes to play and actually he has had a dirty every other one for about a year, meaning: warning, then clean, then warning, then clean...lol...it's almost too obvious.

Anyway, to answer the original question about this, remember one thing (at least in the US), it's illegal to prescribe meds just for "maintenance" unless at a clinic. The clinics are subject to TONS of red tape and laws, etc. The states set the guidlines for priviliges, and so on. swiS's clinic just started being open on Sunday (7days) all due to State laws, so most of the time it isn't the clinic to blame, but the gov't (as always)....

Hope all goes well.......Best regards, S

[Lisa J]

SWIM and her friends have found their own GPs to be more understanding than some of these drug key workers. SWIM gets all her meds including methadone through her GP, if SWIM'S not happy with what GP is doing she has a shared care worker in the local drugs project who will advise the GP on what to do. SWIM has NEVER had a urine test, she collects her methadone weekly and takes it home, it's up to SWIM whether she decreases or increases her methadone, SWIM is also on about 20mls which is nothing compared to some of her friends (90mls +). Is SWIY doing all this through a GP or just with the drug treatment agencies?.

[Spare Chaynge]

are you located in the united states lisa.. i did not know this was possible in the states if you are.. if it is its very rare

[Lisa J]

SWIM is in the UK, she has nothing but praise for her GP & local drugs project, but SWIM knows many are not so lucky, even here in the UK.