Opioids Recent methadone UA didn’t show metabolites?!

[Regulat0r10]

Due to this I got my take homes taken away from me. I don’t understand I have never missed a single day or bottle check. I perscribed adderall and I wonder if that can affect the methadone metabolites? I am a long distance runner, I drink plenty of water and just got the best job offer I have ever received in my life. They also said the urine was diluted (same UA) at which they found from a UA lab result 2-3 months ago and just caught it. They are so behind in schedule but I am being real here, I am proud of the time I put in to get these take homes and my UA’s have always been perfect. I just don’t understand what is going on. Because of this I may not be able to accept this job offer. My doc said he will continue to monitor my UA’s and if I show proof of the job or offer then he will work with me to ensure I get the takehomes I need in order to turn the page to the next chapter of my life. I work out at the gym at 5am every morning and I run 5-10k daily. Before when I had my take homes, I did so much better when I did my own split dosing.... it wasn’t too powerful when taking the full dose at once, but since the methadone does not last long, I found that dosing in the morning and the other half mid day, my body responded well to it, otherwise the medication would wear off too soon. And the last thing I want to do is keep going up on my dose. I was tapering down to 25mg and experienced gnarly bouts of anxiety and my psychiatrist insisted I up my dose till she finds a medication that won cause severe side effects during my lowered doses because I am very sensitive to meds. So finally after getting my recommendation from previous doc and provided the last 10 years of prescription history she put me back on adderall. But since then I swear my dose does not hold as it should so I went back up a bit. Could this have any affect on my UA showing little to no metabolites? I mean this was just from one UA... so far my recent ones have been fine so I’m just really confused and discouraged. This job offers an amazing health insurance with Athena/blue cross and I’ll be going with PPO regardless of how much is deducted from my pay check. It would save me from the 400+ dollars I pay monthly for shitty Kaiser (privately) so. I can’t wait to get off Kaiser so I can really get my mental health in order. I do wonder if switching insurance will still require thet I use the same clinic or if this insurance and depending on the doctor can perwcribe it to me without having to go to a clinic... I.e recieve pills or simply a larger bottle of methadone syrup for take homes. I’m in the USA so I’m not sure if they even do pills over here or not but is really like to know wtf is going on!!!

 

[Keif' Richards]

Hey Regulator! That's crazy that you've been on here for such a long time. Good for you.

This is a really shitty situation. I'm not going to lie to you, fighting the Methadone clinic in any way is a battle of David vs. Goliath. The rules are so rigid I can only guess as a philosophical bulwark against what they perceive as constant manipulation from drug-addicted patients. It leaves you with very little recourse if they truly make a mistake, as even if you are telling the truth, they have a line of people going around the building telling them the same thing. The way that you make yourself heard is going to mean sticking to your guns. I think the assumption among most people is that, if someone is lying, they make a bunch of noise when they get their UA results, they are likely going to stop making that noise after a day or two and accept their fate.

If this actually happened, and I totally believe you, then you probably need to go over the head of the clinic. This is a really big problem and if you're experiencing it, then it's likely others are too. Methadone clinics in the United States get their license/approval to operate after being certified by an organization known as CARF, the Commission on Accreditation of Rehabilitation Clinics. As far as I know, they are an agency independent of the clinics themselves intended to be a check/balance type of thing. Clinics will typically be evaluated annually or bi-annually, but that doesn't mean you can't complain.

I have to admit, at the clinic I once went to, I never met anyone who actually said point-blank, "the clinic screwed me" over a UA. Everyone talks about how the clinic screws them, don't get me wrong, but this argument is usually more of the esoteric "everyone screws me" argument. Something is seriously wrong, because it should be basically impossible for someone maintained on Methadone to pass a UA cleanly without being off of Methadone completely for what I imagine is at least 7 full days and I would say probably 14 dependent upon dosage, weight etc.

I'm pretty sure it's still illegal for a private physician to prescribe Methadone to addicts, for the specific purpose of maintaining their dependence/mitigating withdrawal. I'm sure that some do, but this is not likely to be a viable solution for you. Your best bet is to appeal to CARF. Let us know what you find out and we can try to guide you through all of this.

I would contact CARF and see what they have to say. I know this isn't exactly Harm Reduction, but we can leave it open for a moment or two here and then maybe move it to Drug Culture.

 

[Regulat0r10]

Thanks so much for the prompt and informative response! Yes, I have been here for quite some time huh? I tend to stay in the shadows unless I can’t really find an answer to any questions/concerns. I really should start posting more. That said, I apologize for the rambling and posting in the wrong section!

This is great information... what would be the best way to contact CARF? If you were in my situation, would u continue to put pressure on nurses at the clinic? For instance, the dosing nurse told me she had received my most recent UA (the one I have the day they revoked my take homes). That same day I requested she do a dipstick test and tell me results... she said she would but never followed through. Same with the last couple days I have been in there.. she literally said she has it and will review it but also mentioned that the doctor will be evaluating it. I literally printed out my job offer and acceptance and handed it to her yesterday. Should I let them know I’d like to contact CARF or do I have to contact them outside the clinic?

I have till July 2nd for orientation and I am under so much stress because of this situation. I try my best not to freak out on things I cannot control but this is really making things difficult for me... I can’t even enjoy the fact that I received such a great job offer.