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wayovermyhead

Posts: 4,350 Member Since:07/16/11

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#21 [url]

Apr 1 13 2:51 PM

ANY OF YOU TENNESSEE MMT'ers.........PLEASE LOOK INTO THAT PEER SUPPORT SERVICE BACK TWO POSTS.....Although it is on the website that he works under I would be interested if it is a hoax to support him and his stance or the patient......

@ZAC have you heard of these guys????
http://tn.gov/mental/recovery/oca2.html

Office of Consumer Affairs and Peer Support Services
OMBUDSMAN PROGRAM AND HELPLINE
The Office of Consumer Affairs and Peer Support Services’ Ombudsman Program and Helpline offers direct, individualized support and assistance to individuals who are experiencing problems accessing services and supports with the goal of enhancing outcomes and the well-being of consumers. To accomplish this OCAPSS:
Investigates and resolves complaints for service recipients
Operates Helpline and triages calls
Provides links to services and information on mental health and substance abuse resources
The program ensures compliance with state and federal laws that prohibit unfair treatment through the confidential handling of complaints.
Through the Ombudsman Program, OCAPSS staff helps to resolve problems by mediating the concerns of each person involved in the situation. The Ombudsman accepts statewide calls.


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philly115

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#22 [url]

Apr 3 13 9:30 AM

I'm currently getting my peak and trough done today. I've already had the trough, and waiting on them to pull my blood for my peak. I have to stay for 4 hours today so I've had alot of time to talk to the nurses about other patients from states coming and guest dosing. I just found out that we had a couple people come here from out of state and their doses were in the 200mg range and they hadn't had peak and troughs so their dose had to be lowered to 120. That goes to show it doesn't matter if u go out of state from Tennessee and come back they'll lower ur dose unless you've had peak and troughs done to show h need a higher dose.

Say if u were @ 180 u would need at least 3 peak and troughs done to show u need that dose or state would lower u here in Tennessee.

I also found out a patient come in from another state to first dose @ 190mgs and here in Tennessee @ my clinic or any other they cannot dose anyone over 120 from out of state until the state of Tennessee approves it, and that person had to wait 4 hours in the waiting room to be dosed because they had to wait on state to give the OK, and state did OK them to get their 190mgs, but the nurse did tell me that state made it clear to tell that person that if they come back to guest dose again they will only get 120mgs that there's no proof they need 190mgs. It's ridiculous here in Tennessee.

Pretty much if u have to guest dose and u are in Tennessee I would advise not to come here if ur on a dose higher than 120 because more than likely ur not going to get it unless you've had peak and troughs done, and still that's not enough sometimes, but state has to approve e everything. They also told me that pretty much anyone on a dose over 200 that comes here from out of state will not get their full dose unless like I said unless they've had like 3 or 4 peak and troughs which chances are they've probably only had one peak and through which would mean they'll get denied and only get 120. Tennessee is ridiculous on the peak and troughs they've already made me get 3 and this is my 4th one and I'm currently @ 160 and hopefully this fourth one will get me to 200 at least, bit who knows they may keep making me get a peak and through every 10mgs even though NY levels are super low ugh!!

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the elephantman

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#23 [url]

Apr 3 13 10:48 AM

@philly: This is just absolutely INSANE bud!!!! Tennessee is a JOKE!!!! So they will take a person off there stable dose of say 180mgs down to 120mgs unless the big and mighty "STATE" approves it. Correct me if im wrong but, when did the state become licensed doctors???? I mean, what the hell do they even have doctors for when they have the state?!?! HAH!!!! Talk about a load of BULLSHIT!!!! Man i really hate it for ya philly!! U should really try to transfer to a clinic out of that sorry excuse for a state!! Tennessee is providing counterproductive "treatment". I would not even call it treatment.

Is there no other clinic u can transfer to outta state?? Bc i promise u, even if u luckily get to ur stable dose, u will have to walk around on egg shells watchin every little thing u do or say bc they will look for any reason they can to drop ur dose. EVERYBODY IN THE STATE OF TN ON MMT SHOULD ALL WRITE GRIEVENCES ABOUT THE "TREATMENT" YALL ARE BEING GIVEN. I mean how the hell do they expect anybody to succeed in treatment with the BULLSHIT hoops u gotta jump thru??

Philly, they are wanting u to give up with all the hoops ur havin to jump thru. It is absolutely REDICULOUS!!!!

Hang in there!!!!

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philly115

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#24 [url]

Apr 3 13 11:06 AM

@ eman:That's right if someone comes in on a stable dose like u said 180 then state would have to approve it, and unless they have peak and troughs to prove it then they will be dropped from their stable dose of 180 to 120.

