I have been going to the methadone clinic for a week now. There are some in my family that are okay with it and some that are not. I would like for anyone who has been or is currently on methadone (through a clinic) about their experiences....Did it help ir did you regret ever taking it? So far for me it is working really good. Its like a xanax that doesnt make you fall asleep. I feel very relaxed and normal. But some people like my mom doesnt understand why you would take one drug to get off of another and I guess its a good question. I know that this methadone has stopped my cravings to want to et high and it lasts ALL day long. I know if I get off of methadone before I get done with my therapy and fix whatever it is inside of me that makes me run to drugs that I would just find another drug to do and Im sure the next one will be illegal and more expensive. BUt I would love to hear some pro and con stories of poeple who have or are on methadone.
Well, I am not an expert on methadone nor have I ever used it so I do know a story I can tell you of a old friend of mine.
I would take her to this clinic in Denver to get a dose of methadone. However in her case she would only go there when she couldn't obtain heroin. It in her case was a substitute for her drug.
If it is stopping you from illegal drug use and you are doing good things on it then it couldn't be all that bad. Ask what is the reprecusions of it find out everything you can on its side effects. Are you going to use it to quit your current problems with addiction or is it just a crutch for you. Honestly if the benefit if to become sober without drug use at all then the power in it is good. Are you going to be addicted to it? Ask a physician and seek the truth in everything you put in your body.
I am honestly NOT using this as a crutch and yes methadone is addicting and I will become addicted but they will taper me down and wean me off slowly. I want to use the time i have now that is freed up becasue im not out searching and looking for drugs or money to get drugs instead I want to go to my NA meetings and my outpatient rehab, continue at the clininc and see my psych doctor and see my therapist I think between all of them we can find out and fix whats wrong with me and why i run to drugs and have between constantly addicted. Once Im fixed I wll start coming off the methadone, if i come off of it before im ready and before im fixed i will just find something else to get high on and that would put me, my family, my kids and my freedom in jeapordy so id rather go everyday and do it legally until I can fix myself and be notmal again.
Im2-
I also have only known those on methadone who used in conjunction with other drugs they were using. Obviously it has its place in recovery process, but you should really research this thoroughly.
I've just witnessed firsthand the withdrawal from narcotics used by a person who abused not in the form which he took the medication but in the amount taken which was more then what was prescribed. Altho the withdrawal was actually worse then heroin withdrawals I've seen it is over, the worse part physically lasted about 6 days, tho of course there are some residual symptoms because he'd been on them about 4 years, but now he can move on, deal with whatever lingering effects that are still around because he feels stronger both physically and mentally.
I think you should absolutely get all the counseling and therapy you can get, that is all great and helpful. But I'm not sure that you should continue to go from one addiction to another as you have a history of doing (i.e. crack, Lortabs).
Seems like there was more going on with the Lortabs then you had initially posted about a few weeks ago, why did you not disclose all that information then about forging prescriptions? And if you hadn't yet forged the scripts back then you still knew this was certainly getting beyond your control and that was the direction you were headed. I didn't realize that your Lortab use had gotten so quickly out of hand unless I missed something somewhere thru the posts. Please be up front here so support and advice can be given in the most helpful way for you.
Again, research, read and learn.
Best wishes to you.
Lucy
I have been going to the methadone clinic for a week now. There are some in my family that are okay with it and some that are not. I would like for anyone who has been or is currently on methadone (through a clinic) about their experiences....Did it help ir did you regret ever taking it? So far for me it is working really good. Its like a xanax that doesnt make you fall asleep. I feel very relaxed and normal. But some people like my mom doesnt understand why you would take one drug to get off of another and I guess its a good question. I know that this methadone has stopped my cravings to want to et high and it lasts ALL day long. I know if I get off of methadone before I get done with my therapy and fix whatever it is inside of me that makes me run to drugs that I would just find another drug to do and Im sure the next one will be illegal and more expensive. BUt I would love to hear some pro and con stories of poeple who have or are on methadone.
Well, I, for one, am happy to see this....why?
I'm gonna tell ya why and be honest about it....
I'm going to tell you why I posted the question I did,
on your other thread...and be honest about that as well
Trust me when I tell you Im2,
nothing I'm about to say is meant to
hurt you, put you down, belittle you..etc.
