Guest Dosing

[blutuesday]

I am on vacation in Alabama right now and I am from St. Louis, MO. I had gotten my paperwork to guest dose completed by counselor like 2 months ago. Everything was fine, until like the week before my trip and people from the AL clinic call and say the paper wasnt done right etc. So, after many trips and calls to my clinic, we got it all set. So I thought. I get one take home at my home clinic. My doc at my home clinic wrote my dosing orders for me to face to face dose at the AL clinic from aug 11-15, then get 2 take homes for 16-17 since I will be traveling those days, and cant get back to my clinic till monday and I get home late sunday. Everything was fine I was told, until I get here. I dosed the first day at this AL clinic on monday the 15th. They told me then that my take homes would not be an issue so I went ahead and paid for the 40 dollar intake bullshit fee, and then the rest of the week. So, today I go there and all of a sudden, Im not getting the take homes. WTF. MY home clinic doc signed off on it, what is the problem. They are saying they dont do that here, and they dont close on sundays either. I told them that if I cant get both takes, could I at least get a sunday take if I extend my vacation a day in order to dose here on saturday, and then I could get my take home like I normally would at my own clinic. Still no answer on that. They are really dicking me about.

This whole thing is a money racket. They dont really give a shit.

I AM SO FUCKING FRUSTRATED!

[pharmboy]

Sorry I think MMT is just another way for the bureaucracy to fuck over poor people

who have been shit on enough.

[Narkotikon]

Yeah, I've never actually guest dosed, but I know it's a bitch. I was living in Lexington, KY when I was at the private MMT clinic there, and I normally went home at least once a month to Cincinnati, where I'm from. So, several times I asked the counselor at my clinic to arrange to guest dose at the Cincy clinic, and there was always some problem, either on my clinic's end or the Cincy clinic not returning calls, etc. So, I never did experience guest dosing, but I'm sure it's a bitch. Every MMT patient should be given a federal card, that keeps track of all your dosing days etc. on a computer system, and then all clinics should be connected to this system, so all you have to do is go to ANY clinic and swipe your card and be able to be dosed ANYWHERE. I know some wouldn't like being in a system, but it's a lot easier to do it that way than go through all the hoops and bullshit paperwork that doesn't even guarantee success in the end. I'm sorry to hear your situation.

[Narkotikon]

Sorry I think MMT is just another way for the bureaucracy to fuck over poor people

who have been shit on enough.


LOL, yeah, I love it when clinics always say to clients (especially when they're having trouble paying) that MMT is much cheaper than a drug addiction, and for the most part that's true. But, what they're forgetting is that by the time people get to the point where they need MMT, that they've lost their jobs and have little to no money, and therefore the weekly cost of MMT is a lot to those people. That always irked me, especially when I would be sitting in the clinic's waiting room seeing and hearing clients pleading for the clinic to cut them some slack, and they never would. What do they care, no money = no dosey dose. And it really sucks because in order for most of these people to get back on track to get a job and get money, they need to be stable, which rarely happens unless you're continuously medicated. It's a fucked up cycle.

[ouch]

Did you at least get any of your money back?

[SneefOXYs]

I swear these places are nothin but dealers with liscenses. But then again it's better than the alternative. We are pretty lucky there are places like these for us to go, legally.

Just to start off this story, I've personally overheard the Counslers talking about how happy they were about the amount of Intakes they got. And that even when they get 1 patient a day they are jumping up and down.

Now onto the point. About 6 months into the program I approcahed my Counsler asking for 3 take homes a week, basically 1 every other day. Then I go in both days on weekends. He told me I hadn't been there long enough, and it would be impossible. So I told him I was considering switching to the Sacramento clinic becase it's only 35 min. away, but I would only have to go once a week and get 6 take homes. Save a lot of money on gas in the long run.

All of sudden he was like. Oh I didn't know you were having issues driving here every morning. It's only about 15 miles away, but Sacramento is 35. I'd rather drive 70 miles once a week. Then 30 miles a day, every day. So he gave in put in the paperwork, and I had take homes a week later.

