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scrobdobbins

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Jul 23 13 10:09 AM

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Last Edited By: scrobdobbins Mar 10 17 10:41 PM. Edited 2 times

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mythoughts2

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Posts: 331 Member Since:09/08/11

#1 [url]

Jul 23 13 1:44 PM

Why would anyone think this is your fault? We all experience financial woes - especially considering the excessive cost of MMT. And, you have every right to be proactive about your treatment, which any decent provider should consider to be the responsible way to act.

First, fighting best practices and regulations are difficult. Clinics can be more restrictive than regulations, which are not laws. And, only clinics that are decent and fair care if they follow best practices. The way to fight them is by their own policy.

I think the most valid points are:

1.) You do not have to taper until you cannot pay. It doesn't matter whether they feel that you are in financial trouble and inability to pay is eminent. You are able to pay daily, and they cannot say for sure  that next week you will be unable to pay each day.

2.) You have EVERY LEGAL RIGHT to have the doctor's orders IN WRITING. You are not required to accept a verbal order from anyone else. Ask them for a written copy of this order 'for your records', and because your physician wants it in writing so that if something happens to you during this inhumane taper they know the speed and rate of the taper, as well as have written proof for their files.

3.) Be sure to point out the clinics own policy regarding a 4 day taper for fighting. You should not be penalized for inability to pay.

4.) As you noted, an ethical taper should be based on dosage and percentage. Asking you to taper 25% daily is insane, and it is unethical to not consider dosage when planning a taper.


Do you have any medical conditions?  High blood pressure? Seizure activity? Heart issues? Anything that could be exasperated by this taper? If so, certainly mention his to the doctor and maybe get a letter from a doctor stating that a fast taper in not advisable.

Also ask him if he can provide you with prescriptions for anything that may help. Ask if they can transfer you to a clinic that is sliding scale or help you apply for Medicaid.

Lastly, be sure to save any emails you have from  methadone authorizes stating that this is not acceptable, and that they are required to provide a humane taper. Mention who you spoke to by name if you were told this by phone. Make sure the doctor knows that you do not want to be difficult, but are trying to be proactive about your health, which is why you stopped using and  got on MMT. Explain that you only want a fair and humane taper, and that you do not think it is unreasonable to request a copy of this order in writing.

Good luck - let us know how it goes:)


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mythoughts2

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#2 [url]

Jul 23 13 1:46 PM

Whenever a dosage change is made - increase, decrease, taper, take home level change, etc...an order is handed to the nurse from the ordering physician. The order for your taper should either be in writing or in their computer system. Nothing is done verbally. Again, request a copy of the order for the taper. Then you'll know whether the doctor ordered this or the nurse is BSing you.

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wayovermyhead

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Jul 23 13 4:26 PM


At ur earliest convenience and hopefully tonight (I will  check back off and on to see if you have PM'ed me) I need to know where you are located in NC...I am in Question thinking this is possible a Crossroads facility as they have become very money hungry and are buying clinics left and right and forcing their barbaric practices on MMT patients from all over the Stare.... (no offense if someone attneds Crossroads and fond this to be a good clinic if so I would like to know which one in hopes to give me hopes for them) The reason I ask is we do have several NC Clinics that will do the 30 day $1.00 a day transfer....Mine does not offer that but they will offer compliant patients a fee contract (to be paid back by yada date or detox) or 21 to 30 day Administrative detox etc....

4 days is ludicrous, barbaric and unethical as hell..... the last 40 milligrams is the hardest part of any detox....when you get down to 10 milligrams this should be done no more than 1 milligram a day...

SadLy enough Federal guidelines are that guidelines and altho some of them can't be broken like induction process the detox guidelines can be deviated....they demand a patient be started on no more than 30 to 40 milligrams but only suggest a 30 day detox...IMAGINE THAT?  I am hoping these new drafted guidelines might be a little clearer but so far from what I have read they are still not clear about anything being mandatory or much better yet....It is 130 pages long

I will attach the NC State Methadone Authority Rules/Guidelines below but page 78 this is what it states:  (i) Client Discharge Restrictions. No client shall be discharged from the facility while physically dependent upon methadone or other medications approved for use in opioid treatment unless the client is provided the opportunity to detoxify from the drug.

I just lost a wonderful fact filled reply to your post...In fact I typed this 2 page response to you and lost it in submitting it somewhere I could cry so I think it would be best of you could pm me a way I can call you asap and help you look into best things to do tomorrow.

I would try pleading with the doc to return you to 40 milligrams immediately as you are feeling the effects....If he does not seem responsive I would then tell him to expect you to file a grievance with several agencies and have a MMT advocate awaiting your call to assist you in doing the same.  And I will assist you...

I have a shorter physician guide TIP 43 that is easier to show him It was printed by SAMSHA just for doctors to have and reference...I am also attaching the the NC Medical Board Grievance form along with CARF (the accrediting agency)  These two are the two most threatening ones for the doctor as the NC Board takes all filed complaint serious and investigates and CARF is who holds the key to their being accredited or not.   The I would also throw in filing complaints with SAMHSA and NAMA....ALL OF THESE WILL BE ATTACHED TO THIS POST/REPLY...








