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kjacobs84

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Jun 1 13 8:07 AM

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I have been going to a methadone clinic in eastern Wisconsin for about a year and a half. This particular clinic has quite a few scattered through this side of the state as is well known for their strict policies.

Despite their strict policies, and outrageous prices for treatment (I pay $400 a month) I have never had problem with all there little rules because I was serious about recovery. I have never missed a day, never had a dirty UA after the first week, I've made tremendous progress, bought a car, found a great fulltime job, etc. I got along well w my counselor, I'm sure I was an easy patient for her to have as I did everything expected of me

I was on phase 4 and was about to transfer to phase 5 after a callback. Well, as it turns out, I missed my callback on Friday. My counselor said she called and left a mesg in which I had 24 hrs to come in...but I never received the call. Eventually I figured out the problem, they call privately now, which they never used to, and I have an app which blocks all private calls. I'm so frustrated that this happened, Im very responsible with my take homes and would never tamper or sell them so I had no reason to purposely not go in on Friday. but essentially, it is my fault so I was ready to accept my punishment.

Little did I know how extreme it would be! I was put back to phase 1 of going everyday, and not just for a length of time, but for good. I thought maybe a month or so of phase 1 would be appropriate and then back to my normal phase if I was compliant but to make me start completely over? All my progress and complete compliance means nothing after an innocent mistake.

In addition, they took away my privelage of a Sunday dose. I am tapering off and its hard enough to taper when having medication every day but to take away 1 dose per week from me is just cruel!

Next month I'm supposed to be going to the far north woods of Wisconsin for 5days for my sister's wedding. There are no methadone clinics even remotely close and at this point, they want to take away my privelage of bringing enough bottles with me for the trip. So basically I have to choose, either go to the wedding and get kicked out of my program for missing too many days or miss her wedding by staying behind.

I'm so discouraged at this point. I've workes so hard and earned the right to these privelages. instead of feeling like this program is helping my recovery, its more like its hindering me and making me feel like a criminal. I'll be glad once I taper completely off, but until then, this program and the medication have me imprisoned, and they know it too. So they can dole out any punishment they want because what am I going to do? I'm addicted to the meds and the only clinics in this area are all the same company.

Sorry this is so long, I just had to vent. I'm feeling so helpless right now. They've taken away so much. Does this punishment seem fair?
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briton32

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Jun 1 13 8:38 AM

wow.. to make you start over seems a bit extreme.. At my clinic you lose your full takehomes for 30days then you are dropped down a phase for 2weeks.. For me that would drop me from once every 3 weeks to once every 2 once I got done with my 30day punishment

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kjacobs84

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Jun 1 13 2:00 PM

That sounds like a much more appropriate penalty. It's not as though I expected to get off scott-free once I was told I missed the callback, but I didn't expect them to take away completely everything privelage I've earned.

I suffer from horrible anxiety and at times have really wished I could use marijuana but I never gave in. I may as well use it now, they cant punish me much more than they already have! This whole situation makes me want to act up.

How am I supposed to have respect or trust in a counselor who now has a complete lack of trust in me. I no longer feel like she's helping me work towards a positive outcome. Instead its become a sick game about power and punishment.

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wayovermyhead

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Jun 2 13 8:36 AM

WELCOME TO THE DAWG...I hate it is under these circumstances but it is a good place to turn to for support and help in times like these....

What times are we talking?  The "D" times known as degradating, demoralizing, discriminating, debilitating....at the all too familiar times suffered by the patients at the hands of a "therapeutic community".

HMMMM my mind wanders to a specific period of time where mistakes were unacceptable and punishable.....(horn blows, crowd gathers loud voice behind curtain bellows)....LET IT BE KNOWN ON THIS DATE CLIENT (such and such number) a.k.a. KJACOBS84 HAS DEFIED THE RULES AND BROKE THE LAW OF METHADONE CLINIC (such and such name)......HEADS WILL ROLL!!!!! (crowd roars, protest break out amongst the on lookers/hearers)

Look although your humble and accepting attitude is commendable it will more than likely end up not helping you in your approach.  Now in saying that I mean...Be aware and responsive to the fact there are rules that should not be broken but those are the ones that are defiance based and making a mistake is not one of those.  So do not hang your head in shame and let them make you out to be "criminal"......Selling your methadone is one of those.....even refusing to appear for a bottle recall is one of those....but having purchased an app and not realizing the complication it might cause you with your clinic (as this is the only place I could see it being a real problem) is not deserving of all the repercussion you will suffer for this to include but not limited to your takehome exception for your sister's wedding creating such a problem that it could get you booted back into the dangers of illicit drug use and relapse as losing five clinic days (with no takehomes) will result in discharge. 

