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wayovermyhead

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

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Aug 24 12 7:25 PM

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BELOW YOU WILL FIND GRIEVANCE REPORTS IN SAMPLE FORM


National Alliance for Medication Assisted Recovery

"Just that you people who are involved in advocacy, keep up the work. I have seen
changes come about because of people becoming involved. It is these who are the real heroes
in all this. Without advocacy, changes will not come about within the present system."
Dr. Vincent Dole

HERE IS THE LINK

http://www.methadone.org/grievance_report.html

Grievance Report


     

Is Your Program Punitive?
Fill Out a Grievance Report -- It's Time To Educate Them!

Does Your Program Treat Patients With Dignity?
Fill Out a Compliment Report -- Let Them Know They are Appreciated!

The Grievance Report Project is an ongoing project used to educate the Medication Assisted Treatment (MAT) community about quality treatment. Programs can no longer hide behind a veil of patient confidentiality or call degrading policies quality treatment. The new accreditation organizations will be interested in these reports.

The Dole-Nyswander Program worked because it was a caring program with a sense of community and that is what needs to be brought back to MAT. NAMA Recovery will use the Grievance Report Process to report programs to various agencies for further investigation. This project will not work unless patients themselves tell us about their program. So NAMA Recovery needs you to participate.

Grievance Reports are Not Only for Programs!

A Grievance Report can be filed on any agency, institution, program or professional that does not treat you with common dignity and respect. Here are some examples of Grievance Reports that you can file.

hospital inadequate pain medication
school won't accept methadone patients
family court any involvement because of your medication
probation or
parole officer
have to withdraw from your medication
social worker or
clinical psychologist
have to withdraw from your medication to receive treatment

There are two kinds of grievance reports: a General Report and an Incident Report.

General Report

A General Grievance Report details the situation at a program, service or agency and usually involves their policy. A General Report does not always require investigation or follow up. You are simply reporting the policy or a situation at a program, service, agency, etc. In some instances these policies are discriminatory towards patients. When a policy violates the constitution or law NAMA Recovery will notify any oversight agencies or institutions and begin procedures to end the policy. An example of this kind of General Report would be a homeless shelter that does not allow MAT patients. This is a direct violation of the Americans With Disabilities Act.

When NAMA Recovery has collected several General Grievance Reports about a program an inquiry will be made to confirm if the policy has been changed or not. The program's reply will be shared with the patients that have made the reports and if necessary their will be further investigation. This type of report helps to change policy at your program because it makes program staff re-think policy that may not be doing what was originally intended.

Incident Report

If you are having trouble with your program you can report a specific incident. Incident Reports are for specific problems that you are having with your program right now. Other examples of an Incident Grievance Report include take home medication schedule or dose change, either increase or decrease. Usually patients are having trouble because they do not know program policy, state or federal regulations, or resources that they can use to make the program work for them. NAMA Recovery believes in empowering patients with information that will help them achieve the recovery goals they have set for themselves. By filing an Incident Report you will be assisted in: (1) knowing the regulations that apply, and (2) how to use regulations and "resources" to get a positive result.

Some Incident Grievance Reports are being filed at a critical point. An example of this is the patient that is being disharged from their program. If this is the case after filing the Incident Grievance Report send an email to Claude Hopkins, the Grievance Coordinator. The sooner that Claude Hopkins starts to intervene with a critical issue the more likely your chance at having a positive result.


CONFIDENTIALITY POLICY

All information that is provided will be held strictly confidential in the same manner as the patient protections described in the U.S. Federal Confidentiality Regulations 42 CFR and the Standards for Privacy of Individually Identifiable Health Information (the Privacy Rule) as established by the Department of Health and Human Services (HHS) under the Health Insurance Portability and Accountability Act of 1996 (HIPPA). In order to assist you at the maximum level of follow-up and outcome, we do request certain personal information. However, if you do not want us to disclose your name for any reason, we will honor your wishes.


We offer three ways to obtain and/or file a Grievance Report:

  1. You can print out a Grievance Report and Authorization to Release Information from our website.
    Click Here to go there.

You can download a Grievance Report and Authorization to Release Information in pdf format.
Click below to download:
Grievance Report and Medical Release PDF Logo
Grievance Report PDF Logo
Medical Release PDF Logo

You fill out the online Grievance Report. However we will still need an Authorization to Release Information to speak with a program or many agencies.
Click below to download the Medical Release Form:
Medical Release PDF Logo

To go to the Online Grievance Report  Click Here.

