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bob35614

Posts: 19 Member Since: 02/22/10

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Mar 13 13 3:16 AM

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    I moved to a new clinic here in Las Vegas, NV and took my monthlies with me. In four months they have called me back five times for a diversion check. Seems like a lot to me considering my last clinic called me in once in three years for it. Is there a set amount in the meth. regs that they have to call you back or is it up to them? Thanks for any replies.

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whippy witch

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#1 [url]

Mar 13 13 4:16 AM

No set amounts of call backs and in the regulations it is an option / suggestion to be included in the "Individualized" Diversion Control Plan. 

What that means is that each clinic is supposed to come up with a diversion control plan that is unique to their specific clinic / company / entity.  And MOST use the call backs as part of that plan.

WW

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wayovermyhead

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#3 [url]

Mar 13 13 9:53 AM

This sounds a bit like diversion plan overkill....from what I understand each clinic is allowed to create their individual diversion control plan (DCP).  So it is mandatory/necessary that a clinic create and have a DCP, it is not so necessary a clinic has a set number of call back they are to perform on each/every client per month or year unless they had committed themselves to some kind of schedule in the development of their own DCP to call back for level changes etc, which some clinics have done in their own DCP, which makes me think that the clinic individually can have a real rigid DCP plan or they can have a loose more "Do callbacks within reason or do callbacks only when having a reason/suspicion to do the callbacks" DCP Plan......

So breaking it all down, I am not sure but I think a clinic is not required to do call backs on each and every client at all maybe even never......they are just suppose to have a plan in place where they can and will perform them randomly or in the event that suspicion grants a need to look into any client that might be under any shadow of doubt/suspicion etc....unless like I said they wrote their own script ib the DCP to do otherwise then I can see where they are required to have documented proof  they are abiding by their self developed DCP.

For instance I know in my case, my clinic does call backs when they change levels on a client and when a client has reached their maximum level it becomes a total random or when suspicion calls authority.  I think this due to the director saying to me that if I wanted to stay at my clinic and drive 7 hours one time a month then in that event,  callbacks would not be necessary unless I gave them suspicion or need to do the callback....

In your case I am wondering what it is about your individual case that night be itching their asses such as was there anything anyone said to you in admission/transfer regarding your dose or level you are on?  Is there anything "out of the ordinary" about your specific needs i.e. high dose or split dose?  Or here is the real biggie...do they give monthlies at all to the patients originating at that clinic?  Ask around if you can.....I do think they must have some kind of motive behind all the bottle recalls like they are trying to find you tripped up or run you off etc..I am not so sure this has helped or answered your questions at all but my personal opinion is they are being ridiculous at best

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wayovermyhead

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#4 [url]

Mar 13 13 10:00 AM

Wow I was going to say whippy would know and when I hit submit....all these responses updated...

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philly115

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#5 [url]

Mar 13 13 11:15 AM

@ bob: Ur clinic has no reason to give u that many callbacks. Something is wrong there and if I were u I would ask them what the problem is because they're going way overboard on the callbacks. Here in Tennessee I have to call my clinic line and enter my password on an automated line twice a week to see if it's my time to come in which is overboard 2, and we have 1 callback every 3 months, no more & no less than one every three months..

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anntelope

Posts: 30 Member Since:04/14/10

#6 [url]

Mar 13 13 11:27 AM

There should not be ANY call backs.  If a patient has supplied clean urines, not lost bottles and not missed any days - they EARNED their privileges and should not be forced to re prove they're behaving.
I'm so glad they don't do that where I live because I would just flip the hell out.   I have to wonder in the meantime WHAT is happening?  WHY don't we have more rights after all this time?  NOBODY else on medications are forced to submit to such outrageous scrutiny.  It angers me so badly that I'm going to have to go make myself a cup of coffee and calm down.   I'm SO SORRY for any of you who are being tormented this way.  Like what if you have a job?   They think you can just leave and travel to the program so some ninety day wonder that calls themselves a counselor can count your bottles or whatever?  As for diversion discouragement?  PUHLEEZE.  Anybody with half a brain can get around that if they really want to so frankly, I think they're just being outrageous and stupid and I absolutely HATE the idea of such a thing.  Thank GOD my program doesn't put people through that.   Also - what about sick or disabled patients?   Are they also expected to make long trips to the program for these reasons?  How sad.
Again - so sorry you guys have to contend with that stuff.   We really need a patients union.  Really.  If I was younger and stronger that is exactly what I would attempt to start.  After all, without the patients, the doctors, nurses and counselors would NOT even have a job.  HELLOOOOO?