I've heard of it happening alot here in Tennessee & @ my clinic. The nurse today said she hated it for us here because she agreed with me that the state is way too strict and that it's really hard for anyone to come to Tennessee and be able to stay on their stable dose if its over 120. I've had to jump through so many hoops to just get to where I'm @ and the doc and nurses all agree that it's ridiculous how many peak and troughs that state has made me take.

All in all the current doctor we have right now I really like because he's 100% supportive, and trying his best to get me @ a stable dose, but then state wants to butt in and make me get a peak and trough after only a 10mg increase even though my levels on my peak and trough were low. It just doesn't make sense and its true eman state is just wanting me to give up and that's why they're making it so hard on me, but I'm not giving up, and the doc is supporting me and he told me he was going to call the head guy over approvals for the state and talk to him about me because my doc was pist when he found out they were making me get another p&t after only a 10mg increase with my low levels. Hopefully this will be the last p&t I'll need, but with the way state is I may have to get one every 10mgs which is ridiculous. Hopefully my doctor talked a little sense into them though.

There's a clinic in cape girardeau Missouri that's a 2 1/2-3 hour drive one way that I was about to transfer 2, but I'm waiting to see what happens here first after this peak and through I just did today. The clinic in cape sounded awesome mean it's like I couldn't believe how much better it was the way the nurses told me it was run that I talked to. The nurse from the cape clinic told me they don't do peak and troughs, and that if I transferred that I would get my increases if I needed them, and that I would be getting carryouts the first day I get there so that right there is good. They also said in cape that say if I get an increase on a Thursday that I would still get my carryouts that same day which is awesome because here in Tennessee they make u come for 7 days and dose in front of them after an increase before u get ur carryouts back.

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beth

Posts: 96 Member Since:03/11/10

#25 [url]

Apr 3 13 12:38 PM

This is just redickulus!!  Just seems that it is practicing medicine with out a license.  You just have to wonder how foolish the State of TN SOTA  are going to feel and look when they get around to reading all of the scientific evidence they claim to follow ??  One of thier web sites claims that they follow evidence based scientific principals , but somehow this one has gotten past them and they are somehow lost in the dark basement of the  local 12-steppin facility , i think "dr" drew is down there with them too!!   I feel for you!! I have been in treatment first in mid to late 70's, the second time  since late 1999 . I have never had the infamous P&T !! and I am over 200mg.  What other area of medicine would dare to try and let the admin staph limit the amount of medication a patient could have and lower them if they deemed it too high!! ??

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philly115

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#26 [url]

Apr 3 13 3:39 PM

@ beth: Yes it's very ridiculous. Honestly after the way I've been done and the things I've found out over these past 6 months nothing really surprises me anymore with Tennessee. It's like they have their own set of rules that are 10 times stricter than what it's supposed to be. I figure Tennessee is this way because they don't want MMT in this state period and try and push peoples buttons where they get frustrated. I know I shouldn't let it get to me, but it does because I've been going now for a year and almost 3 months and I'm still not @ a stable dose. I've had to take 4 peak and troughs, and yet they're still not satisfied it's like I'm thinking what else do I have to do to prove to the state that I really need increases. They're making it really hard on me to get increases and it's costing alot of $ for all these peak and troughs because I pay for em, but I'm trying to think positive maybe I'll be able to finally get @ a stable dose and be able to put all this drama and stress from the state behind me.

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wayovermyhead

Posts: 4,350 Member Since:07/16/11

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#27 [url]

Apr 4 13 2:24 AM

@philly....does this not make you feel like you will be in constant fear of something interfering with your clinic or dose????  Like you will be taunted and teased all the time to walk a chalk line????  I think next will be you have to have PT levels done randomly to be able to remain on 200 if you make it there...

I love your optimism but I am afraid it seems presumptuous because from what you have said about people having to show peak and troughs for every ten milligram increments they have past 120 milligrams why would you think or even trust that they would let you get to 200 (40 additional milligrams)without 4 more PT's?  And if by chance they do, I would be so afraid even tho they had allowed it ...in a month or two or if lucky maybe a little longer they would inform you they are going to drop you forty because you do not have the legitimate amount of PT's to substantiate your 200 milligrams etc...

One way this might happen is like here in NC apparently the clinics are held liable to random State Request for a patients chart to be pulled that has over 200 milligrams and prove this patient to be stable on their dose.  I of all patients (since I am such a hard almost impossible stick to draw blood) was pulled by the State last year for a "Random Peak".  They were not worried about a trough the  State just wanted to make sure  my Peak was not too high and I was over medicated or possibly diverting my meds etc....