Grievance Reports can be sent to:

Claude Hopkins, RMA CMA, Grievance Coordinator
ch.grievance@methadone.org

Or mailed to:

National Alliance of Medication Assisted Recovery
435 Second Avenue
New York, NY 10010

Or faxed to:
(212) 595-nama/6262


Last Edited By: wayovermyhead Mar 30 14 12:23 PM. Edited 1 time

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ptrsnake13

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Aug 25 12 9:14 AM

Wayover, great grivance post. I know at my clinic in NY there are 80% Spanish speaking people with 1/2 of those speaking no English at all. There's a huge information gap because of that and the program feels it doesn't need to inform us about all the rules and regs.
  Because of this my counselor told me in confidence that out of about 1200 patients, we average about 1 % of grievances a month!
 I'm printing your report and posting it in my program. With Google I think I can print it in Spanish also. I will do this next week.
  I hope all's well with you Way
Pete

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whippy witch

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#3 [url]

Aug 25 12 11:33 AM


Like Cher, we have them available with counselors, in the lobby and we will help you fill them out if you request it.  Allow you use of a computer or help you write it out.  If you are calling the State Advocacy board we give you the number and allow you to use the phone.  The policy is printed on a poster I had made in our lobby. 

WW

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wayovermyhead

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#4 [url]

Aug 26 12 3:54 AM

We offer none of the above at our clinic.  When the medical director ask me to feel out a grievance on those two nurses I ask for a form or layout he looked at me strange and said just write it out I don't need it on a form...But I am thinking the forms should say who all to send them to and I guess by not posting the info you don't have to worry as much about clients even knowing that it can be sent out of the clinic to the methadone authority or samhsa or carf etc...

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mythoughts2

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Posts: 331 Member Since:09/08/11

#5 [url]

Aug 26 12 4:15 AM

Our clinic used tohave a jury trial for greivances with staff and compliant patients on the jury. Now, I don't think the new staff even knows how to file a greivance. Though in all fairness, they work with you on issues so it would be rare that one would need to be filed. Great post, Way! This wil help many people for years to come. It seems that you took the advocacy call seriously and are carrying the torch - great job! :)

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wayovermyhead

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Aug 26 12 4:35 AM

Most clients do not even know we are accredited by CARF or what or who SAMHSA or the State Methadone Authority even is.  I have heard all kind of misconceptions spoken like some people think the doctor who is there one time a week owns the place therefore his practices can not be questioned.  At my clinic rules are never made common knowledge until you break them therefore consequences are not known either.  Medication interactions were not part of admission paperwork until I told what had happened to me when I took a suboxone while I was on 160 milligrams of methadone.  When I ask about their failure to inform clients I was told well the consequence of precip withdrawals might just be a good lesson for someone to not take drugs while on MMT by the lead nurse. 

Sometimes it's not just a client trying to get high or break rules...Like Me, they might take it out of fear I had missed a Saturday clinic day and getting 3 extra emergency takehomes because of a blizzard so all I had to work with is the idea of being sick for 4 days or....taking a suboxone.  Personally I was trying to do the next right thing when I chose to do suboxone instead of Opana;s that I could have gotten just as easy.  THAT NURSE....WHAT A TERRIBLE WAY OF THINKING THAT THE CONSEQUENCE WAS APPROPRIATE.  I was hospitalized 9 days because I was soooo sick I knocked my pancreas and common bile duct into overload and my body reacted haywire plus I busted a vein in my eyeball from throwing up so hard. 

Anyways enuff bitching.  I am trying to get them to allow an orientation group for our clients to be taken after 30 days of MMT when they are not so distracted from their personal pains and issues of USING and/or detoxing.....where the rules and adverse reactions are explained and what to expect can be talked about etc...I am getting mixed support and lack of support from the staff.  I plan to keep trying though.

OFF TOPIC though....I watched that movie Methadonia the other day and I most certainly have mixed feelings about it but I must admit because I do not take benzo's I did not ever really think about this fact....... that clients that were heroin users like to take the two in conjunction because it results in a "high" that feels similar to a heroin high.  IS THIS TRUE or just another lie that the movie seems to have a few of.  I like Steve tho. 

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kylea2

Posts: 553 Member Since:08/09/12

#7 [url]

Aug 26 12 4:39 AM

that old movie methadonia is not how it works here, thats the city look,  i think, we dont act like that here

The KMaN is bAck in MoTiOn,MONY MAKIN MoFo,, no rAgE , Im FReE , nOt A FrEaK..

