Eye Opening Experience At Drug Rehab Clinic

[tednlou2]

A friend had been on pain meds, for about 10 years.  While he had enough supply each month, he decided he was just tired of dealing with it.  He was tired of having to plan trips around when he got his refill, tired of worrying what would happen if they were cut-off, and he felt it had effects on his mood.  On Monday, I was surprised, when he told me he had made an appointment at a treatment center.  He asked, if I would go with him for support. 

The appointment was this morning at 5:30am.  I got no sleep.  I was still on here as late as 2am, I think.  I figured it was better to just stay up.  I wanted to go with him.  My one day lack of sleep is nothing, compared to what he is doing.  And, I came home and took a nap.  We were there 4 hours.  They did a TB test and a syphilis test.  Go figure.  They said the state mandates it, saying it is a silent killer and causes mental health issues, which often is associated with drug use.  I get that; I was just surprised that was the mandated test.  The office is in a old medical office building.  It is obvious they don't have cleaning staff.  But, it still seemed well run.  He saw a counselor for about 40 mins.  Then, he saw the doc.  They don't take insurance and only deal in cash.  That raised red flags, for me.  Perhaps, it is to keep costs down by not taking credit cards.  I have no idea whether insurance even covers it, even if they wanted to do insurance claims.  And, I suspect many clients do not have insurance anyway.  Many probably don't have a debit card.  They would have to hire an insurance billing person(s), if they did take it.  So, perhaps it is to keep costs from being insanely high.  But, I still am a little curious about that.  He did call other clinics.  They all had waiting lists, or were very expensive.

He had to stop taking the pain meds 24 hours prior.  They decided Suboxone would be best for him, as he doesn't have multi-drug issues.  Most go there for methadone.  I was impressed by his bravery.  Stopping pain meds on your own, without being court-ordered or because you can't get them, is a big deal.  Well, it is a big deal in the other situations, but to decide to stop on your own (when you still have a bottle of pills) takes a lot of determination.  He will go daily for his dose.  Daily Suboxone treatment is $140 a week and methadone is $110 a week.  That covers all costs, for drug tests and counseling.  He finally got his dose. Within just a few minutes, he acted like he was drunk.  The 8Mg's may be too much for him.  He's been nauseous today.  He came back to my house and laid down, and has been throwing up.  He says he isn't feeling withdrawal, rather just sickness from the Suboxone.  It may just take time to get use to it. 

I left with many thoughts.  This is just one facility and it was like a McDonald's drive-thru.  I would guess they have to replace the hinges on the doors regularly.  It was one person after another.  In our 4 hours there, I would say I saw 200 people.  People had to wait for parking spaces.  Some had the stereotypical look of someone who has a drug problem.  But, most were just like him.  You would never suspect it.  There were teens getting treatment.  I noticed it was probably 70% men to 30% women.  I also noticed many were wearing their work clothes or uniforms, so most had jobs that I saw.  They are open from 5am to noon.  Everyone checks in at the front desk and then go back to teller-like windows, to get their dose.  Trusted patients can get take-home meds.  It really made me think how many we all may know, who are dealing with this, but they are able to keep it secret-- just like HIV.  It does make you think that you never know what problems people are carrying on their shoulders. 

I also wondered how someone poor could afford this, and where do they get treatment.  $140 a week and we are talking $560 a month.  He cannot afford that for very long.  I heard conversations from people, who said they've been coming there or other places for years.  Did they just replace one addiction for another?  I guess many are in a cycle of using drugs again, and then return--either on their own, or by court order.  I heard one guy complain about the cost and how all that money could be used to buy whatever his drug of choice is.  But, he said he is subject to his dealer's supply and his dealer's schedule.

But, it was the cost that really struck me.  I now want to research where poor folks go for help.  We have all these drug laws, where we throw people in jail and just make their lives worse, but apparently no funding to help.  Perhaps there are govt funded places.  But, I wouldn't be surprised to learn there are not.  I suppose this is why heroin arrests have increased 1,000%+ here.  Heroin is much cheaper, especially with the crack down on pain meds.  We really need to stop the failed war on drugs, and put that money into treatment programs.  It really was reinforcement of what I already knew.  Most have a picture of what a "drug addict" is, and I know many have no sympathy.  Not to get on a rant, but I have noticed those awful statements often come from people, who like to talk about how religious they are.  I know I am guilty, too.  I felt uncomfortable today, thinking people would think I was "one of them."  That feeling passed quickly, as I reminded myself that I could easily be "one of them."  And, being addicted to prescription drugs doesn't make you better than someone with an addiction to another drug.  Yes, many get addicted to pain meds, after some injury, where a doc hands you a script.  But, the reasons people abuse is really the same.  Many use illegal drugs to cope with physical and mental pain. 