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wayovermyhead

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#7 [url]

Jul 23 13 4:42 PM

@mythoughts thank you so much for your quick response to our new member in distress.  Your post of course as usual were right on time and full of facts and reason/rationale...I feel terrible that I just saw this  not but an hour ago or I would have responded back so much quicker and been on it all day to help out here. 

This being my State too I feel shamed that any clinic would act this way as we are not usually noted as one of the worst clinic States...

@scrob...It makes me wonder what they got up their butt..iyswim I tend to believe they might not think you being 'In Need" because of 40 milligrams is not considered a blocking dose but some patients do fine on this and it amazes me that they like to keep our doses low but when we decide ourselves they think we still are using and keeping it low to still get high on illicits or we don't need to be on it at all if we can maintain on 40 milligrams....Damned if you do damned if you don't....But trust me it is something they have up their sleeve or they have made a judgment about....I tend to believe it is the director lady is a control freak and got her toes stepped on and has it out for you now....

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wayovermyhead

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#8 [url]

Jul 23 13 4:47 PM

I did not see the update until after I posted the above....That is sounding better...atleast some hope...... but like I said I will help too...you let me know by PM your specifics and I will look into the clinic and the doctor etc....I will assist you in grievances etc....

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wayovermyhead

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#9 [url]

Jul 23 13 4:55 PM

I would REALLY love to be able to be in a position to advocate for other patients in North Carolina.  I'm not sure how something like that would work, but I feel like there is a need for a way to get disputes resolved quicker, and would love to provide input to legislatures as to what changes could be made to the regulations to make opioid treatment even better.  I'm not sure if there are any such groups already in NC, or if they are taken seriously, but it's something that I feel VERY strongly about, as MMT has saved my life.. and I worry about those who were less informed of their rights that were just tossed out because they had no one advocating for them.

-scrobdobbins

We have the NAMA Abby Coulter and she can assist you in this....
http://atwatchdog.lefora.com/members/abby/

Abby Rakosi Coulter
Director ~ Methadone Patient Advocate
NAMA Recovery of West Virginia
www.facebook.com/NAMARecoveryTNWV
WVDirector@methadone.org


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sapphire76

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#11 [url]

Jul 24 13 5:03 AM

Hi Scrobdobbins and welcome to the Dawg. Sorry to meet you in such stressful circumstances.

As far as NAMA goes, they don't have an advocate specifically for NC, so speaking to Abby would be your best bet.

If you want to get involved in advocacy, and the fact that NAMA don't have a specific advocate for NC, seems like a perfect storm!!

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mythoughts2

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#12 [url]

Jul 24 13 6:33 AM

You can refer the doctor to SAMSHA'a website were the TIP guides (each guide is about a certain aspect of care) can be obtained FOR FREE. If he is interested or wants to back it up, there's his reference.

Thanks Way.  I used to be the Northern CA Director of ARM and I'm sure Asilek can vouch for me but I used to be very involved in advocacy about 7 years ago. I had some health issues that slowed me down as far as going to conferences and putting my face out there, but I'm ALWAYS available to assist members in need. :)

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wayovermyhead

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#13 [url]

Jul 24 13 8:33 AM

yes Abby helps everybody what a wonderful woman she is I would contact her immediately....I will now go back and read the rest of the response but I wanted to add that u might want to contact her asap in case you need to now

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wayovermyhead

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#14 [url]

Jul 24 13 8:38 AM

We are all sitting on tacks waiting to hear from you...so get back with us soon let us know how this went...I sent you a PM of 6 clinics with 30 miles of you...I bet you could find a clinic that would do the $1.00 a day for 30 days transfer bonus bad thing is I know Crossroads will do it and I am sure from the way you speak your clinic is crossroads....

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mythoughts2

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#16 [url]

Jul 24 13 6:33 PM

You have already returned the favor by posting the issues that you've faced. Others can see the way we are treated, and maybe those that are too shy to post can get some ideas on how to resolve their clinic issues. :)

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mythoughts2

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#17 [url]

Jul 24 13 6:34 PM

BTW, I don't believe for a minute that it was an error, and I do think they will 'have your number' now. I knew that as soon as you asked to have a copy of the order in writing things would change. Even if the doctor had ordered the taper at that fast rate, he likely wouldn't cop to it on paper because if you died, he would be up shit's creek.

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wayovermyhead

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#18 [url]

Jul 24 13 8:06 PM

You have already returned the favor by posting the issues that you've faced. Others can see the way we are treated, and maybe those that are too shy to post can get some ideas on how to resolve their clinic issues. :)

-mythoughts2

BTW, I don't believe for a minute that it was an error, and I do think they will 'have your number' now. I knew that as soon as you asked to have a copy of the order in writing things would change. Even if the doctor had ordered the taper at that fast rate, he likely wouldn't cop to it on paper because if you died, he would be up shit's creek.

-mythoughts2


Amen @mythoughts and @scrob you get in touch with me and I will call some of the local clinics as an advocate and see of I can't get any transfer fee waived etc....to get you transferred.  You have no idea how you just made a great stride in the MMT population and it will help others begin to stand up where need be...  Thanking You immensely...

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wayovermyhead

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