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scorpiotl

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#8 [url]

Aug 26 12 9:37 AM

that's not how it works...I am prescribed Xanax and have been for over a decade.....It didn't make me feel high at all...It actually made it harder for me to get used to the methadone because I found out later that I needed to have my methadone dose lowered.  Because upon induction the combination of the two really sedated me.  I mean methadone on its own will really sedate you upon the first months of induction  for me it just always seemed to wear off mid-day.....But that movie and the stigma realy is messing up the Clinics for people.....If someone wants to get high they will do it regardless I think@Peter spoke to that the other day....Benzoes  just happen to be involved because alot of us if not all of us are dual diagnosis patients....@Way.....just curious but how long did it take you to recover from incident?

I'm going to change. This is the last of that sort of thing. Now I'm cleaning up and I'm moving on, going straight and choosing life. I'm gonna be just like u

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ptrsnake13

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#9 [url]

Aug 26 12 11:40 AM

Wayover, my experience with xanax is a little different than most I hear. I was prescribed them a few years ago and all it did was make me fall asleep and wake up really mad that I slept the day away. As a long time heroin user in the past, I don't know how people feel a "heroin high" from it. That was the last time I took it because falling asleep for hours in mid-day is scary and to dangerous for even me to play with
Pete

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wayovermyhead

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#10 [url]

Aug 26 12 12:43 PM

@scorp....Well I think it took about three days for me to get over the precips in their severity i.e. the nausea, diarrhea and hot cold chills.  Then another 6 days along with common bile duct surgery to get out of the hospital.  For that pain I would get  2 mgs. dilaudid every two hours because the pancreatic pain and common bile duct pain was so bad and yes it did help because when they would give me the shot the pain would subside but only for an hour or so.  ...I was still getting the 16 methadone pills they gave me every morning.  And I guess I would not have been able to get the shots as often had my clinic doctor not tried to explain to them why my pain was untouchable almost.  Personally I never got out of pain I think if they would have let me just skip the methadone it would have been better but they made me take them. 

It pisses me off as it could have all been avoided had I known the deal but I also have to assume the responsibility that I should have found another solution I guess like going to the hospital when the regular withdrawals got bad enough, but in all honesty I do not believe they would give me my methadone and that was what scared me.  I am flagged at every hospital within 100 miles.  So that scared me that they would not treat me.  They tried not to treat me when I got there by ambulance but thank god that one doctor just happened to pass by my room that understood what I had done....18 hours into the ordeal.  Apparently they were not going to admit me as why else would they keep me in the emergency room 18 hours????

@pete, yeah I have done heroin but never done methadone with benzo's to compare but some of  those methadone clients in the movie were agreeing it was a similar feeling is why I had ask.  I do know there are clients that do like the mixture of the two even though they do not have panic/anxiety disorder or a reason to be on benzo's they brag about it so what is it they like???  The sleeping???  The nodding??? IT REALLY SUCKS THOUGH THAT PEOPLE THAT DO HAVE REASONS NOW ARE HAVING TO CHOOSE BETWEEN THEIR DUAL ISSUES.  Across the board it is wrong therefore if another doc finds the need then they should be allowed to be on both.  PERIOD POINT BLANK. OOPS that's my opinion.

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ptrsnake13

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#11 [url]

Aug 26 12 1:18 PM

Wayover, I think any medication that's prescribed legally for a methadone patient should be allowed. Or do clinics think addicts don't get other diseases? It's crazy
Pete

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scorpiotl

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Posts: 339 Member Since:06/27/12

#12 [url]

Aug 26 12 1:54 PM

Very well stated @pete and @way....man I would that post and I never thought it was you until you said that the other day....
Thank god u r alive.

Scorp

I'm going to change. This is the last of that sort of thing. Now I'm cleaning up and I'm moving on, going straight and choosing life. I'm gonna be just like u

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scorpiotl

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#13 [url]

Aug 26 12 6:19 PM

Man @way you said it beautifully.  My personal fear is that methadone and benzoes for pain or maintenance are done.  Sub is the big money maker and drs, clinic directors etc will shove that down everyone's throats whether they want it or not....my old clinic director told me that ou can't mix sub and Xanax or klonopin,Valium,Ativan etc.....so they r running scared evidently I think that movie methodonia and all the ods have alot to o with it...my counselor toldme that nd I am inclined to agree

S

I'm going to change. This is the last of that sort of thing. Now I'm cleaning up and I'm moving on, going straight and choosing life. I'm gonna be just like u