Although I might get accused of telling you not to accept your guilt and take your punishment like a spoon full of sugar because you did indeed break a rule.  I am only saying the punishment does not fit the crime in this case and I believe this is the "line of defense" you need to use with whomever you must.  Whether that be the director of your clinic or the director of the corporation you need to have your case heard here because like I said the punishment in this case does not fit the crime.  You simply purchased or had an app that created a hardship you are only guilty of not realizing this.  You did not mean nor desire this to happen. 

Immediately approach beginning with the bottom of the chain or command and that is your counselor and the director of your clinic.  Plead the above and ask for favor and consideration/credit in and for your 18 month "compliant" track record.  If this gets you no favorable/workable solution then immediately ask what their appeal and grievance policy is and where you might obtain a form to submit your appeal/grievance....

Make sure you send a copy of this to the home office and SAMHSA and NAMA (maybe even to whomever accredits your facility such as CARF).  I would at the time of denial of consideration ask them who is the accrediting agency and let them know you are filing appeal.  (all of those entities have a form for the grievance policy and procedure if your clinic fails or refuses to oblige you of the form/policy)See the attached.

Patients all to often just accept their fate...some even agree they should lose all their right and favor they have gained in the past etc...Don't be one of those.  Do it for yourself and for the ones behind you that might be considered differently if patients will make way for this by submitting grievances when in your case....
"THE PUNISHMENT DOES NOT FIT THE CRIME" ..........

I hate saying this because I don't believe in any of the punitive/punishment crap as we volunteered for help and we pay for it, but you might suggest they tailor the punishment by allowing your sister's wedding exception be free standing and not associated with this punishment.  And while I was asking I might be inclined to ask that they take your takehomes for an allotted period of 30 to 90 days if they must that way at least giving you some kind of favor for the past compliance.

I hope this helps...please keep us informed and if we can help let us know your concerns You will be very well supported and feel some of that anxiety loosen/lessen if you hang tight with us daily or as time permits.  



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wayovermyhead

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#4 [url]

Jun 2 13 8:38 AM

How am I supposed to have respect or trust in a counselor who now has a complete lack of trust in me. I no longer feel like she's helping me work towards a positive outcome. Instead its become a sick game about power and punishment.

-kjacobs84

Personally this is a rather major eff up on the clinics part evident of the fact they must not want to offer therapeutic environment/community when they placed counselors in charge of doling out punishment.  They often speak of our actions speaking louder than words...Hmmmm.

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wayovermyhead

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Jun 2 13 9:12 AM

I am on a roll as you can see as I get so mad over these "HOT TOPICS"...

I think each clinic not only should and are suppose to have a grievance policy...ot should not end at the directors shut door.  It  should consist of a peer proceswhere some of the older clinic patients be submitted a copy of the grievance and the pleading statement and voice their vote to.  It wouldn't take more than one or two of those in a clinic and even those would be chose by staff but it would equal out the scales of justice as of now there is no lady liberty at all. 

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maronne

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Jun 2 13 1:19 PM

Dear Kjacobs -

I'm sorry to hear about the unfortunate circumstance you're in of going to an unreasonably punishing clinic.  I live in Massachusetts, and my clinic is similar - but WORSE!  For example, the fee is higher than $400 per month ($448).  And the MOST takehomes one can earn is 6 - for a total of coming in weekly.

I've been going there for eight years now, and was demoted from weeklies to coming in twice a week because this clinic's NEW doctor "doesn't agree with the psych meds I'm prescribed."  However, I was told NOT TO CHANGE the prescription - that it wouldn't make any difference - and that I now must get 3 takehomes and then 2 takehomes per week (for a total of 5 per week).  The medication I take - that I've taken since I came in the clinic door - I get verified whenever they request it in writing from my doctor AND I bring in the new prescription each month AND it is NOT a benzo or sedating medication.