If NC SOTA does such I am fairly positive Tennessee would be susceptible to doing the same probably making it not even random but anyone over 200mgs and up required to prove their case/cause.  What sucks is this is always a learn as you go situation.  You won't know until it happens etc.....Have you actually seen it in writing where it is required every 10 milligrams???  Good Luck and I say Get the H out of that clinic and State asap.

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savalast

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#28 [url]

Apr 4 13 3:33 AM

Wayover. don't know about you but I'm so damned tired of hearing "diversion" as an excuse for p&k's, allowable th's etc. I said this before, if this is a disease when the hell are they going to treat it in the same class of others? No other "disease" has call back rules or talks of diversion. I'm just tired of the different B.S. from different ststes that people on MMT go thru, and being prejudged on what we "might" do with medication. Needed to get that out. I'm so tired of different rules that seem to pop up whenever a clinic feels like playing with their patients.

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wayovermyhead

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#29 [url]

Apr 4 13 11:37 AM

I can't even tell you how many times just with me alone the clinic staff has tried to pull something over as a rule that WAS NOT a rule. At first you know I did like most everyone else and knew in the back of my head it was BS but then, after a few times of finding out they were even capable of changing the rules and making new ones to fit the situation in their favor and my unfavor I decided to speak up and find out.  I had to learn the hard way tho...to walk lightly with the verbiage/wording I use and how I use it but if I present it calmly and not react I am heard and given the respect to get answers.  It took a while to develop this relationship tho.

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philly115

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#30 [url]

Apr 4 13 2:01 PM

@ way:Yes I am always worried that the state is going to pull something else because of all that's happened to me so far and me not even being stable yet and already experienced all this bs. It really wouldn't surprise me if state didn't require me to get a p&k twice a year just to try and piss me off..

The reason why I'm hoping that I can get to 200 if I need it which I'm pretty sure I do and possibly more is because my doctor said he was going to call the head guy over state that does the approvals. Hopefully by my doctor talking to him about me needing quite a few more increases he will allow it on this peak and trough. It all boils down to what state says and what they want to do.

We don't have to have a peak and trough every 10mgs unless state requests it, or unless the doctor requests it. Here lately state has been making alot of people get a peak and trough every 10mgs, but it's not in writing it just depends on how big of an ass state wants to be. I know my doctor would allow me 40-50 at least on this peak and trough, and he told me that, but in the end state makes the final decision, and the nurses told me yesterday that state has been denying alot of patients increases the past few weeks and only letting them get 10mgs no matter what the levels where. This is the reason why my doctor is calling the state because of what they're doing to me and a few other patients because he was pist and said this isn't right, and that it must be one of those months where they're in a bad mood and just want to do what they want.

I like my clinic with my original doc being there temporarily, but that's what sucks is he's only there temporarily since the other doc I disliked got fired for sexual harassment and not seeing patients. I know things are going to get bad again once my original doc leaves because he's only there temporarily there until we get another one. It's like state doesn't want anyone over 120, but my doctor knows I need it so he's trying to keep me positive and that's why he made sure to tell me he was going to talk to state about me and hopefully help me out.

I've got another callback tmro, and I'm glad me and my brother no longer live together anymore because he attends the clinic as well that I do. The reason why I'm glad we no longer live together is when we get a callback in Tennessee not only do I have to go in, but all members of my household that are on methadone and attend the clinic have to come in for a callback as well. Say that three people live in the same household in Tennessee and all are on methadone @ the same clinic and the rules are in Tennessee that we get a callback once every three months then we would have to come in for a callback 12 times in 12 months and that's because all patients in the same household have to come in when one person has a callback.

The more I think about it Tennessee is ridiculous. Idk if that's a BHG rule or a Tennessee rule, but that's a rule @ my BHG clinic in Tennessee where all members in the household that attend the clinic have to come in for callbacks when anybody has a callback. We also have to call the clinic twice a week to check to see if we have a callback and if we don't call we can loose our carryouts. I've never heard of any state being as bad as Tennessee the more I think about all the rules we have @ my clinic, but the clinic has helped me tremendously, but I've had to jump through hoops to get to where I'm @ and I'm still sick. I really should transfer out of state like way suggested, but I guess I'm just still testing the waters to see what else ridiculous stunts state trys to pull on me. It would be nice if I could get to a stable dose here in Tennessee and not have a to have a peak and trough every 10mgs and be treated like most normal patients in the clinic system.