I just think it was funny how he was saying it was impossible, it couldn't be done no matter what. I have to be here for a certain amount of time. Then I threatened to switch clinics, and all of a sudden it was doable within a few minutes. I thought that was funny.

[monkeyphunk]

i second the fed data base so i can dose where ever woyuld make my life hella easierYeah, I've never actually guest dosed, but I know it's a bitch. I was living in Lexington, KY when I was at the private MMT clinic there, and I normally went home at least once a month to Cincinnati, where I'm from. So, several times I asked the counselor at my clinic to arrange to guest dose at the Cincy clinic, and there was always some problem, either on my clinic's end or the Cincy clinic not returning calls, etc. So, I never did experience guest dosing, but I'm sure it's a bitch. Every MMT patient should be given a federal card, that keeps track of all your dosing days etc. on a computer system, and then all clinics should be connected to this system, so all you have to do is go to ANY clinic and swipe your card and be able to be dosed ANYWHERE. I know some wouldn't like being in a system, but it's a lot easier to do it that way than go through all the hoops and bullshit paperwork that doesn't even guarantee success in the end. I'm sorry to hear your situation.

[Raz]

I swear these places are nothin but dealers with liscenses. But then again it's better than the alternative. We are pretty lucky there are places like these for us to go, legally.

Just to start off this story, I've personally overheard the Counslers talking about how happy they were about the amount of Intakes they got. And that even when they get 1 patient a day they are jumping up and down.

Now onto the point. About 6 months into the program I approcahed my Counsler asking for 3 take homes a week, basically 1 every other day. Then I go in both days on weekends. He told me I hadn't been there long enough, and it would be impossible. So I told him I was considering switching to the Sacramento clinic becase it's only 35 min. away, but I would only have to go once a week and get 6 take homes. Save a lot of money on gas in the long run.

All of sudden he was like. Oh I didn't know you were having issues driving here every morning. It's only about 15 miles away, but Sacramento is 35. I'd rather drive 70 miles once a week. Then 30 miles a day, every day. So he gave in put in the paperwork, and I had take homes a week later.

I just think it was funny how he was saying it was impossible, it couldn't be done no matter what. I have to be here for a certain amount of time. Then I threatened to switch clinics, and all of a sudden it was doable within a few minutes. I thought that was funny.

Its a business bro, a drug business goverment sanctioned.....

[SneefOXYs]

Its a business bro, a drug business goverment sanctioned.....

It's funny, I originally just said the same exact thing in my original post. But it got deleted when I had to start it over for hitting the back button on my IE. I just never wrote it back in, but I thought it was a trip it got responded back. Just thought I'd share that.

But yeah, everythings a business, but you do hear Counslers saying that the clinics don't bring in that much money. That they are mainly there to help society. I believe that to a certain extent. But they are making a much larger profit then they make it seem. But like you said it's a business and the goal of a business is to make as much money as possible.

[Indy]

I don't have experience with MMT, but IMO there isn't anything inherently wrong it being a business. I mean they provide a service, you provide payment. Would you rather them be volunteers? Sure, you'd get more people who do it just cause they like to help you, but you'd also get people who do it, who CLAIM they like to help people, but really just want to feel 'BIG' and 'POWERFUL', and 'SELF-RIGHTEOUS'.

Granted, i'm sure you have those types of people there already, but take away the money from it and then that's the ONLY reason they have

[I-Nod]

I just think it was funny how he was saying it was impossible, it couldn't be done no matter what. I have to be here for a certain amount of time. Then I threatened to switch clinics, and all of a sudden it was doable within a few minutes. I thought that was funny.

That's fuct up!! Hope he felt like a lying shit-tard after that... cuz that's basically what he is. "Here to help people"... ha!!