Anyway - a few months ago, at my yearly clinic doc appointment, I was made aware that I never brought in one of my rx's during one of the 4 or 5 emergency tooth extractions I had this year (which ended up being true).  So I've lost my takehomes . . . and I've kind of given up.  NOT given up on myself.  But given up on my hopes that being an MMT patient is going to be anything other than having to go every day and be treated like I'm in the criminal system.  (I'm tapering too, and if it gets too bad I guess I'll try suboxone.  However - it's a shame the way things have deteriorated at my clinic over the past 8 years.)


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mas215

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Jun 2 13 4:54 PM

These callbacks seem more a punishment than a prevention.  I've been at my current clinic for almost 10 years, never a dirty u/a.  It was always one callback a year usually the same month eacy year.  A few times I was out of the country (one of the major reasons I get monthlies) and of course they asked for documentation (airline tickets, itinerary).  

Last year I was visiting relatives in Philly and they asked me when I returned to bring a receipt from a local store and a gas station along the way (I drove).  

One callback last year was 3 days before I was due for my monthlies so I had to bring in 3 doses, take one in front of them and leave a u/a. 

Oh and I also pay $425/month.  these callbacks are a giant pain in the you know what but they seem to be the rule almost anywhere you go.


mas

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wayovermyhead

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Jun 2 13 7:03 PM


 (it's a shame the way things have deteriorated at my clinic over the past 8 years.)

-maronne

I haven't even been in the clinic 8 years (only 3) but it doesn't take a rocket scientist to do the mathematics 2 plus 2 equals 4 nor see things are getting worse not better for patients...

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kjacobs84

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Jun 2 13 8:20 PM

I can't tell you all how much I appreciate the replies and hearing your input as I don't really know anyone anymore who would understand this process of recovery while in mmt. They are all friendships I have had to end for my own good. My family is supportive as they can be but I think that they feel judging from the harsh punishment that I must have been caught using or something worse than is actually the truth in this case.

Wayovermyhead, I'm so thankful for your guidance because ill admit, I don't really know my rights as a patient and being able to submit a grievance or even talk with someone higher up than my own counselor. I am definitely going to do that and ill let u know how it goes.

I agree I should be punished to some point but not to the degree I have been.

Maronne, I'm sorry to hear about your situation as it is also so discouraging and unfair. I feel the same exact way and told my counselor as much once I found out I was losing all my privelages. I just don't care any longer. I feel so good about the progress I have made but soon as I walk thru those clinic doors I am upset and feel like I'm looked at as a liar. I care tremendously for myself and my recovery but I could careless anymore about pleasing anyone who runs this program. Its just not worth it to me anymore. I have been so depressed over this whole incident and feeling guilty when I shouldnt. It's entirely too much additional stress to take on while trying to taper and be successful in my recovery.

I'm planning on tapering off sooner than planned. Right now I'm down to 48mgs down from 120 at my highest. I am going down 3mg's every 10 days. At this rate, ill be there another 5 months, I just cant see going there daily another 5months.

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kjacobs84

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Jun 2 13 9:02 PM

one callback a year would be heavenly! This callback I missed was the 5th I had in my 16 months of attending. The other four callbacks I have had I was called from their regular phone number and therefore went in the next morning to take my dose in front of the nurse as well as produce the usual "every 3 months" observed UA for them, which is incredibly difficult when someone is a foot away staring at my privates while I'm trying to force out of it! All the frequency seems a bit excessive now that I read other patients stories.

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wayovermyhead

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Jun 3 13 1:34 AM

I can feel your pain friend...all the way thru my computer.....you feel as close as next door not over a thousand miles away.  I have been there several times...I have a condition brought about I am sure over situational trauma from a pervert uncle who loved to shave or shower etc...when any of us girls (myself and 2 sisters) were in the bathroom on the pot iyswim....For the life of me I can not pee with someone standing there and even worse than that I can't pee on command or knowing someone is outside the door etc....

At first we did not practice observed UA's at my clinic....I will never forget the first time one of the nurses got the cup and this hat looking thing that goes in the toilet and began walking towards the bathroom saying this spill about a new policy and how I was going to have to pee in her presence.....she was going on and on as we were walking down the hall and I couldn't hear a word after the pee in front of me comment because I could hear my heartbeat pounding in my ears and she sounded like that lady on those charlie brown cartoons "whomp, whomp, whomp, whomph".