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wayovermyhead

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#14 [url]

Oct 10 12 4:13 PM

How to submit feedback or resolve a complaint with a CARF-accredited provider

As part of our continuing effort to improve the quality of services of CARF-accredited providers, feedback from consumers, employees, and others is used to strengthen the value of CARF accreditation. Anyone can register feedback about a provider that is accredited by CARF. Remember that it is as important to acknowledge the strengths of a provider as it is to cite its weaknesses.
  • You may summarize your comments or concerns by completing the online contact form. Please include the name of the service provider, its city and state or province, and your own name and complete address so that we may acknowledge your feedback.
  • You may e-mail your comments or concerns to feedback@carf.org. You must include the information requested above.
  • Or you may fax your feedback to:
    (520) 318-1129
  • Or you may mail your feedback on 1 to 3 pages of paper to:
    CARF
    6951 East Southpoint Road
    Tucson, AZ 85756
  • Or you may call toll free (866) 510-2273 or (866) 510-CARF, which is a dedicated telephone line for receiving public feedback during business hours. (Other business calls should continue to be directed to CARF's main number.) The number is TTY-accessible for persons with hearing impairments.
CARF's office hours are 8:00 a.m. to 4:30 p.m. (Mountain Standard Time), Monday through Friday, except holidays.

Tips on resolving a complaint with a provider

In becoming accredited by CARF, a provider demonstrates that it focuses on quality improvement, the best possible outcomes of its services, and customer satisfaction.
However, even the best providers will receive a complaint from time to time. If you have a concern about the services you are receiving, you can take several steps.
First, tell a staff member about your concern and ask who can help you resolve it. A CARF-accredited provider pledges to work hard to resolve concerns about its services.
Then, if you are unable to quickly resolve the concern, ask a staff member to tell you how to use the formal complaint/grievance process. A CARF-accredited provider must have a formal complaint/grievance procedure available to the people it serves and other interested persons.
Finally, if you feel your concern is not resolved through the grievance process, you may want to contact the Protection and Advocacy agency in your state, province, or territory. You might also contact the governmental agency that is responsible for licensing the provider to operate, making referrals, or funding the services.

HERE IS SAMHSA/CSAT

The Federal regulations include provisions for receiving and acting upon patient grievances (42 CFR Part 8.4.(e)). The SAMHSA/CSAT approved accreditation bodies are required to have policies and procedures to respond to complaints from SAMHSA/CSAT, patients, facility staff, and others, within a reasonable period of time but not more than 5 days from the receipt of the complaint. Some accreditation bodies permit complaints to be submitted online. Additionally, in the SAMHSA/CSAT Guidelines for the Accreditation of Opioid Treatment Programs, under Consumer Bill of Rights and Responsibilities (XVI.B.14.g) Complaints and Appeals: All consumers have the right to a fair and efficient process for resolving differences with their health plans, health care providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review. This is an area that the surveying accreditation organization will review. 

dpt.samhsa.gov

nreuter@samhsa.hhs.gov  Email for Nick Reuter at SAMHSA/CSAT

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wayovermyhead

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#17 [url]

Apr 1 14 5:30 AM

I decided to move it out of the "featured topics" area as I went to look for it to give @marone and .....

sapphire76 wrote:
Thanks for posting this Way.

I could not find it back in any of the old post archives....well duh it was right there in the featured area in front of my face on the main forum front [age....lol so I unfeatured it and made it a sticky thread instead....

At the very top of the Original post/thread here there is a "click here for the file attachment" which opens up into a word file I had constructed back in the old forum ...I HATE THAT WE CAN NO LONGER ATTACH FILES LIKE THESE TO OUR POSTS....I have over 2000 pdf files, works and word that I would love to share with the forum when appropriate...Links save space....but not everyone finds this to be as convenient and plus if they want to save it they have to copy and paste it on a blank word document ...and save it on their computer in their docs.....I WANT THAT BACK...THE ATTACHMENT OPTION.....

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Last Edited By: wayovermyhead Apr 1 14 5:41 AM. Edited 1 time.

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kristjen86

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#18 [url]

Apr 25 14 11:04 AM

@way

Hey way!