[blutuesday]

Yeah, I've never actually guest dosed, but I know it's a bitch. I was living in Lexington, KY when I was at the private MMT clinic there, and I normally went home at least once a month to Cincinnati, where I'm from. So, several times I asked the counselor at my clinic to arrange to guest dose at the Cincy clinic, and there was always some problem, either on my clinic's end or the Cincy clinic not returning calls, etc. So, I never did experience guest dosing, but I'm sure it's a bitch. Every MMT patient should be given a federal card, that keeps track of all your dosing days etc. on a computer system, and then all clinics should be connected to this system, so all you have to do is go to ANY clinic and swipe your card and be able to be dosed ANYWHERE. I know some wouldn't like being in a system, but it's a lot easier to do it that way than go through all the hoops and bullshit paperwork that doesn't even guarantee success in the end. I'm sorry to hear your situation.

The federal id card idea is a great one. Everything about MMT seems to be a pain in the ass, and every excuse they give for every inconvenience is that it's "a federal regulation." Of course the ID card thing would never happen, that would be too easy and convenient!

[red26]

The clinic I used to go to , well theres 3 clinics in this area. Downtown Denver, north Denver, and boulder. Theres all owned by the same person but the rules changed from day to day differently at each clinic. It was convienient that if I was in Denver I could just call the boulder clinic and within 5 minuites I got my guest dose, but the takehome policies really did change from day to day sometimes.It got so fukin frustrating sometimes when I had my time in for getting my extra takehomes but because I was hurt and couldnt walk to the clinic or too sick to go there and too poor to go to the doctor but because I didnt have a fuckin legit medical excuse from a hospital or doctor they'd deny me?!?!

Its such a goddamn racket and so profitable. The business of addictions is a steady thing, like just think about alcohol and tobacco.

[SneefOXYs]

Yeah, I've never actually guest dosed, but I know it's a bitch. I was living in Lexington, KY when I was at the private MMT clinic there, and I normally went home at least once a month to Cincinnati, where I'm from. So, several times I asked the counselor at my clinic to arrange to guest dose at the Cincy clinic, and there was always some problem, either on my clinic's end or the Cincy clinic not returning calls, etc. So, I never did experience guest dosing, but I'm sure it's a bitch. Every MMT patient should be given a federal card, that keeps track of all your dosing days etc. on a computer system, and then all clinics should be connected to this system, so all you have to do is go to ANY clinic and swipe your card and be able to be dosed ANYWHERE. I know some wouldn't like being in a system, but it's a lot easier to do it that way than go through all the hoops and bullshit paperwork that doesn't even guarantee success in the end. I'm sorry to hear your situation.

This definately sounds like one of the best ideas. I luckily have never had to guest dose. Whenever I go out of town I was lucky enough to get take-homes to take with me, even when I wasn't technically there long enough to be allowed to.

Anyhow the thing you said about people not wanting to be in the system. It doesn't matter because they are in a system anyway. At least my clinic is. All our info. is stored in a computer, and I know my clinic is up and down through California. It's called MedMark.

[blutuesday]

Did you at least get any of your money back?

They actually made me a deal, that if I stayed down there a day longer and face to face dosed, that they would give me ONE take. Of course they would not have wanted to give me a refund after I already paid for the whole week. If they wouldnt have given me that take home for one day, they would have lost that money. So they act like they were helping me out. The director kept telling me that she "had to jump through a bunch of hoops" to get me the take home. She said it more than once. God, some people just have such a need for recognition. Maybe I should have got down on my knees and kissed the ground she walked on to show my appreciation. Stupid bitch! Now if she would have gotten me all the takes that my clinincs doc said I could have, THEN maybe, just maybe I would have. :D

[nick]

I don't have experience with MMT, but IMO there isn't anything inherently wrong it being a business. I mean they provide a service, you provide payment. Would you rather them be volunteers? Sure, you'd get more people who do it just cause they like to help you, but you'd also get people who do it, who CLAIM they like to help people, but really just want to feel 'BIG' and 'POWERFUL', and 'SELF-RIGHTEOUS'.

Granted, i'm sure you have those types of people there already, but take away the money from it and then that's the ONLY reason they have

There is something inherently wrong with private 'done clinics and that is by definition their primary concern is profit not the service user.

I delude myself by thinking that the better service they offer the more clients they'll attract and the more money they'll make,but sadly for obvious reasons,it is not like that.