When she turned to see what my silence was etc...she asked me "are you okay?" as apparently I looked as if I had seen a ghost is what she told the lead nurse when she went and told I had refused to do an observed UA.   Which by the way made me look guilty as if I was panic stricken in fear cause I must have been thinking I was going to be able to fool them with a non observed.  I even admit I might have thought the same thing had I been in her shoes, but I was panic stricken because I knew I was not going to be able to produce any UA at that point.  I use to get spanked too as a child when I would embarrass my mother at the doctors office when they would command a cup of pee as a survivor of sexual abuse I kept urinary track infections and for some reason unbeknownst to me or my mother I would be unable to do....

Finally when the doctor realized it made my mother sooo mad because I would have entered the office in tears and/or cry swollen eyes he put a stop to it and demanded to get to the bottom of why I had issue with it.  He knew at that moment something had traumatized me and it wasn't going to be "stubborn or defiant modesty" as my mother was claiming.  I guess although I don't remember the exact details, my mother was made aware of his thoughts and she did indeed get to the bottom of it all and my uncle one day took an ass whipping by my stepfather and he was gone and I never had to pee in a cup at the doctors office again. 

Anyways this had caused me issue over the years but I, since being that "abused little girl" had never felt this fear and/or shame again at that level until that moment there in the clinic when I had tried to do an observed UA for almost 4 hours, drank gallons of water, cried, tried, plead with the nurse not to go through with her threats "not to dose me" nor "take my weekly takehomes"....like I said I had been going there over 18 months or so and this had never happened because apparently observed UA's were supposed "random" and I had somehow "cheated the system and not ever had one done"...I could not believe how quickly this got out of control....I had went from someone valued at my clinic, liked by pretty much all staff, an example for other patients to being a lying, cheating, defiant, law breaking patient all because of this issue.....

I did lose my takehomes that day but they did dose me in the end and when I went to the bathroom the minute getting written up was over I peed a river and cried a river because I felt so many emotions for that little girl I had almost in time forgotten about because I was finally making favor in life with me, my family and others with my total success in MMT.  This that day almost changed all that too because I left wanting to give up, fearing what was going to happen when my counselor gets involved tomorrow and she hears all this nurse was saying about I must have had something to hide etc....I sat in a parking lot and almost called my Opana dealer thinking I might as well because I would never be able to produce an observed UA and I would probably get kicked out for such....I can take things way out there in my head and heart when old "shit" resurfaces from my past....iyswim.

Thank God I didn't tho, I went home got on my computer thinking someone out there somewhere in some kind of medical or methadone forum would know something and that is how I found this place and a few others....I went online found the forums wrote out my heartfelt defeated panic stricken story and found friends that told me just what to do.  I stayed up all night writing a grievance in detail of my uncle and doctor visits as a child etc...I went in the clinic the next morning at 5 am empowered not defeated anymore....

Short version here (believe it not) my counselor read my grievance sent ,me to window A to get my takehomes then asked me to wait until the director got there he was on his way.  He called the nurse in and she and her supervisor came as she already knew my counsleor was upset with her actions apparently my counselor has to approve loss of privileges etc....He asked them to show him where it states that I was to get such treatment/punishment and they said they had been doing this for years...somehow I had slipped thru the system and had not been asked for one since my admit.  I should have been submitting to a Observed UA once every three months like all the others and my refusal the day before made them question my integrity as a compliant patient.  It ended up being a nurse ten years earlier had enforced this ruling and no one had ever complained or grievanced it they just accepted their fate...my counselor was new about six months in so I was her first to lose my takehomes over it. 

They still do Observed UA;s at my clinic but we are allowed swabs in place of them.  Others that do not complain have to pay 5 dollars to get swabbed...I pay nothing.... O now am a patient advocate at my clinic and I inform them as I had been informed by the various forums I registered on that day I felt so defeated and taunted by old ghost.  Grievances don't always get honored and yours may not but I would say you have an excellent line of defense as I had laid out in an earlier post.  Losing my takehomes was not the problem to me because I drove other patients to the clinic daily anyways but my injured integrity and pride was a problem that day.  The grievance helped me restore that moreso than the benefit of getting my takehomes restored the very next day although I do appreciate that too.  I hope they restore your takehomes etc...but there is also a call to do the grievance that matters more and that is to empower that hurting child I hear in your writings.  The one that needs to be acknowledged for all the effort and accomplishment you have gained in MMT.