For the same reason I posted what I did,
before you left and came back...
are the same reasons for anything I post now.
From one addict to another, It's for your own good.
I asked the ??? I did cause
I wanted to see if you'd be honest.
The info you posted on *Opinions please*
was misleading...which made it very alarming,
the reason why I asked Gene to delete my *thumbs up*
I had previously posted on the thread.
Have they placed you in a program yet...they should of
If so, if you were honest about the length of time
you gave for your Lortab addiction...
you should be in Short term detoxification..
being on Methadone no more then 30 days.
Im2sweet4u1983 wrote:
I know if I get off of methadone before I get done with my therapy and fix whatever it is inside of me that makes me run to drugs that I would just find another drug to do
The Methadone programs, run from the Methadone Clinics,
are strictly guided by the Federal Government,
having been taken away from the FDA and now
under the supervision of HHS, Health and Human Services.
You do not dictate your treatment plan in any way, shape or form.
Your history and situation determines the help you will receive.
So, you need to know right now,
your not going to be on Methadone,
until you feel you've got your sh!t together.
First of all, Methadone can not do that for you,
nor is that what it's doing for you now.
It's helping you to be void of the Lortab withdrawals,
It will last all day long, it starts storing itself
the moment you start taking it and guess what,
because it will remain stored in your body for months
after the Methadone withdrawals you'll go through,
you'll have those after effects to deal with..
depression, lack of motivation, inability to sleep, are just a few
which, I'd like to jump over to for a moment.
You stated
Im2sweet4u1983 wrote:
I am honestly NOT using this as a crutch
Either your lying or not being honest with yourself
Your using the Methadone as a crutch to not have to deal
with the consequences from getting hooked on the Lortabs
You could have easily weaned yourself off the Lortabs
instead of turning to yet, another drug...The WORST one I might add
Your running yourself through vicious circles my friend,
and, no matter what you turn to, you will not get away from yourself.
Im2sweet4u1983 wrote:
I know if I get off of methadone before I get done with my therapy and fix whatever it is inside of me that makes me run to drugs that I would just find another drug to do
lucyb wrote:
Please be up front here so support and advice can be given in the most helpful way for you.
This is what you need to look at and be honest about.
It doesn't have to do with crack or Lortabs or Methadone,
it has to do with you and your willingness to continue using.
Stop blaming using on these problems you think you use to get away from.
IMO, If you had no problems, you'd use anyway.
And, since life is full of problems, there is no escaping that,
you need to decide what it is your going to do.
No amount of therapy, intervention or substitutions,
can do for you, what can only come from within you.
The desire to stop using and the willingness to do it.
If your not there, your not there BUT, being honest about that
will get you on the road to recovery faster, then not.
Peace & Strength,
Lynn
_________________ If you can not stand for something, you will fall for everything
I plan on gettng the strength, knowledge and ability to not use again by going throu therapy and mettings and etc...I wasnt hones in my first thread because I didnt want everyone to know I was forging scripts, it was embarassins. As for the length of time I was on the lortabs I was honest with them and when I met with my counselor friday Iasked him how long he thought my treatment would be and he said he had to finish is psych assessment and then hed know a little more but he said that there are wuite a few pepople who have to stay on for the reat of their lives and not becaue of the length of time they were getting high but because of who they are which was revelaed in their psych assessment and they give you a plan from there. They said it is under my control at the moment I can stop if I want or I can increase my own dose by 5 mg every other day until I reach 100 mg. I WANT to get better. Finally i actually want to. getting caught forgining those scripts made my heart stop and my usage of pills but the wihdrawls were he|l I was taking HUGE amounts of pills a day so I found the clinic tohelp me through getting my life togeyjer. If i stop this clinic before i ger "fixed" then it will just be another drug and I know it, Id rater it be this one its at least legal and I cant get in trouble for it. so yeah maybe I am using it as a crutch to get over this rocly part of my life but soon the path will be straight and I can walk on my own without any crutch
I plan on gettng the strength, knowledge and ability to not use again by going throu therapy and mettings and etc...I wasnt hones in my first thread because I didnt want everyone to know I was forging scripts, it was embarassins. As for the length of time I was on the lortabs I was honest with them and when I met with my counselor friday Iasked him how long he thought my treatment would be and he said he had to finish is psych assessment and then hed know a little more but he said that there are wuite a few pepople who have to stay on for the reat of their lives and not becaue of the length of time they were getting high but because of who they are which was revelaed in their psych assessment and they give you a plan from there. They said it is under my control at the moment I can stop if I want or I can increase my own dose by 5 mg every other day until I reach 100 mg. I WANT to get better. Finally i actually want to. getting caught forgining those scripts made my heart stop and my usage of pills but the wihdrawls were he|l I was taking HUGE amounts of pills a day so I found the clinic tohelp me through getting my life togeyjer. If i stop this clinic before i ger "fixed" then it will just be another drug and I know it, Id rater it be this one its at least legal and I cant get in trouble for it. so yeah maybe I am using it as a crutch to get over this rocly part of my life but soon the path will be straight and I can walk on my own without any crutch
Darling, I can't speak for anyone else but,
do you think I didn't know you were forging your scripts,
or using countless Doctors to obtain scripts to get Lortabs?