[red26]

There is something inherently wrong with private 'done clinics and that is by definition their primary concern is profit not the service user.

I delude myself by thinking that the better service they offer the more clients they'll attract and the more money they'll make,but sadly for obvious reasons,it is not like that.
A perfect example of soley for profit is this: even if you paid for the whole week at one of the 3 klinics owned by the same people here, and miss 3 days you CANNOT dose for the rest of the week. It used to be that if this happened your dose was cut in half. Either way its for thier interest only, not ours.:mad:

[pharmboy]

If the government is so fucking down on drugs and their users shouldn't they


pay for MMT ? I would think they would be happy to pay, because then


THEY are in control and we all know how they LOVE their control.

[red26]

If the government is so fucking down on drugs and their users shouldn't they


pay for MMT ? I would think they would be happy to pay, because then

THEY are in control and we all know how they LOVE their control.

Do you think they REALLY want us around?

[blutuesday]

A perfect example of soley for profit is this: even if you paid for the whole week at one of the 3 klinics owned by the same people here, and miss 3 days you CANNOT dose for the rest of the week. It used to be that if this happened your dose was cut in half. Either way its for thier interest only, not ours.:mad:

At my home clinic, in st louis (Im back in stl) it is a state funded place. This is the first "free" clinic Ive ever been to, and I waited for 2 years to get in, and even then I had to know someone there to push my paperwork ahead. Anyway, they get 350 dollars a month from the state of mo for each patient. If the patient misses a day the CLINIC charges them 10 dollars. If you miss two days in a row, it goes up to 40 dollars. We have groups every week on mondays, and if you cant make the group, you get charges 10 dollars, and then you cant dose without going to group, and if you want to dose without going to group cause u missed group, thats another 10 dollars, so 20 dollars total. Also, we bring our bottles back on mondays from our sunday takes, (not back on saturday when you get your next take like most clinics,) and if you forget your bottle, you cant dose, or else you have to pay 10 bucks. It seems like at my clinic, anything goes for the right price. It is a money racket, but I am thankful it is available, dont get me wrong, but it does make me laugh when the waiting room of the clinic has a sign saying how they are one 100 percent dedicated to the sobriety of their clients, no matter what. Most clinics should say they are dedicated to their clients if the have MONEY. I cant complain, my clinic is free right now, but Ive been to many that arent. It is a business, and business is good!

[pharmboy]

I think they think of junkies like Indians, The only good Indian is a dead

Indian . . . but short of that they want you on a reservation and the

closest thing they'll get to a reservation for junkies is a MM clinic.

[red26]

At my home clinic, in st louis (Im back in stl) it is a state funded place. This is the first "free" clinic Ive ever been to, and I waited for 2 years to get in, and even then I had to know someone there to push my paperwork ahead. Anyway, they get 350 dollars a month from the state of mo for each patient. If the patient misses a day the CLINIC charges them 10 dollars. If you miss two days in a row, it goes up to 40 dollars. We have groups every week on mondays, and if you cant make the group, you get charges 10 dollars, and then you cant dose without going to group, and if you want to dose without going to group cause u missed group, thats another 10 dollars, so 20 dollars total. Also, we bring our bottles back on mondays from our sunday takes, (not back on saturday when you get your next take like most clinics,) and if you forget your bottle, you cant dose, or else you have to pay 10 bucks. It seems like at my clinic, anything goes for the right price. It is a money racket, but I am thankful it is available, dont get me wrong, but it does make me laugh when the waiting room of the clinic has a sign saying how they are one 100 percent dedicated to the sobriety of their clients, no matter what. Most clinics should say they are dedicated to their clients if the have MONEY. I cant complain, my clinic is free right now, but Ive been to many that arent. It is a business, and business is good! My god! I'm speachless actually...

[Suboxstitute]

LOL, yeah, I love it when clinics always say to clients (especially when they're having trouble paying) that MMT is much cheaper than a drug addiction, and for the most part that's true. But, what they're forgetting is that by the time people get to the point where they need MMT, that they've lost their jobs and have little to no money, and therefore the weekly cost of MMT is a lot to those people. That always irked me, especially when I would be sitting in the clinic's waiting room seeing and hearing clients pleading for the clinic to cut them some slack, and they never would. What do they care, no money = no dosey dose. And it really sucks because in order for most of these people to get back on track to get a job and get money, they need to be stable, which rarely happens unless you're continuously medicated. It's a fucked up cycle.