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sapphire76

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#7 [url]

Mar 13 13 11:28 AM

       
In your case I am wondering what it is about your individual case that night be itching their asses such as was there anything anyone said to you in admission/transfer regarding your dose or level you are on?  Is there anything "out of the ordinary" about your specific needs i.e. high dose or split dose?  Or here is the real biggie...do they give monthlies at all to the patients originating at that clinic?  
    [/quote

That's what I was wondering too.........

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bob35614

Posts: 19 Member Since:02/22/10

#8 [url]

Mar 13 13 12:46 PM

I was on this same clinic 13 years ago and they are the ones who gave me the monthlies back then. I left it about 6 years ago and just came back last December.  I have gave clean urines for 19 years now so I see no reason to go this far with it. I felt like asking them this last time but thought I might piss them off and they may be even worse. I would never sell of give away or even double dose so I have nothing to worry about when they call me in. Its just seemed to me like overkill. Thanks for all your replies!

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briton32

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#9 [url]

Mar 13 13 1:13 PM

I know here in the state of tn its stated in the States rules and regulations that every patient recieving 3 or more takehome bottles per week MUST be called back atleast once in a 3month period...

 That being said I am eligible for monthlies according to the state rules and regulations and have attended 2 different clinics owned by 2 seperate groups in my 9yrs on MMT and BOTH clinics had rules set that if you get monthly takehomes(or 27days worth) then you MUST call the clinic once a week I think(i cant remember if it was weekly or may have been daily) and you were expected to come for callbacks once a month... So I mean if you have to come back anyways once a month for a callback whats the point of monthlies? I personally pick up 3weeks every time and that works out for me only having to go to the clinic one time every other calendar month.. Like this month I went in on march 1 and picked up 3weeks worth and I go back on march 22 to pick up again.. But next month I will only go in on April 12th and thats all for the month...

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wayovermyhead

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#10 [url]

Mar 13 13 2:41 PM

Well @bob so as you can see from all the replies...."CALLBACKS" is a clinic mandated rule, excluding the State of Tennessee.  We have, just in these few responses, seen callbacks as.......some clinics not at all, some clinics when you change levels, some clinics call in every week, some clinics once every three months etc....So it is a problem/inconvenience at your clinic and I would be finding out wtf..???....

once again, it is the clinic punishing the good guys to make sure they get all the bad guys....not good when their motive is to establish and fulfill a Diversion Control Plan with the diversion of methadone being possible regardless of that callback inconvenience/rule etc....

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whippy witch

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#11 [url]

Mar 13 13 4:01 PM


I guess I should have added that, I believe that many call backs is rediculous.  Why the hell would anyone call someone back so many times??  You trust them with monthly carries.  Ummm Unless there were PROVABLE issues with diversion and I mean that, not someone calling and saying so and so is doing this and that. 

For us as I have said people are aware of call backs.  They have choices, it is part of our diversion control plan and I have to say I don't believe we have done more then one in a year. 

WW

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anntelope

Posts: 30 Member Since:04/14/10

#12 [url]

Mar 13 13 7:51 PM

When are these programs going to go by the FEDERAL GUIDELINES instead of making up their own mickey mouse rules?  Even in NYC there are different rules at different clinics.  I don't think that should be permitted.  I think all programs should be run according to the same rules and there shouldn't be so many things left to the discretion of the program director or owner.  It's sickening.  Absolutely sickening and I don't CARE what is written in Tennessee's rule books or whatever.  WHO the hell do they think they are anyway that they should be stricter than anybody else?  The same with the state of Nevada and their overly strict clinic rules.  It boggles the mind that it's okay to gamble and drink till you die but if you take Methadone, you're forced to jump through hoops no matter how good you are or for how long.  Garbage.

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whippy witch

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#13 [url]

Mar 14 13 4:22 AM

Anntelope.  

Federal Opioid Treatment Standards at best can be considered guidelines.  How they are interpreted is anybodies guess and as we have seen from this board can be done in many different ways.  Unfortunately they are all as different as each person.  Sorry and then if you read the standards they must all follow state and local regulations per Federal Standards.  It get scary with as many entities as we have to abide by.

