Not happy with my keyworker at my clinic....

[anahas3cats]

I am in the process of researching my rights regarding a key worker who seems to have it in for me ,or rather,is taking my case a bit personally.The backround-I am a long tern user,have been happily scripted for 17 years with occasional use on top.In this time,my doctor has seen me successfully raise 2 kids to adulthood,and another who is still under 10.In the time I have used,I have been arrested twice,both times for scoring a ten bag of gear. The 2nd time I was arrested was 6 months ago,and apparently my doctor and keyworker got into trouble with social services for not letting them know I was using on top of my script.My key worker took this very badly,put me on a daily pick up which meant I couldn't go on holiday that I had bought tickets for. When my social worker was told of this missed holiday,even she was pissed with him! So 3 months later-I am still being piss tested every week and having to see my keyworker every week.Social services have closed my case.Then I fail my piss test 3 times in a row.He calls social services in again and make them reopen the case.I have since been on holiday and returned and given 2 clean tests.But too late,am being checked out again by social services...My point is I have openly admitted to using on top,I don't smoke,I don't drink,I occasionally smoke a ten bag. My home life is stable.My kids are happy.I don't mix with other users.In every other way I am a 'normal' person. I also have issues with my keyworker-in that he seems to be a bit out of it sometimes and I daren't open that can of worms! Any advice gratefully received! I get my script from a doctors surgery and they only seem to have the one key worker. Can I change doctors? Should I tell my doctor my concerns? The social worker suggested I tell my key worker,but I can't see him taking it well.He has my life all planned out,and he WILL get me clean...feeling scared,frustrated and slightly restricted.

 

[Keif' Richards]

I'm sorry but these are all questions that you would do best to ask your program representatives about. It's a vague possibility that you'll run into someone who can actually answer your specific question regarding your clinic situation, but I'm really not going to count on it. The only way that you will be able to truly ascertain what your rights are as a patient is by reading through your patient handbook/guidebook, checking out your patient bill of rights and by discussing your issues directly with whoever the person-in-question's supervisor is.

Generally though, when you test positive for drugs at the Methadone/Buprenorphine clinic, you get privileges taken away. It doesn't really matter how long you've been doing well for. If you piss dirty, you are going to have your level of trust reduced. If it's "just a ten bag" every once in a while, then why not just stop dabbling? It's clearly fucking with your life somehow, regardless of how you're being treated by clinic staff. Often times we don't have a lot of choice as addicts, but I'm sorry to say, that when you're on maintenance and not worrying about your next hit, you have to take some accountability for your actions, because staying clean on Methadone is easy-peasy vs. with no medication.

 

[T. Calderone]

(moving to EADD)

 

[Shambles]

You may be able to switch to a different DSP if you happen to live in an area where there is more than one available... but I wouldn't count on it making much difference with the issues you mention. Failing a pisstest is a Big Deal when scripted. Even if you have an "understanding" with your keyworker that won't stand up at the administration level. Whilst the keyworker him/herself may be cool with you using on top this will not be the case when it comes to showing results further up the chain. Restrictions on maintenance scripts become ever more restrictive by the year...

If you intend to continue in the way you have the only advice I could offer would be to take much more care with testing. You need to test clean. What happens at other times is your bizniz. I have to agree with Mr. T up above in that you have to take some responsibility for your situation. Short of a major change in thinking when it comes to drug treatment policy, nobody is obliged to provide you with a script - especially when you don't want to stick to it. From what you have said, I totally agree that you are not a problematic user. The problem is that the system regards ALL use as problematic by definition. You just have to work with that. Quite frankly there are no other options. They can and will cut you off dead if you take the piss - and they will certainly regard three failed pisstests as taking the piss. What you or I or anybody else thinks makes no odds unfortunately.

 

[keeping]

^ shambs is on point here, but one little thing i'd like to raise - i tested positive for benzos twice whilst on my bupe script and never had my privileges taken away. now i know its not the same drug, and i'm not seeing my drug-worker about valium but i freely admitted i was using them illicitly and tested pos and still nothing? so is all use using or am i just splitting hairs?

 

[Shambles]

My DSP has a "Three Strikes" policy - and they have to be consecutive to result in being cut off completely. Anything short of that is up for discussion and may (or may not) result in punitive action or restrictions of some kind. I have failed a few pisstests - and missed a few pickups - but not consecutively and, in more than one case, for what had to be false positives because I know damn well what I do and don't take and I hadn't taken what I failed for in a couple of instances.

Each DSP will have their own rules but, as a general guideline, I'd suspect the "three consecutive strikes" thing is commonplace because I've heard it mentioned a lot.

 

[mickeyfinn79]

In my area miss 3 pickups and your off script,
Test dirty 3 x in a row and it's back to daily supervised,
Miss a medical and your script gets held until you pick it up in person or you get put on faltering engagement dropping 5mls weekly until you attend,
OP why not subs/bupe?? Wouldn't it make it less easier to use on top??

 

[PredatorVision]

You should definitely try and get a second opinion from another counsellor with whatever service you are with, or ask for a change in keyworker and try to explain the situation. I changed key worker mid-way through my script (though that was due to him being moved to "high risk" cases rather than by request, though apparently that was also an option) I was a bit pissed off as my new Key worker didn't seem to really give a toss and kept on being overly condescending towards me trying to get me to fill out bubble boxes of what my "life goals" were despite repeatedly stating I have a full time job and a career/family life and my only goal was to stop doing gear. Not to mention the fact that they were late/missed appointments with me more than most of their "clientele" likely would with other keyworkers.

They let me get away with only ever having to do one piss test in 9 months I was on a subs script and getting my pickup down to once weekly, probably because I don't "fit" their junkie stereotype and still used on top more or less the entire time and just said I didn't to my keyworker... for some reason the "Substitute" system seems to promote dishonesty as telling the truth (which I desperately wanted to in hope of increasing my script) would more likely be a bigger hassle than just dealing with a minor withdrawal on top of the script. All I learned was that when money or supply drops off their is an option other than withdrawal.