Well I happen to be one of the folks who have been sent by the Veteran's Administration over to the Methadone Clinic for "pain management" and "substance abuse" but actually the "substance abuse" was from my attempt to stop the pain, but I digress... I have used heroin before as well as other opiates and methadone does not make me feel in any way like I did when I was on heroin. I am prescribed clonazepam and temazepam as well as barbiturates (primidone) and leviteracetam and I don't get "high" at all. I am given my two week take-homes and take every UA that I'm asked to take. I guess because the VA docs have sent my medical files over the doc at the clinic doesn't really care as I had a closed head injury and PTSD from the Army - that is the reason for my taking of seizure/anxiety medications because, well, i have seizures if I don't take it and am not even able to walk without my medication (if I don't take my medication the glutamate is simply too high and the GABBA cannot bring it down but the Leviteracetam allows that to happen so I can actually walk without busting my head open every couple of hours).

I can't speak for other people who take benzodiazepines but I for one do not necessarily want to take them, I just have to because of my condition(s). I am eager to get off of methadone as soon as possible if I could just get the surgery on both of my shoulders and on my shins as well as my left hip but the VA moves slower than the single-payer socialist systems in Canada and the UK, so I think it will be another year or so until I even can get my shoulder scoped (which will only take care of the three little tears, not the two massive ones which need to be repaired with full invasive surgery) but I am taking this one day at a time and am attempting to start Voc Rehab so I can get a decent job which will allow my wife and I to start a family as living off of disability is basically living in complete poverty in which it is almost impossible to take care of yourself much less other people... Anyhow, I'm gonna quit my whining and complaining, I just wanted to comment about the benzo thing...

Sincerely,
Kris

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sapphire76

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

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#19 [url]

Apr 26 14 5:13 AM

Hi Kris, god to see you back. How is everything apart from the pain issues?

In your case, benzodiazepine use is a little different. As a Vet, you have PTSD that is likely to be a little worse than the anxiety that a lot of people take benzo's for. Some of these people do have genuine anxiety, I'm not doubting that, but I think that they would have been better off if their doctor had prescribed them something non addictive and referred them for CBT or other counselling.

Anxiety is kind of like addiction, if you don't change the behaviours that go with it, and just give in to it and practice constant avoidance, the anxiety will never get any better, the pills can't do all the work!

Regarding you coming off the methadone, do you think you could come off it and be OK being abstinent?

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RachetWench

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Posts: 1 Member Since:01/10/17

#20 [url]

Jan 10 17 4:19 AM

Thank you!

I am currently finding that information seems to be the LAST thing the for-profit clinics want to give out. The idea of having an orientation class is AWESOME - I am currently being retaliated against for exactly what you're talking about: asking for copies of any/all of the forms I signed on admittance. I don't plan to do anything with them, but when I find that "implied consent" plays such a big part in an MMT, seeing what I signed and agreed to has become important, especially since I was in full on WD when I arrived at the clinic. That request has me now at odds with my "counselor" who will not speak civilly, will not submit my phase up requests, and will not even condescend to carry on a conversation with me, instead preferring to flag me not to dose to tell me my recovery willpproceedat the pace she decides, "When she gets to it."

I am currently searching for a document that gives specific rules for ALL methadone clinics as my 'program' is not just a little outof conpliance. From having ZERO counseling to being asked to submit unsealed/unidentified urine samples, my clinic has a lot of things to answer for, but I am terrified if I ppasstthemoff they will retaliate more than they already have. My counselor is not truthful when she doses talk to me, and I feel like I am trapped at this place with a methadone habit I did not want and didn't ask for. When I ask about tapering I am told I haven't been on it long enough, and at 100mg (for 4 months) I have wanted to start backing off for a while - I wasvery clear with the staff that I wanted to detox from the hero inand did not want to be a long term methadone user. I have never truly stabilized, but my counselor acts like she has no idea what the side effects are or what the withdrawals are like, either - not sure why II'meven calling her my ccounselor at this point!
Anyway, while I know methadone has saved so many people, I also know that I wanted to use it as a tool to stop using, not to take it on as a new habit. With the clinic staff insisting I haven't yet given them enough money to have them consider letting me off the hamster wheel, I feel trapped and afraid to ask questions or file grievances or anything - i am stuck with a methadone habit I ddon't want, can't afford, and can't get off of. What do I do? I don't know if I can survive the WD and with zero support (aside from my beloved, long suffering husband who attends with me) and a bad case of self destructive depression, where do I go? The clinic takes more than half our income every month and we've had to choose to dose over our house payment to stay well, but when do I get to get off this ride? A grievance will only mmake itworse, I believe.

Any suggestions would be aappreciated. I'ma relative newbie at the methadone 'game' and all I want to do is get clean.

Hope this post isn't too old to jump into!
C~

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