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philly115

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#31 [url]

Apr 8 13 10:25 AM

Update: Alright I did my peak and trough like the state wanted Wednesday like the state wanted and the results just come in today. My results come back pretty quick which is good. Tmro I'll be seeing the doc to get another increase since my peak and trough come back, and we'll have to send it in to the state again and wait for their approval. My peak and trough was pretty much the same as the last one I had a month and a half ago so the state pretty much made me waste 36$s being an ass..

I knew that with me only getting a 10mg increase that there was no point in state making me get another peak and trough because first off my levels are really low, and they only hive me 10mgs. When u get a peak and trough here in Tennessee they make u come in daily for 4 days and dose in front of the nurses, but for some reason state requested for me to come In daily for 7 days in a row. They made me come in for seven days and face dose versus what everybody else does which is 4 because I'm special yea right. They're just being complicated the state that is.

I'm really hoping that with my doctor calling the state on my behalf and a couple of other things that they'll let me get stabilized off this peak and trough. Hopefully I won't have to get another peak and trough, but I doubt it. I figure I'll probably have to get at least one more if not two. I've already had to get 4 peak and troughs just to get to my dose that I'm @ right now.

I talked to one of my friends family members that are from Louisville,Kentucky and I told em what all I was having to go through and they were stunned. They were @ 260mgs and never had to get a peak and trough and they were in Kentucky. I thought Tennessee was just a little bit stricter than Kentucky, but I was wrong Tennessee is alot stricter than Kentucky. They told me in Kentucky that they're are some clinics that are strict like Tennessee, but they said the bigger clinics like where they attend are really good clinics to attend and they allow patients to get on higher doses if needed.

It makes me realize when I talk to people that attend clinics outside of Tennessee that the grass is greener lol. I'm really glad that I've talked to people on this forum, and other people that attend clinics out of state because if I hadn't then I would've thought all clinics in the U.S., and other places tried to keep patients @ 100mgs or less like they try to do here.

Now I know that other states run clinics good and allow patients to get on doses that they need. I definitely want to check out getting into becoming an advocate here in Tennessee. I'm not trying to run Tennessee down all the time, but I do get upset and disappointed with the way Tennessee MMT is compared to all the other states. I would like to be able to help make a change here in Tennessee. Even if I couldn't make a change I would like to be able to put in my opinions and be able to speak about issues going on here and hopefully have a positive outcome out of it.

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briton32

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#32 [url]

Apr 8 13 1:02 PM

Philly I sure hope you get what you need.. I just gave up and refuse to deal with what it would take to get me where I need to be.. which I guess is sad but heck I had to do a total of 4 methadone blood levels(which is just the trough level) and 1 peak and trough just to get to 120mg back years ago when I was fighting for my increases.. I have my physical on the 26th and I think I will just talk to the doctor about my dose and see what bs I would have to do to get somewhere where I feel decent.. I doubt it goes anywhere though... ugh..

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philly115

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#33 [url]

Apr 8 13 2:07 PM

@ Briton: Yea in order to get past 100mgs in Tennessee u have to get a trough, and then when u hit 120 u have to get a peak and trough. I know once I got to 100mgs I had to get my trough done, and they let me get to 120, then I had to get a peak and trough, and yea then another, and another, and another etc lol well u get the point a lot ugh.. Don't give up Briton I've thought about giving up, but the more I think about it I'm not going to let Tennessee win this battle.

I'm going to keep going until I get stable whether they wanna keep doing a peak and trough every 10mgs or not. They want us to give up and stay @ 100 and below, or 120 and below. TN doesn't like patients being over 100 because as u can tell they make us jump through so many hoops. All I can say Briton is don't give up you'll get to a stable dose eventually, but it might take 10 peak and troughs, but keep fighting and don't let Tennessee win the battle..

I hate it Briton because I swear at least 75% of patients I talk to here in Tennessee are struggling to keep from using because a lot of em can't get over 100mgs because they're trough was too high so Tennessee won't allow them over a 100mgs, and I feel bad for them because I can't tell by looking @ them that they're having really bad withdrawals, and they're COWS scores are through the roof, but yet there's nothing a MMT doc here in Tennessee can do unless their blood work shows their levels are low which is ridiculous. If Tennessee would get out of this "low doses are the best treatment phase" then things would change for the better.

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sapphire76

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#34 [url]

Apr 9 13 5:49 AM

@philly - I admire your staying power. I'm not sure I could have gone through all that for every 10mg increase.

Maybe that's TN's aim? If they put in enough hoops for you to jump through, most people will just give up?
Plus the cost of all the P&T's must put a lot of people off, especially in this economy.

