LET's TALK ABOUT TAKE HOMES . . . . .
All too often I have patient's say to me "but I have earned my take homes" or "I have worked really hard to get my take outs". So lets take and minute and talk about what it takes to have take home doses.
First, we all know that you must have urine screens that are negative for illicit substances. That's just a given, but it is only one of the steps required by federal and state law.
Other things include "regular attendance at the clinic", which means NO MISSED DOSES or UNEXCUSED ABSENCES. You honestly wouldn't believe how many times I hear "I overslept", ""I was sick", "No transportation", "I had to work", but the best is "I had a doctor appointment". Let's get real, how many doctor's offices open before 8:00 in the morning. Attendance at regular counseling appointments, without the counselor having to "HOLD" you to be seen or going to group as required without having to be "HELD" by administration indicates that your are regularly attending and participating in treatment.
"Absence of a behavior problem at the clinic" is another requirement that many people forget about. Behavior problems would include things like loitering, disruption in the waiting room, using water instead of urine in the specimen bottle or being just down right rude to other patients or staff. But probably the best is when there is a suspicion of attempting to buy or sell illicit substances at the clinic. Come on you guys perception is a big part of reality and if it looks like a duck, walks like a duck, quacks like a duck, it most likely is a duck.
And then there is one of our favorites, FINANCIAL COMPLIANCE. Program policy requires that treatment fees be paid in advance and by the 5th of the month. Now while the business office will sometimes accommodate special needs your bill has to be paid to have take homes. If you are on a financial contract, beginning January 1st you are at risk to loose your take homes. The Business Office will discuss this with you individually, but after 01-01-06 if you have a financial contract you will not be allowed to increase your take homes. We try very hard to keep treatment fees at the lowest rate in the area, but when patient's don't think payment of their treatment fees are a priority, it makes it difficult for us to do this. Let's face it RAM CLINIC has financial obligations just like everyone and everything else. It is important to keep the doors of this place open and provide the services that everyone here needs and enjoys.
Other things like can you safely store and be responsible for your take home medications. If another patient shows up with your take home bottle--at this clinic or another- that tells us you are not paying attention to your doses. Better yet do you know that every purse, backpack, jacket, etc. that is lost on Trimet and found never has a take home dose with it. Must be only people who are honest drug users find things on the bus, search them for drugs and turn them into Lost and Found at Trimet.
While much of this is presented sarcastically, a lot of it is the things patient's tell us about their take homes. Please realize that we are talking about a controlled substance and many regulations apply to it. We do our very best to allow you freedom from the clinic, please help us do our job.