| Methadone Questions and Answers: |
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| MMT Clinic Rules: Methadone maintenance treatment (MMT) clinics have a lot of rules. The best way to deal with them is to learn what they are. Who makes all the rules? Rules and regulations governing MMT clinics come from federal, state, and local authorities. Clinics must follow these to stay licensed to practice medicine, to distribute methadone, and to remain welcome in the community. MMT clinics are subject to regular, unannounced inspections, so they must be abide by every one of those rules, without exception, all the time. This may seem rather rigid, but the clinic has no choice. Some clinics also have their own rules, such as those dealing with behavior in the clinic. Other rules help the clinic stay in good standing with neighbors; for example, no loitering outside the building. How are clinic hours determined? All businesses, including medical clinics, operate only at certain times. MMT clinics hire staff to work specific hours and days that are most convenient for the majority of the people they serve. There is rarely flexibility to open earlier or stay later to accommodate individual situations. Knowing this, you need to plan your schedule and travel to the clinic accordingly, allowing extra time for unforeseen events. Why are the urine tests necessary? Taking �street drugs�, defeats the purpose of MMT. Yet some people in treatment do this. Random urine screenings to detect methadone and rugs of abuse help clinic staff provide the best treatment tailored to individual needs. Urine tests also are required by government regulations and they must be performed �in a manner that minimizes falsification.� This usually means that providing urine samples must be witnessed by a clinic staff member. This is unpleasant for everyone involved, but it is necessary. Why is methadone so restricted? Ever since its development as a maintenance treatment for opioid addiction more than 35 years ago, methadone had been strictly controlled by the government. That is, specific rules and regulations determine how much methadone may be prescribed, when, where, and to whom. This is because methadone is a very powerful drug with potential for abuse. It could be extremely harmful if used improperly or by the wrong persons. An MMT clinic must account for every drop of methadone it receives and dispenses. For this reason, there are many rules to follow concerning the proper handling and care of methadone doses. MMT medical staff tailors methadone doses to individual needs. However, special permission must be obtained from state or federal authorities to prescribe methadone doses above certain limits. (By the time you read this, there could be changes made to this particular rule/law). So there may be clinic rules regarding who might qualify for higher doses and under what circumstances. Similarly, there also are rules for methadone dose reductions or stopping the medication entirely � called �detoxification� or �medically supervised withdrawal�. Methadone should never be stopped abruptly or reduced too fast, or the patient could get sick and feel intense drug craving. Who is allowed take-home doses? Normally, methadone doses must be taken every day under supervision at the clinic. Federal and state regulations control who may have doses of methadone to take home � take-homes � and how many days at a time. Takes-homes are an earned privilege. (By the time you read this, this rule/law may have changed). Generally, take-homes are available only to persons comfortable on their methadone dose, avoiding all drugs of abuse, following clinic rules, cooperating with staff, and having a stable home life. Take-home dose privileges can be canceled if certain rules aren�t followed requiring proper care of the medication and ongoing participation in treatment. What should the patient do? The patient must do their part to get the full benefits of what MMT has to offer. Always treat clinic staff as you would like to be treated in return, with courtesy and respect. If a particular rule is causing you problems, calmly explain your situation to appropriate clinic staff and listen carefully to their suggestions. If you have a complaint, find out the proper way to go about letting it be known. At all times, avoid behavior that may appear hot-tempered or threatening. Working together with your clinic staff, cooperating with rules, will help make your MMT clinic experience much more satisfying and rewarding. |