Yes, you can up your dose so much each day up to xx amount,
cause only you know when the current dose isn't stopping those Lortab withdrawals anymore..but, let me tell you something,
those people are also trained to know, at about what time
your current level isn't working and you should be asking for an increase, they are watching you
You my friend, WILL NOT BE in any extended program over a 2 month Lortab addiction....
I have obtained the most updated and finalized copy of
the Methadone Clinic guidelines, mandated, revised
and finalized in 2006.
It is not called the Methadone Clinic Guidelines but,
I want to give as least amount of info so it is harder to find. I know what steps you should have been through
and what steps are next, unless you meet the requirements set forth, you CAN NOT enter any long term Methadone programs.
Your problem wasn't Heroine, it was crack.
Your problem wasn't Heroine, it was Lortabs.
You weren't addicted to Lortabs all that long before getting caught.
But, then again, I really don't know what you've been honest about, now do I.
That's why you would always say..YOU DON"T KNOW ME, NO MATTER WHAT YOU READ, YOU DON'T KNOW ME.
Well, I knew enough to peg it last time, and again, this time.
You can't bullshit another addict, especially one
whose been using on and off for almost as long as you've been alive.
Again, wanting to quit using drugs isn't something
you obtain the strength for through therapy, meetings, etc..
IT COMES FROM WITHIN YOU.
You don't LEARN the WILLINGNESS to stop using,
you feel the DESIRE to WANT to stop,
then are WILLING to do so.
Peace, Strength & Luck,
Lynn
_________________ If you can not stand for something, you will fall for everything
Im2-
Here is alternative to methadone, you should check out this info at
buprenorphine.samhsa.gov
Again, this is trading one substance for another but this medication was designed specifically for narcotic withdrawal and is worth taking a look at.
It is for the physical sx of withdrawal.
At the clinic I go to Lynn they dont just go on how long yove been taking your current drug of choice they look at how long you have been addicted to drugs in general. My counselor and I have had meetings and Ive asked him how long he thinks I should stay on the methadone and he said that is completely up to me. As for raising doses its not that easy anymore and I have not and do not plan on increasing my dose thats a promise I made to myself. I am an adddict and not to one specific drug just to drugs in general. If I were to get off the methadone now before I successfuly completed my rehab and counseling and find out what it is that I use drugs to numb and try to keep deep inside of me then I will just find another drug to do. My counselor and I have talked and he knows my treatment plan and how I want to go about things and he says its up to me and I can do it how I wanted to. So thanks for worrying about them cutting me off but Ive talked to my counselor and I know whats going to happen with my treatment at the clinic, at the rehab, and at my therapy.
Lucy yes I have heard of and researched the suboxone and it is too expensive for me to afford and there are only 4 doctors in my area who prescribe it and can only have 30 patients at a time so theres like a waiting list. I wish I could afford it but I cant. Ive called the Doctors and they dont take my insurance and the initital visit is $500 and the medication works out to be about $6 a pill.....