[klouny]

i honestly had the same reaction
im dealing right now with getting clean myself from years of addiction ( im 22, but ive been using drugs since i was 14 )
my case workers here wanted to put me in a halfway home that mostly helped people with dual-diagnosis ( this place in particular had a lot of HIV positive patients )
but i was surprised, that they didnt have a lot of rules or boundaries. i asked my case worker if the patients ( for better lack of words ) needed to pay rent ( which some places require you to have a job ) or did weekly drug tests ( which is the norm ) and this place didnt.

it came as a surprise to me that there are places like that out there.
they have the right idea in trying to help individuals with addiction, which is already a hard thing to deal with on its own. but to be so blasé about it... its just a real shocker. i hope your friends finds a better doctor and clinic to go too, this place sounds very sketchy

[Jeff G]

These Suboxone clinics are set up to do step down therapy to get people who are dependent on opiates off them .

Its important to remember there are many people in chronic pain that are opiate dependent that do not abuse their medications that use these clinics , or simply taper off over a period of time . I have been a pain management patient for many years and there was a time I wanted to be drug free again and insisted that I didn't need the narcotics to cope with pain anymore . I went cold turkey off my pain meds and I tell you that isn't the way to go , it was hell .

Some people with chronic pain are sometimes like people who take psyche drugs , they get to feeling better because of the meds then make the mistake of thinking they do not need them anymore . This is what I did , I built up a huge tolerance to narcotics and began to think they were not doing me good any more and were way too much trouble . I was wrong and the drugs were doing what they were supposed to . I walked around in moderate to severe pain for years before I could bring myself to go back into pain management because I knew what it would take to get off them again and didn't want to face that ever again . It was when I realized I was never going to get better that I allowed myself to accept that I was going to have to choose pain or manage it with drugs and the dependency that comes with taking them .

There is a significant amount of stigma for those of us that are dependent on narcotics for chronic pain , I even experience it from a new doctor now and then and although I'm out about my HIV status I would rather stand in a room full of strangers and announce that I have aids than to tell people I am dependent on narcotics .

I have been asked at the hospital where I get my HIV treatment and pain management to become a part of a program that works directly with the doctors to help better serve the HIV patients who are experiencing chronic pain . I haven't began the program as of yet and I'm not sure what all is involved or what's expected of me but I am excited to be a part of it , maybe some thing good will come from it .   

[BT65]

i hope your friends finds a better doctor and clinic to go too, this place sounds very sketchy

No, that's actually pretty typical of a Methadone/Suboxone clinic.  They open that early to accommodate people with early morning jobs, and are only open for about 5 hours.  The Methadone clinic here, however, does not provide take-home meds other than the weekends.  Most people here who want take home go to Chicago.

Jeff, I think it's wonderful you're going to do that study.  I'll be very interested to see what it entails.  And you're right, there is a huge stigma among those of us who have to be on pain management, because of all the abuse that goes on. 

[Ann]

i asked my case worker if the patients ( for better lack of words )

In a situation like this, people are usually referred to as clients.

[Theyer]

Timely topic as I have just returned from my  Pain consultant appointment, with a bag off Fentanyl Patches and Morphine sulphate Tablets.

In 1994 when I first developed PN It took me a good 3 years to accept the doc,s advice and take the pain control before the Pain hits. After the chemo treatments the PN increased and a pain that feels like my Bone marrow is Toxic sludge , came and never left. Without the Pain Control Drugs I would have no Quality off life.  On  a few occasions I have gone over the 3 day patch period , then I really know why I need them. I have huge admiration for anyone who goes cold turkey.

In the UK Methadone clinics are part of the NHS , there is occasional press coverage basically saying it replaces one addition for another , however it does stabilize peoples lives and breaks the reliance on there dealers, and that is seen as beneficial. Occasionally death,s  occur from people using it recreationally and this I believe has led to clients off the clinics being observered taking there daily dose sometimes at  the chemists where they collect there dosage. I don,t know if a trusted patient scheme works officially. About three years ago my doc had to stop the 3 months supply to only one month due to NHS changes, however he swung me 3 months this  May for the Orkney trip, this visit back to the one Month.

Many private rehab clinics in the UK have NHS patients among the private patients with the  NHS paying the clinic , there has been periods when there is a huge waiting list for NHS patients , and because off how the funding works the waiting lists will be differant area to area. This mixing I believe reduces some off the stigma , though undoubtedly stigma exists towards non perscrition dependency ,I have not felt any stigma .