Remember your line of defense is acknowledging you accept your part in making the mistake regarding the phone app (I say this grinding my jaw and clinching my teeth because it was truly just a mistake) but the punishment does not fit the crime and especially under these terms and lay out all the phone app, your detoxing already, all the callbacks you have had and compliant behavior you exxhibited in the past....yada, yada, yada.  Good luck and keep us informed. 

@zac...you got any pointers????


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sapphire76

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Jun 3 13 3:52 AM

Hi Kjacobs, and welcome to the Dawg!

Revoking all your TH's and sending you right back to the start does seem a little excessive, I think most places revoke them for 30 days and then send you down a phase?

Does your clinic do this for all people who fail a call back, or have they acted differently for you?

Regarding the observed UA's, most times the reasons that clinics will do them instead of swabs is the cost.

What @Way dd to get round this was to offer to pay some money towards the cost of the swab ($5), as she physically cannot do observed UA's.

Do you think your clinic would be amenable to that?

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Jun 3 13 3:55 AM

    Dear Kjacobs - 
  But given up on my hopes that being an MMT patient is going to be anything other than having to go every day and be treated like I'm in the criminal system.  
   

-maronne

It is a real shame the way things are going isn't it. Things did seem to be getting a little better about 10 years ago, but since then it's been downhill all the way.

I can't get more than weeklies either, no matter how compliant I am, and it really sucks!!

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wren

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Jun 3 13 10:23 AM

I'm trying to think outside the box - is there a reason you blocked private phone numbers - abusive ex or someone stalking you? Include any and all evidence for your case and submit a grievance immediately. Whether or not it is ultimately successful, I guarantee you will fee better for having taken positive action in your own behalf. In fact, just had another idea, how about including character statements from friends, family members, coworkers (IF they know that you are receive MMT of course). Overwhelm this klinik with a glowing picture of your success and detail the numerous ways their extreme over-reaction will HARM you, not help you.

Also, and sorry if I missed this, but is there another clinic you can transfer to? Seems like it would be worth a drive to keep the THs.

-Wren



ps. They are closed Sundays and will deny you a TH? Am I understanding this? That just seems outright illegal, and against even the pretense of decent treatment.

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kjacobs84

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Jun 3 13 3:40 PM

Wren, the reason for blocking private numbers is because unfortunately as I'm sure we all know too well, when you spend years on drugs, you tend to do some major damage to your finances. At this point I'm paying every collector $20 or so and cant give anything more. I was entirely fed up with the calls so I blocked them. My counselor asked how could I possibly not have thought of the possible problems the app could cause me as far as clinic interaction. Well, seeing as they never used to call private, I hadn't thought of it! I suggested they at least alert other patients of their private calls so that they are aware and because I'd hate to see someone else go thru this, but they had no interest in making other patients aware. Most ppl I know don't answer private calls even without an app. Its as if they are intentionally setting a trap!

And yes, that is correct, they are closed on Sundays but refuse to give me a dose for the day until "the doctors orders are in" A Dr whom ive met with a whole 3times maybe! He knows nothing about me. Well except for a past situation when my p&t results came back and were too high for his liking at which point basically accused me of taking more than my actual 90mg dose and that he was willing to bet it was someone from "his" clinic. I was irate! at that point I had wanted to see him because I was concerned about my extreme tiredness and excessive sweat being a side effect of too high a dose. I wanted to get it lowered so why on earth would I be taking additional methadone!? The next closest clinic is 60 miles away. Now that I'm back to going daily, I couldnt drive there and back everyday, plus I work Mon thru Fri, and my office starts at 7am.

Everyone's advice as far as filing a grievance is so helpful. Apparently my counselor will be meeting with the Dr thurs and said she will let me know what is worked out for "my situation", so once I hear from her Friday what they intend to do concerning my future Sunday doses as well as takehomes for my sister's wedding, I will decide what to do from there. I think first ill ask to speak to the director because either way I'm not in agreeance with them about starting over from phase 1. If that doesn't work, then ill file a grievance.