At the clinic I go to Lynn they dont just go on how long yove been taking your current drug of choice they look at how long you have been addicted to drugs in general. My counselor and I have had meetings and Ive asked him how long he thinks I should stay on the methadone and he said that is completely up to me. As for raising doses its not that easy anymore and I have not and do not plan on increasing my dose thats a promise I made to myself. I am an adddict and not to one specific drug just to drugs in general. If I were to get off the methadone now before I successfuly completed my rehab and counseling and find out what it is that I use drugs to numb and try to keep deep inside of me then I will just find another drug to do. My counselor and I have talked and he knows my treatment plan and how I want to go about things and he says its up to me and I can do it how I wanted to. So thanks for worrying about them cutting me off but Ive talked to my counselor and I know whats going to happen with my treatment at the clinic, at the rehab, and at my therapy.
§ 8.12 Federal opioid treatment standards.
(a) General. OTPs must provide treatment
in accordance with the standards
in this section and must comply with
these standards as a condition of certification.
(b) Administrative and organizational
structure. An OTP’s organizational
structure and facilities shall be adequate
to ensure quality patient care
and to meet the requirements of all
pertinent Federal, State, and local
laws and regulations. At a minimum,
each OTP shall formally designate a
program sponsor and medical director.
The program sponsor shall agree on behalf
of the OTP to adhere to all requirements
set forth in this part and
any regulations regarding the use of
opioid agonist treatment medications
in the treatment of opioid addiction
which may be promulgated in the future.
The medical director shall assume
responsibility for administering
all medical services performed by the
OTP. In addition, the medical director
shall be responsible for ensuring that
the OTP is in compliance with all applicable
Federal, State, and local laws
and regulations.
(c) Continuous quality improvement. (1)
An OTP must maintain current quality
assurance and quality control plans
that include, among other things, annual
reviews of program policies and
procedures and ongoing assessment of
patient outcomes.
(2) An OTP must maintain a current
‘‘Diversion Control Plan’’ or ‘‘DCP’’ as
part of its quality assurance program
that contains specific measures to reduce
the possibility of diversion of controlled
substances from legitimate
treatment use and that assigns specific
responsibility to the medical and administrative
staff of the OTP for carrying
out the diversion control measures
and functions described in the
DCP.
(d) Staff credentials. Each person engaged
in the treatment of opioid addiction
must have sufficient education,
training, and experience, or any combination
thereof, to enable that person
to perform the assigned functions. All
physicians, nurses, and other licensed
professional care providers, including
addiction counselors, must comply
with the credentialing requirements of
their respective professions.
(e) Patient admission criteria.—(1)
Maintenance treatment. An OTP shall
maintain current procedures designed
to ensure that patients are admitted to
maintenance treatment by qualified
personnel who have determined, using
accepted medical criteria such as those
listed in the Diagnostic and Statistical
Manual for Mental Disorders (DSM-IV),
that the person is currently addicted to
an opioid drug, and that the person became
addicted at least 1 year before admission
for treatment. In addition, a
program physician shall ensure that
each patient voluntarily chooses maintenance
treatment and that all relevant
facts concerning the use of the
opioid drug are clearly and adequately
explained to the patient, and that each
patient provides informed written consent
to treatment.
(2) Maintenance treatment for persons
under age 18. A person under 18
years of age is required to have had
two documented unsuccessful attempts
at short-term detoxification or drugfree
treatment within a 12-month period
to be eligible for maintenance
treatment. No person under 18 years of
age may be admitted to maintenance
treatment unless a parent, legal guardian,
or responsible adult designated by
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§ 8.12 42 CFR Ch. I (10–1–06 Edition)
the relevant State authority consents
in writing to such treatment.
(3) Maintenance treatment admission
exceptions. If clinically appropriate,
the program physician may waive the
requirement of a 1-year history of addiction
under paragraph (e)(1) of this
section, for patients released from
penal institutions (within 6 months
after release), for pregnant patients
(program physician must certify pregnancy),
and for previously treated patients
(up to 2 years after discharge).
(4) Detoxification treatment. An OTP
shall maintain current procedures that
are designed to ensure that patients
are admitted to short- or long-term detoxification
treatment by qualified
personnel, such as a program physician,
who determines that such treatment
is appropriate for the specific patient
by applying established diagnostic
criteria. Patients with two or
more unsuccessful detoxification episodes
within a 12-month period must be
assessed by the OTP physician for
other forms of treatment. A program
shall not admit a patient for more than
two detoxification treatment episodes
in one year.
