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Opioids getting methadone from Dr office vs clinic?

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walterdini

Bluelighter
Joined
Aug 28, 2012
Messages
118
So I'm thinking abut switching from getting my methadone at a clinic to getting it Rxed to me at a Dr office....2 things:

1) Can a doctor, assuming they're properly licensed/certified, Rx methadone for opiate replacement purposes? (In the USA)

2) How do the 10mg methadoone pills compare to the liquid given at the clinics? If a doc can rx it, I'm assuming it will come in 10mg pill fiorm, which would mean a lot of pills, are they as effective?
 
1) Yes, it is possible but your doctor must feel out a form and write a letter to the DEA to explain why you can not recieve your medication from a clinic. Doctors are allowed to do this with two patients at a time. I can't remember the link to the forms to be honest. I'm sure the link is somewhere on here if you search.

2) I spent a good year on MMT and I took the pills beforehand for a few years. Both are just as effective as one another.
 
I'd recommend the outpatient doctor option if it is available to you. Some people find the clinic regimine helpful; I did at first, but it quickly outlived its usefulness and became a dehumanizing experience (the fast food aspect of it; it's like you're a beggar in a bazaar when standing with a huge clump of other patients, who all have shit they want to complain about to the nurses and receptionists- then the stampede toward the dosing window when the place first opens).
 
You really just have to talk to your doctor and see... Where I am in CA I have always been told that doctors cannot prescribe methadone for addiction, only methadone clinics can. But doctors can prescribe it for pain.
 
Thanks alll, yeah I had thought docs could only rx for pain and not for replacement therapy, but it seems from what Wiggi wrote I might be wrong...

I agree about dehumanizing aspect of the clinic, but don't know if that iss a sufficient reaason to get rx'd the stuff if the doctor needs to provide justification to the dea.

I've been going to the clinic for over a year now, and am only thinking about trying to get it from a doctor instead b/c I travel a lot for business, sometimes without advanced notice. And this means there are times I'm unable to go to clinic for daays at a time. And when I can't give the clinic enough advanced notice, they will not give me takehomes for my trip... If I was rx'd the methadone, then this would not be an issue.

My other concern, was that I'm on 140mg/day now, meaning I'd need 14 pills per day Rx'd to me, as I believe 10mg pills are the srtongest strength available. When I was on suboxone, I'd get 1 month per script and would see my doc once a month to get my new script. I can't imagine a doctor writting me a script for 14 pills per day even if they are okay with the actual dosage. So:
- does that mean I'd need to see the doctor and get my script refilled once a week or once every 2 weeks?

Any helpful info or experiences are appreciated, thanks
 
It's easier just to go to a clinic and get Methadone. Getting Methadone from a doctor is pretty hard because there are alot more opiods medications out there that have less dependence, withdrawals, and side effects. If you get Methadone from a doctor it would have to be for pain. . To me the liquid given at Clinics are more effective. I wouldn't take the risk of switching to a doctor personally.
 
While it OBOT w/ methadone is technically allowed, most docs don't want to go through the DEA bs and scrutiny. The paragraph below outlines the regs and below that is a link to the page.
Best of luck to you but I don't think it'll be easy to find a OBOT doc who writes for methadone.
-izzy


Practitioners wishing to administer and dispense approved Schedule II controlled substances (that is, methadone) for maintenance and detoxification treatment must obtain a separate DEA registration as a Narcotic Treatment Program. Application for registration as a Narcotic Treatment Program is made using DEA Form 363. In addition to obtaining this separate DEA registration, this type of activity also requires the approval and registration of the Center for Substance Abuse Treatment (CSAT) within the Substance Abuse and Mental Health Services Administration (SAMHSA) of the Department of Health and Human Services (HHS), as well as the applicable state methadone authority.


http://www.deadiversion.usdoj.gov/pubs/manuals/pract/section6.htm
 
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