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kjacobs84

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Jun 3 13 3:42 PM

Wren, the reason for blocking private numbers is because unfortunately as I'm sure we all know too well, when you spend years on drugs, you tend to do some major damage to your finances. At this point I'm paying every collector $20 or so and cant give anything more. I was entirely fed up with the calls so I blocked them. My counselor asked how could I possibly not have thought of the possible problems the app could cause me as far as clinic interaction. Well, seeing as they never used to call private, I hadn't thought of it! I suggested they at least alert other patients of their private calls so that they are aware and because I'd hate to see someone else go thru this, but they had no interest in making other patients aware. Most ppl I know don't answer private calls even without an app. Its as if they are intentionally setting a trap!

And yes, that is correct, they are closed on Sundays but refuse to give me a dose for the day until "the doctors orders are in" A Dr whom ive met with a whole 3times maybe! He knows nothing about me. Well except for a past situation when my p&t results came back and were too high for his liking at which point basically accused me of taking more than my actual 90mg dose and that he was willing to bet it was someone from "his" clinic. I was irate! at that point I had wanted to see him because I was concerned about my extreme tiredness and excessive sweat being a side effect of too high a dose. I wanted to get it lowered so why on earth would I be taking additional methadone!? The next closest clinic is 60 miles away. Now that I'm back to going daily, I couldnt drive there and back everyday, plus I work Mon thru Fri, and my office starts at 7am.

Everyone's advice as far as filing a grievance is so helpful. Apparently my counselor will be meeting with the Dr thurs and said she will let me know what is worked out for "my situation", so once I hear from her Friday what they intend to do concerning my future Sunday doses as well as takehomes for my sister's wedding, I will decide what to do from there. I think first ill ask to speak to the director because either way I'm not in agreeance with them about starting over from phase 1. If that doesn't work, then ill file a grievance.

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kjacobs84

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Jun 3 13 3:50 PM

It's always bothered me a little that my counselor is younger than I am, I'm 29 and she must be around 26 or so, plus she's never been an addict and has very little experience in counseling. she isn't even yet certified to be one, she must need to put in so many hours of work in a setting with real patients or...I don't know really how that all works. But...maybe that will work to my advantage in building my case

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kjacobs84

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Jun 3 13 4:08 PM

Thank you Wayovermyhead, it sounds like u have some very similar experiences in life. I went thru much of the same as u a child and pain will never go away. Situations like observed UA's are always sure to make ever emotion I felt as a child resurface. Especially the helpless and vulnerable feeling in the pit of my stomach knowing that this is something I'm being forced to comply with. I think its amazing to have people like yourself, an advocate for others. It's making me take a step back and realize, I do have more power than I think I do. I might not win my grievance case, but you're right, ill feel so much better to know I didn't just lie down and accept it as my fate.

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wayovermyhead

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Jun 3 13 8:45 PM

If I were you I would go ahead and write a letter to the Director and explaining your situation, include your detox and past performances etc...in the body...give it to your counselor or office secretary that will make sure the director and doctor will receive it the day you turn it in and do this before Friday...IN the letter ask if you could be invited on Friday to address your case/appeal with them personally but if not would they accept and read this letter in consideration of your circumstance before making a final decision on your consequence/punishment....

Do not call this letter a grievance or even an appeal call it a letter of defense etc....(although at the very end of this letter you could tell them if they will not give you any favor within your plea here then you would like to file an appeal and/or grievance with the corporate office, SAMHSA and NAMA as you feel the punishment that is being threatened does not fit the crime and due to your detox you are already on shaky ground and now for sure on more of a danger of possible relapse over this being added to your already shaky area due to the emotional and mental impact this all is having on you and your family etc....Tell them you would also like this letter to be placed in your file.....As you feel it is a open and honest approach in asking them to reconsider the harshness of penalty.   

I feel if you do not do this or be allowed to talk to them personally before Friday...your case will go just like cases go when no one shows up in court.  If innocent people fail to show up in court...they lose immediately, no questions asked, no proof even has to be offered or evidenced.  It is imperative if you want to possibly change your circumstance...you must be heard somehow someway before the gavel hits the wood....Once they make a decision on Friday they will not reconsider even with a grievance.  The grievance will just make the home office change it happening to the next guy down the road etc.... Proactive is a must here and I can tell ny your writings you could put it on paper without appearing "rebel" etc...

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Wishing You Best In Love & Life 
wayovermyhead

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