(f) Required services.—(1) General.
OTPs shall provide adequate medical,
counseling, vocational, educational,
and other assessment and treatment
services. These services must be available
at the primary facility, except
where the program sponsor has entered
into a formal, documented agreement
with a private or public agency, organization,
practitioner, or institution to
provide these services to patients enrolled
in the OTP. The program sponsor,
in any event, must be able to document
that these services are fully and
reasonably available to patients.
(2) Initial medical examination services.
OTPs shall require each patient to
undergo a complete, fully documented
physical evaluation by a program physician
or a primary care physician, or
an authorized healthcare professional
under the supervision of a program
physician, before admission to the
OTP. The full medical examination, including
the results of serology and
other tests, must be completed within
14 days following admission.
(3) Special services for pregnant patients.
OTPs must maintain current
policies and procedures that reflect the
special needs of patients who are pregnant.
Prenatal care and other gender
specific services or pregnant patients
must be provided either by the OTP or
by referral to appropriate healthcare
providers.
(4) Initial and periodic assessment
services. Each patient accepted for
treatment at an OTP shall be assessed
initially and periodically by qualified
personnel to determine the most appropriate
combination of services and
treatment. The initial assessment
must include preparation of a treatment
plan that includes the patient’s
short-term goals and the tasks the patient
must perform to complete the
short-term goals; the patient’s requirements
for education, vocational rehabilitation,
and employment; and the
medical, psychosocial, economic, legal,
or other supportive services that a patient
needs. The treatment plan also
must identify the frequency with which
these services are to be provided. The
plan must be reviewed and updated to
reflect that patient’s personal history,
his or her current needs for medical,
social, and psychological services, and
his or her current needs for education,
vocational rehabilitation, and employment
services.
(5) Counseling services. (i) OTPs must
provide adequate substance abuse
counseling to each patient as clinically
necessary. This counseling shall be provided
by a program counselor, qualified
by education, training, or experience to
assess the psychological and sociological
background of patients, to contribute
to the appropriate treatment
plan for the patient and to monitor patient
progress.
(ii) OTPs must provide counseling on
preventing exposure to, and the transmission
of, human immunodeficiency
virus (HIV) disease for each patient admitted
or readmitted to maintenance
or detoxification treatment.
(iii) OTPs must provide directly, or
through referral to adequate and reasonably
accessible community resources,
vocational rehabilitation, education,
and employment services for
patients who either request such services
or who have been determined by
the program staff to be in need of such
services.
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67
Public Health Service, HHS § 8.12
(6) Drug abuse testing services. OTPs
must provide adequate testing or analysis
for drugs of abuse, including at
least eight random drug abuse tests per
year, per patient in maintenance treatment,
in accordance with generally accepted
clinical practice. For patients
in short-term detoxification treatment,
the OTP shall perform at least
one initial drug abuse test. For patients
receiving long-term detoxification
treatment, the program shall perform
initial and monthly random tests
on each patient.
(g) Recordkeeping and patient confidentiality.
(1) OTPs shall establish and
maintain a recordkeeping system that
is adequate to document and monitor
patient care. This system is required to
comply with all Federal and State reporting
requirements relevant to
opioid drugs approved for use in treatment
of opioid addiction. All records
are required to be kept confidential in
accordance with all applicable Federal
and State requirements.
(2) OTPs shall include, as an essential
part of the recordkeeping system, documentation
in each patient’s record
that the OTP made a good faith effort
to review whether or not the patient is
enrolled any other OTP. A patient enrolled
in an OTP shall not be permitted
to obtain treatment in any other OTP
except in exceptional circumstances. If
the medical director or program physician
of the OTP in which the patient is
enrolled determines that such exceptional
circumstances exist, the patient
may be granted permission to seek
treatment at another OTP, provided
the justification for finding exceptional
circumstances is noted in the
patient’s record both at the OTP in
which the patient is enrolled and at the
OTP that will provide the treatment.