WW

Federal opioid treatment standards.  CFR 42 Part 8.12

C (2) 

(2) An OTP must maintain a current “Diversion Control Plan” or “DCP” as part of its quality assurance program that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use and that assigns specific responsibility to the medical and administrative staff of the OTP for carrying out the diversion control measures and functions described in the DCP. 

Here is the link to CFR 42 Part 8. 

http://www.law.cornell.edu/cfr/text/42/8.12

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mythoughts2

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#14 [url]

Mar 17 13 9:07 PM

Actually, California Title regulations require call backs. So it is incorrect to say that they do not have to do call backs. some states do require them, unfortunately.

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countyworker

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#15 [url]

Mar 20 13 8:46 PM

I posted a while back that my clinic a COLONIAL MANAGEMENT clinic was taking my takehomes after 13 years because I did not make a return call by 1.30 on the day the message was left it did not matter if you show up in 24 hours with the correct amount you still lose your takehomes so I ask the doctor since nobody ever gave the same answer you know how it is the director said its the DEA the nurse said its the state rule we have to follow it . The doctor said the return call rule is to keep and I quote shanagains from going on .He must watch alot of batman my consoler said he didn't know but he would find out so he told me recently it was a state rule but I had called Colonial Management and ask them saying the state has confirm its your rule and COLONIAL ADMITTED ITS THEIR RULE but refuse to tell me why so I confronted my consoler and he said he was sorry for lying to me . This is a perfect example of the U.S. METHADONE CLINIC SYSTEM AT WORK. Making methadone clinics get accredited has not  stop the abuse and the lying and the unreasonable rules that has plagued the clinic system for years . In my state clinics have to do at least 9 drug screens per year last year I was given 15 never failed one in 13 years why drive up the cost to the clinic then the clinic will just go up I pay 4750.00 a year and it keeps going up. I say abolish the clinic system and let doctors treat opiate addiction . 

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sapphire76

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#16 [url]

Mar 22 13 5:23 AM

@countyworker - so if it's just a clinic "rule" that they made up, if it bothers you that much can you not just change clinic?

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countyworker

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#17 [url]

Apr 4 13 10:35 PM

sapphire would you believe I check at the clinic 10 min from my house its called Mcleod center . They are 2 dollars a day cheaper but they will not let me transfer my phase. I was told at least for the first 30 days I would have to come in 7 days a week then I may or may not get 3 takehomes. I told the woman I have 13 years of clean drug screens she said it doesn't matter here. We don't know you .The U.S. clinic system allows these directors make up any rules they want so even in the same state methadone clinics have freedom to make rules how ever they feel so you have federal rules state rules and crazy clinic directors rules the clinic owner puts in rules and the clinic doctor may throw in some of his rules so the poor patient can't build a good live with out spending alot of money if they work and try to buy a home and live a normal live the system want allow it. The federal guidelines is all that is needed to run a clinic but nobody can see that in this country everything is dollar driven and personal power trips from the ones in charge kills what methadone is or was all about no matter how hard you try the cost and rules keeps you in chains. When I look at my paycheck stub and all the taxes taken out federal taxes state taxes ssi taxes medicare taxes then 550 a month for health insurance plus 400 a month for the methadone clinic I get what is left for me and my family to live on til next month I get paid once a month. I feel like just giving in and let the government take care of me and my family.

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sapphire76

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#18 [url]

Apr 5 13 3:05 AM

If the callback thing is bothering you that much, would it be better to transfer anyway?

It clearly is on your mind a lot as you keep posting about it!!!

Even if the new clinic don't transfer your TH's, as you only live 10mins away, it's not like you'd have to travel miles away.

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countyworker

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#19 [url]

Apr 5 13 8:01 PM

sapphire76 I go privately not even my wife knows so I can't go in everyday plus I don't want to give up 13 years of work and start all over again. I may look into a clinic that is more than an hour away if they will give me 30 day takehomes. The state of North Carolina allows it but I can't find a clinic that allows it . I don't understand why the clinics are blocking what the state and federal government have approved for North Carolina .

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sapphire76

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#20 [url]

Apr 6 13 4:01 AM

Wow, that's a heck of a secret to keep from your wife. What do you think her reaction would be if you did tell her?

If it were my husband, I'd be more mad that he'd lied to me for so long, rather than him actually being on the clinic.

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