If other UK members have direct experience off Methadone clinics / rehab facilities please correct me if I have got anything wrong , you can PM me if you want to remain anonymous to the general readership. I will them pass on the info you provide.

The one worry I do have is if I was ever burgled by anyone who knew what they where as I,d imagine I,d be inline for some repeat visits.

I wish you all that you need  Klouny to succeed.

And  likewise for your friend , Teddy.

[tednlou2]

This Suboxone seems to be a wonder drug, thus far.  My friend hasn't had any withdrawal symptoms.  He slept a lot the first few days, as the med made him sick on the higher dose and also made him tired.  He reduced the 8mgs to 4mgs.  They said he may need less, because they say he shouldn't be so tired.  He did get out for dinner with us tonight.

I was wondering why his doctor couldn't have just prescribed this.  I mean, if the doc is prescribing the pain med, then it would seem they should be able to prescribe the med to get off them.  He doesn't get any special care at the clinic, that his own doc couldn't do.  In fairness to his doc, he never discussed this with her.  She knows now, because he told the clinic who prescribed them, and they called his doc, to tell her to not prescribe any more.  And, I suppose many docs are not familiar with this med.

So, I have been amazed how Suboxone has worked to take away any withdrawal symptoms.  I just worry what happens, when the Suboxone is stopped.  He is very serious about this.  He did this soon after getting his pain med refill, so he had almost a full bottle.  He could have finished that bottle, if he wanted.  But, he didn't.  I also worry what happens when all is stopped and he is still in pain.  It would seem Tylenol isn't going to cut it, after being use to potent meds.  He says he will work with a pain clinic for non-opiate meds.  He also believes the pain meds may have caused him to think he was in more pain, than he really is.  And, taking a pain med can be like smoking.  You get use to taking a pill to cook or work in the yard, just like people smoke after dinner.  While providing pain relief, they can also have a psychological routine component. 

[BT65]

Teddy, doctors have to have a special license to write for meds like Suboxone, and Methadone.  Most doctors do not have this as there is not a big need for them to.

[Theyer]

He also believes the pain meds may have caused him to think he was in more pain, than he really is.  And, taking a pain med can be like smoking.  You get use to taking a pill to cook or work in the yard, just like people smoke after dinner.  While providing pain relief, they can also have a psychological routine component.

Yes have struggled with that one.

The one thing that worries me about your friends determination is what has happened to the condition/situation that caused the Pain in the first place?

[tednlou2]

Yes have struggled with that one.

The one thing that worries me about your friends determination is what has happened to the condition/situation that caused the Pain in the first place?

I keep wondering what will happen, when he is off the Suboxone and still has chronic pain.  It is causing him to sleep a lot, so I don't think he's had a chance to know yet.  I guess time will tell. 

Without writing a novel, I understand the feelings he had.  I have to take pain meds for a really bad back, that only got worse after back surgery.  A recent MRI showed what I already knew;  my back is even worse than I thought.  It use to be just lumbar, but now all my cervical discs are bulging.  There are a few, where I'm bone on bone. 

While I know I need them and have been able to manage them (don't take more than prescribed), I do worry sometimes what would happen if they were suddenly cut off, either by my doc or some other issue.  I did have an issue where the pharmacy was closed, due to a huge ice storm.  Power was out for days.  Luckily, I had some reserve.  But, I do remember when a so-called friend stole mine.  I did have withdrawal symptoms on top of no pain control.  Luckily again, I was due for a refill in a few days.  This is why only a few people know.  I have another friend who was telling everyone he had some from surgery.  Sure enough, someone stole them.  You really have to be careful who you tell. 

And, I've had to change family vacation plans, because the date they wanted to leave conflicted with needing a new paper script.  And, that is suppose to get worse.  The FDA/DEA is moving to make hydrocodone like Percocet.  You will need a new paper script each time, and docs cannot call them in.  No refills that you can have filled at the Walgreens on your trip.  My pain clinic is on the opposite side of town, which is 25 miles from me.  I have no other business on that side of town, so that would mean a trip each month.  I have asked about this, and there is a lot of confusion about whether it is just a recommendation now, or whether the govt is about to mandate it. 

So, I see how all these new rules is making it more a hassle.  But, I know I would be on the couch without them.  I could not help with things around the house.  So, I deal with the hassle.  I think my friend just hated having to plan things around appts and refills.  Time will tell whether he was making more of his pain, as an excuse to take them.  It isn't like he was taking them and partying.  When he took them, he would still often have to go lie down.  I don't think he was inventing pain, but I'm not him.