(h) Medication administration, dispensing,
and use. (1) OTPs must ensure
that opioid agonist treatment medications
are administered or dispensed
only by a practitioner licensed under
the appropriate State law and registered
under the appropriate State and
Federal laws to administer or dispense
opioid drugs, or by an agent of such a
practitioner, supervised by and under
the order of the licensed practitioner.
This agent is required to be a pharmacist,
registered nurse, or licensed
practical nurse, or any other
healthcare professional authorized by
Federal and State law to administer or
dispense opioid drugs.
(2) OTPs shall use only those opioid
agonist treatment medications that
are approved by the Food and Drug Administration
under section 505 of the
Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355) for use in the treatment
of opioid addiction. In addition, OTPs
who are fully compliant with the protocol
of an investigational use of a
drug and other conditions set forth in
the application may administer a drug
that has been authorized by the Food
and Drug Administration under an investigational
new drug application
under section 505(i) of the Federal
Food, Drug, and Cosmetic Act for investigational
use in the treatment of
opioid addiction. Currently the following
opioid agonist treatment medications
will be considered to be approved
by the Food and Drug Administration
for use in the treatment of
opioid addiction:
(i) Methadone;
(ii) Levomethadyl acetate (LAAM);
and
(iii) Buprenorphine and
buprenorphine combination products
that have been approved for use in the
treatment of opioid addiction.
(3) OTPs shall maintain current procedures
that are adequate to ensure
that the following dosage form and initial
dosing requirements are met:
(i) Methadone shall be administered
or dispensed only in oral form and shall
be formulated in such a way as to reduce
its potential for parenteral abuse.
(ii) For each new patient enrolled in
a program, the initial dose of methadone
shall not exceed 30 milligrams and
the total dose for the first day shall
not exceed 40 milligrams, unless the
program physician documents in the
patient’s record that 40 milligrams did
not suppress opiate abstinence symptoms.
(4) OTPs shall maintain current procedures
adequate to ensure that each
opioid agonist treatment medication
used by the program is administered
and dispensed in accordance with its
approved product labeling. Dosing and
administration decisions shall be made
by a program physician familiar with
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68
§ 8.12 42 CFR Ch. I (10–1–06 Edition)
the most up-to-date product labeling.
These procedures must ensure that any
significant deviations from the approved
labeling, including deviations
with regard to dose, frequency, or the
conditions of use described in the approved
labeling, are specifically documented
in the patient’s record.
(i) Unsupervised or ‘‘take-home’’ use.
To limit the potential for diversion of
opioid agonist treatment medications
to the illicit market, opioid agonist
treatment medications dispensed to patients
for unsupervised use shall be
subject to the following requirements.
(1) Any patient in comprehensive
maintenance treatment may receive a
single take-home dose for a day that
the clinic is closed for business, including
Sundays and State and Federal
holidays.
(2) Treatment program decisions on
dispensing opioid treatment medications
to patients for unsupervised use
beyond that set forth in paragraph
(i)(1) of this section, shall be determined
by the medical director. In determining
which patients may be permitted
unsupervised use, the medical
director shall consider the following
take-home criteria in determining
whether a patient is responsible in handling
opioid drugs for unsupervised use.
(i) Absence of recent abuse of drugs
(opioid or nonnarcotic), including alcohol;
(ii) Regularity of clinic attendance;
(iii) Absence of serious behavioral
problems at the clinic;
(iv) Absence of known recent criminal
activity, e.g., drug dealing;
(v) Stability of the patient’s home
environment and social relationships;
(vi) Length of time in comprehensive
maintenance treatment;
(vii) Assurance that take-home medication
can be safely stored within the
patient’s home; and
(viii) Whether the rehabilitative benefit
the patient derived from decreasing
the frequency of clinic attendance
outweighs the potential risks of diversion.
(3) Such determinations and the basis
for such determinations consistent
with the criteria outlined in paragraph
(i)(2) of this section shall be documented
in the patient’s medical record.
If it is determined that a patient is responsible
in handling opioid drugs, the
following restrictions apply:
(i) During the first 90 days of treatment,
the take-home supply (beyond
that of paragraph (i)(1) of this section)
is limited to a single dose each week
and the patient shall ingest all other
doses under appropriate supervision as
provided for under the regulations in
this subpart.