The same argument was just made at my mandatory sub group at my bupe doctor's. Even those who have insurance see our benefits limit out mid-year or earlier since our state requires group health plans to cover only $1,800 of AODA treatment per year, so even the good plans (and mine is good) just do the minimum and it is not enough for year of sub treatment not counting the bupe itself.

So EVERYONE in group the other day, the insured and uninsured, wanted to talk about money the other day.

So the two counselors in group say: "You ALL spent way more per month on your habits. BTW sub treatment can add up to hundreds a month (before meds) at my place : sub group/plus 5 min dr. visit to get your script that same day ($174 for both together) and another $124 for a mandatory monthly couselor visit (my counselor does NOTHING for me) . Then add the cost of bupe itself (for my insurance, that is still covered outside of the $1,800 limit). The counselors shut down the whole discussion asap even though the group is supposed to be "client-directed".

At the end, one guy said that he was really offended by the counselors' attitude that "you spent way more on your monthly habit than on your monthly recovery" - he said "That may be true but that is why we're here: we reached bottom, we stopped using...and now we're totally broke and we owe our families what money we do make..... after NOT contributing to them for so long due to our habits" He said it much better than that and everyone started clapping, etc. The counselors were pissed.

I ithink bupe also has been a windfall for doctors, esp psychiatrists who don't want to work very hard There are exceptions of course/some really great docs- -but sorry not mine.

[blutuesday]

Yeah, in general, people did things to support their habits that they would not ordinarily do. That is part of addiction and the behavior that goes along with it. I hate when people say "its a lot cheaper than dope," because it is totally different. Ive never heard of someone sucking a fucking to pay their clinic money. Is that what they want when they say that? Part of cleaning up and going to clinics is to get rid of the stress put on one by trying to "support" a habit. Surley they dont expect us to do the same behaviors in order to get methadone or subs at a clinic? It's absurd.

[Badly Drawn Girl]

\

So the two counselors in group say: "You ALL spent way more per month on your habits.

I hate that line of thinking. If I could afford the habit I had, I'd still have it! The only reason I'm on 'done is because I could no longer manage my habit. If I had a load of money, I sure as hell wouldn't be driving daily to a clinic.

[nick]

At my home clinic, in st louis (Im back in stl) it is a state funded place. This is the first "free" clinic Ive ever been to, and I waited for 2 years to get in, and even then I had to know someone there to push my paperwork ahead. Anyway, they get 350 dollars a month from the state of mo for each patient. If the patient misses a day the CLINIC charges them 10 dollars. If you miss two days in a row, it goes up to 40 dollars. We have groups every week on mondays, and if you cant make the group, you get charges 10 dollars, and then you cant dose without going to group, and if you want to dose without going to group cause u missed group, thats another 10 dollars, so 20 dollars total. Also, we bring our bottles back on mondays from our sunday takes, (not back on saturday when you get your next take like most clinics,) and if you forget your bottle, you cant dose, or else you have to pay 10 bucks. It seems like at my clinic, anything goes for the right price. It is a money racket, but I am thankful it is available, dont get me wrong, but it does make me laugh when the waiting room of the clinic has a sign saying how they are one 100 percent dedicated to the sobriety of their clients, no matter what. Most clinics should say they are dedicated to their clients if the have MONEY. I cant complain, my clinic is free right now, but Ive been to many that arent. It is a business, and business is good!

Sorry,but business isn't good.It maybe better than your public service,but that's a sad indictment of your public services.

I will say this,I have noticed significant differences in attitude to folks who pay for their 'done and folks who don't.

[blutuesday]

Sorry,but business isn't good.It maybe better than your public service,but that's a sad indictment of your public services.

I will say this,I have noticed significant differences in attitude to folks who pay for their 'done and folks who don't.