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philly115

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#35 [url]

Apr 9 13 6:26 AM

@ sapphire: That's exactly what I think is they make it almost impossible, and for the ones who's peak and trough #'s are low enough like me they want to make us take one after another until we get disgusted with how much $ we've spent, or just give up from it taking 4 months to get a 30mg increase. I talked to my doc this morning, and I asked him I said well since state made me come 7 days and since we've done cows on me the last 8 days will I have to keep getting peak and troughs every 10mgs?? He said he figured I should at least get 20mgs off this peak and trough no problem because of all that state made me go through. See u only have to come for 4 days here in Tennessee for the peak and trough, but state wanted to make it harder on me and requested I come for 7 days and dose in front of them.

I figure they wanted me to come 7 days to try and make me not want to do the peak and trough, or to make sure that I wasn't cheating and which idk how u would cheat when ur dosing in front of them and staying there for 15 mins after you've dosed because its all absorbed in ur system. These past few days have been good so far because I did my peak and trough Wednesday, and my results were back in time for me to see the doc today which is really quick compared to how long it takes other times. Maybe state will approve my increase by Thursday because that's when I have to go back, and then I can go ahead and Hurry up and get the seven days of dosing in front of the nurses with an increase over with.

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whippy witch

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#36 [url]

Apr 9 13 8:28 AM


My one and only question Philly (hoping you can answer it)  Is the person giving the approval for increases a Doctor with a license to practice Medicine?  If it isn't, the person approving your increases is practicing medicine WITHOUT a license.  I personally find it offensive for a non medical person to determine if someone needs a medication. Which could all be moot if the person is a practicing Doctor.

WW

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philly115

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Posts: 410 Member Since:01/01/13

#37 [url]

Apr 9 13 2:08 PM

@ whippy: Honestly I really can't remember. I know @ one point and time I asked my doctor if the people over the state that approved were doctors or not, and I can't remember if they are or not. I go back to the clinic Thursday and I'll make sure to ask the nurses if they are or not. Honestly I just don't understand why here in Tennessee they don't just take the doctors word because my doctor said I need an increase and I took a peak and trough Wednesday, and he's approved it, but he has to send it to state and wait for them to approve it before I get a increase. It's like they don't trust the doctor but they just have to make things so complicated instead of my doctor having to approve it it has to get approved by another person, and sometimes state will wait a couple weeks before approving it so i's a very long process sometimes to get a 10mg increase.

I'm trying to stay positive though because I like everyone @ my clinic now that my original doc is temporarily back because the other new doc I didn't like got fired. I love everything about my clinic now, but it's just the state that's being complicated now. Some of the employees @ my clinic do have a low dose mindset, but pretty much all of them have come to realize that they see I actually need a higher dose, and they told me that I changed their way of thinking about nobody needing a really high dose by their standards because they see me everyday and they can never tell if I've took my meds or not. I know that some of the employees don't like higher doses because they've seen patients come in messed up because they were on too high of a dose, and I explained to them that my medication methadone just keeps me from being sick, and I'm glad that they've changed their mindset and since they've met me they realize that some patients may need quite a bit more than 120mgs.

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savalast

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Posts: 181 Member Since:02/13/13

#38 [url]

Apr 9 13 2:21 PM

The only time I hear of people having to take a p&t is voluntary. They're on a high dose and can't understand why 200-250 mgs doesn't hold them. When we want an increase, we tell the counselor who calls the doctor on the phone. She'll okay over the phone or ask us to walk down the hall to her office. I live in Pa but go to an MMT in Manhattan NY. Sliding scale fee that covers exams, ua's, everything. I'm only working p/time now so I pay 19.00$ a week. I never heard of p&k's until I came to this forum. Sorry for the way a lot of you are treated. I understand why some prefer to drive a 100 miles to a clinic they like.

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philly115

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Posts: 410 Member Since:01/01/13

#39 [url]

Apr 9 13 2:26 PM

@ savalast: I wish my clinic was like yours it sounds great there. Yea once we get to 100mgs we have to get a trough to go any higher than 100mgs, and once we get to 120mgs we have to get a peak and trough to get any higher than 120, and then they make it hard and sometimes make us get a peak and trough every 10mgs, but sometimes let us get more, but its rare to see anyone over 120mgs here in Tennessee..

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sapphire76

Posts: 3,678 Member Since:02/22/10

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#40 [url]

Apr 10 13 3:00 AM

               I know that some of the employees don't like higher doses because they've seen patients come in messed up because they were on too high of a dose, .

-philly115

That's a shame if they think that Philly, as often it's not methadone that does this. It's people mixing methadone with benzo's/any sedative that get's people all fricked up.

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