(ii) In the second 90 days of treatment,
the take-home supply (beyond
that of paragraph (i)(1) of this section)
is two doses per week.
(iii) In the third 90 days of treatment,
the take-home supply (beyond that of
paragraph (i)(1) of this section) is three
doses per week.
(iv) In the remaining months of the
first year, a patient may be given a
maximum 6-day supply of take-home
medication.
(v) After 1 year of continuous treatment,
a patient may be given a maximum
2-week supply of take-home
medication.
(vi) After 2 years of continuous treatment,
a patient may be given a maximum
one-month supply of take-home
medication, but must make monthly
visits.
(4) No medications shall be dispensed
to patients in short-term detoxification
treatment or interim maintenance
treatment for unsupervised or takehome
use.
(5) OTPs must maintain current procedures
adequate to identify the theft
or diversion of take-home medications,
including labeling containers with the
OTP’s name, address, and telephone
number. Programs also must ensure
that take-home supplies are packaged
in a manner that is designed to reduce
the risk of accidental ingestion, including
child-proof containers (see Poison
Prevention Packaging Act, Public Law
91–601 (15 U.S.C. 1471 et seq.)).
(j) Interim maintenance treatment. (1)
The program sponsor of a public or
nonprofit private OTP may place an individual,
who is eligible for admission
to comprehensive maintenance treatment,
in interim maintenance treatment
if the individual cannot be placed
in a public or nonprofit private comprehensive
program within a reasonable
geographic area and within 14 days
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69
Public Health Service, HHS § 8.13
of the individual’s application for admission
to comprehensive maintenance
treatment. An initial and at least two
other urine screens shall be taken from
interim patients during the maximum
of 120 days permitted for such treatment.
A program shall establish and
follow reasonable criteria for establishing
priorities for transferring patients
from interim maintenance to
comprehensive maintenance treatment.
These transfer criteria shall be
in writing and shall include, at a minimum,
a preference for pregnant
women in admitting patients to interim
maintenance and in transferring
patients from interim maintenance to
comprehensive maintenance treatment.
Interim maintenance shall be
provided in a manner consistent with
all applicable Federal and State laws,
including sections 1923, 1927(a), and 1976
of the Public Health Service Act (21
U.S.C. 300x–23, 300x–27(a), and 300y–11).
(2) The program shall notify the
State health officer when a patient begins
interim maintenance treatment,
when a patient leaves interim maintenance
treatment, and before the date of
mandatory transfer to a comprehensive
program, and shall document such notifications.
(3) SAMHSA may revoke the interim
maintenance authorization for programs
that fail to comply with the provisions
of this paragraph (j). Likewise,
SAMHSA will consider revoking the interim
maintenance authorization of a
program if the State in which the program
operates is not in compliance
with the provisions of § 8.11(g).
(4) All requirements for comprehensive
maintenance treatment apply to
interim maintenance treatment with
the following exceptions:
(i) The opioid agonist treatment
medication is required to be administered
daily under observation;
(ii) Unsupervised or ‘‘take-home’’ use
is not allowed;
(iii) An initial treatment plan and
periodic treatment plan evaluations
are not required;
(iv) A primary counselor is not required
to be assigned to the patient;
(v) Interim maintenance cannot be
provided for longer than 120 days in
any 12-month period; and
(vi) Rehabilitative, education, and
other counseling services described in
paragraphs (f)(4), (f)(5)(i), and (f)(5)(iii)
of this section are not required to be
provided to the patient.
[66 FR 4090, Jan. 17, 2001, as amended at 68
FR 27939, May 22, 2003]
§ 8.13 Revocation of accreditation and
accreditation body approval.
(a) SAMHSA action following revocation
of accreditation. If an accreditation
body revokes an OTP’s accreditation,
SAMHSA may conduct an investigation
into the reasons for the revocation.
Following such investigation,
SAMHSA may determine that the
OTP’s certification should no longer be
in effect, at which time SAMHSA will
initiate procedures to revoke the facility’s
certification in accordance with
§ 8.14. Alternatively, SAMHSA may determine
that another action or combination
of actions would better serve
the public health, including the establishment
and implementation of a corrective
plan of action that will permit
the certification to continue in effect
while the OTP seeks reaccreditation.