I was simply saying that business is good, like business is booming. The methadone clinics arent going out of business anytime soon. I think methadone clinics are bullshit like most everyone else. not sure what you thought I meant, but this is the first clinic ive ever been to where I didnt pay and this is my 6th methadone clinic. I have paid many many dollars to clinics.

[nick]

I was simply saying that business is good, like business is booming. The methadone clinics arent going out of business anytime soon. I think methadone clinics are bullshit like most everyone else. not sure what you thought I meant, but this is the first clinic ive ever been to where I didnt pay and this is my 6th methadone clinic. I have paid many many dollars to clinics.

I thought you meant business is good as opposed to business is booming.

[red26]

I will say this,I have noticed significant differences in attitude to folks who pay for their 'done and folks who don't.
How so nick?

I'm really curious about this comment. On one hand when I've ended up in a meth. clinic I've been releived that I didnt have to do whatever I was doing anymore to score. On the other hand I resent the rules and the basic attitude of people there. For example-I have a few friends still at the clinic. I was a dumbass one weekend and spent all my clinic money on coke. I went to the clinic and only had a few bucks on me and they wouldnt let me dose. My buddy walks in and with no thought at all pays for my week, so I offer to drive 'em to the clinic every morning cuz he's on my way anyhow.

Because we start showing up together the nurse starts to make blatent accusations towards me for fucking around with my other meds and ALL kids of bullshit! Last I heard she was still harping on this shit now saying that "I'm sure he was useing his diabetis to get high. Alot of diabetics screw with thier glucos levels to feel a high." Now, I havent been there in 7 fucking months!

I'm getting off topic now, sorry. One thing good I do have to say is that theres no mandatory meetings except for your monthly meeting with yer councillor. I was always happy with the attitude of the one on one therapists and typically ended the sessions feeling better about things in general.

[nick]

Ok,here in the socialist paradise that is England,all methadone is free and this seems to leads to more ambivelent attitude to it.Compliance is poor and methadone is almost taken for granted.I have known hundreds,maybe thousands of people on methadone over the years and I can count the totally compliant folks on my fingers.

Folks that pay for methadone in the U.S. seem much more likely to be compliant and regard methadone as part of some kinda recovery.

[red26]

What happens to the non-complient? Typically we get robbed by someone who has no legal repercussions.

[blutuesday]

The non compliant has to pay on certain things, as I stated in another post somwhere. Some things (like missing a group, missing a dose) are accepted as long as you can pay for them. Example: Missing a dose for one day = $10, Missing for 2 days = $40 and so on. Also, missing a group = $10. I should note that if you miss a group, you cant dose. If you want to dose after missing a group, you have to pay the $10 for missing the group and then $10 to dose, since u missed the group.

Things that will get you kicked out are fighting with a staff member or other client. They claim too many benzo drops will get you terminated but I have yet to see that happen. I think the only thing that can get you kicked out is fighting. People even do benzo transactions outside and Im sure they know about it. It is sooo obvious.

[nick]

What happens to the non-complient? Typically we get robbed by someone who has no legal repercussions.

Nothing happens to the non compliant.If it did there'd only be a handful of folks in treatment.Depending on where they are in the treatment system they may be offered more 'done or a switch to bup.
I only know of a couple of guys that kicked out of treatment,one pulled a knife on a doc and the other put a brick through one of the clinics windows.I also have a friend that was visiting the clinic and several local docs for'done at the same time,when caught he just lost his surplus scripts,but the clinic kept treating him.Hell,I know someone that was caught breaking in to a docs car and he's still there too.

Of course this isn't the case for those that enter the system through dip(court mandated treatment) screw up enough with those guys and it's straight off to jail.Sadly folks entering treatment through dip is increasing due to the fact that in some areas the fastest way into treatment is through the criminal justice system.

[Dune]

Nick, what does "dip" stand for?

[nick]

Nick, what does "dip" stand for?

dip stands for drug interventions programme.It's the treatment part of the criminal justice system.It's a little like the U.S. drug courts,but dip includes methadone and sub maintenance as options.