(b) Accreditation body approval. (1) If
SAMHSA withdraws the approval of an
accreditation body under § 8.6, the certifications
of OTPs accredited by such
body shall remain in effect for a period
of 1 year after the date of withdrawal
of approval of the accreditation body,
unless SAMHSA determines that to
protect public health or safety, or because
the accreditation body fraudulently
accredited treatment programs,
the certifications of some or all of the
programs should be revoked or suspended
or that a shorter time period
should be established for the certifications
to remain in effect. SAMHSA
may extend the time in which a certification
remains in effect under this
paragraph on a case-by-case basis.
(2) Within 1 year from the date of
withdrawal of approval of an accreditation
body, or within any shorter period
of time established by SAMHSA, OTPs
currently accredited by the accreditation
body must obtain accreditation
from another accreditation body.
SAMHSA may extend the time period
for obtaining reaccreditation on a caseby-
case basis.
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_________________ If you can not stand for something, you will fall for everything
Interim maintenance treatment means
maintenance treatment provided in
conjunction with appropriate medical
services while a patient is awaiting
transfer to a program that provides
comprehensive maintenance treatment.
Long-term detoxification treatment
means detoxification treatment for a
period more than 30 days but not in excess
of 180 days.
Maintenance treatment means the dispensing
of an opioid agonist treatment
medication at stable dosage levels for a
period in excess of 21 days in the treatment
of an individual for opioid addiction
Opiate addiction is defined as a cluster
of cognitive, behavioral, and physiological
symptoms in which the individual
continues use of opiates despite
significant opiate-induced problems.
Opiate dependence is characterized by
repeated self-administration that usually
results in opiate tolerance, withdrawal
symptoms, and compulsive
drug-taking. Dependence may occur
with or without the physiological
symptoms of tolerance and withdrawal.
Opioid agonist treatment medication
means any opioid agonist drug that is
approved by the Food and Drug Administration
under section 505 of the Federal
Food, Drug, and Cosmetic Act (21
U.S.C. 355) for use in the treatment of
opiate addiction.
Opioid drug means any drug having
an addiction-forming or addiction-sustaining
liability similar to morphine or
being capable of conversion into a drug
having such addiction-forming or addiction-
sustaining liability.
Opioid treatment means the dispensing
of an opioid agonist treatment medication,
along with a comprehensive range
of medical and rehabilitative services,
when clinically necessary, to an individual
to alleviate the adverse medical,
psychological, or physical effects incident
to opiate addiction. This term encompasses
detoxification treatment,
short-term detoxification treatment,
long-term detoxification treatment,
maintenance treatment, comprehensive
maintenance treatment, and interim
maintenance treatment.
Opioid treatment program or ‘‘OTP’’
means a program or practitioner engaged
in opioid treatment of individuals
with an opioid agonist treatment
medication.
Patient means any individual who undergoes
treatment in an opioid treatment
program.
Program sponsor means the person
named in the application for certification
described in § 8.11(b) as responsible
for the operation of the opioid
treatment program and who assumes
responsibility for all its employees, including
any practitioners, agents, or
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57
Public Health Service, HHS § 8.3
other persons providing medical, rehabilitative,
or counseling services at the
program or any of its medication units.
The program sponsor need not be a licensed
physician but shall employ a licensed
physician for the position of
medical director.
Registered opioid treatment program
means an opioid treatment program
that is registered under 21 U.S.C.
823(g).
Short-term detoxification treatment
means detoxification treatment for a
period not in excess of 30 days.
State Authority is the agency designated
by the Governor or other appropriate
official designated by the
Governor to exercise the responsibility
and authority within the State or Territory
for governing the treatment of
opiate addiction with an opioid drug.
Treatment plan means a plan that
outlines for each patient attainable
short-term treatment goals that are
mutually acceptable to the patient and
the opioid treatment program and
which specifies the services to be provided
and the frequency and schedule
for their provision.
_________________ If you can not stand for something, you will fall for everything
ok sweety Im not about to read ALL of that you could just summarize it. But I know and have talked to people at the clinic who have been on methadone for 7+ years and they werent getting treated for heroin they were getting treated for Lostabs, percoc
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Posted:Feb 03, 2007 - 10:25 AM
