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 Post subject: Liquid vs Disolving Tablets??
PostPosted: Wed Dec 30, 2015 9:00 pm 
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Joined: Tue Dec 29, 2015 10:56 am
Posts: 5
Location: West Palm Beach, FL
I live in South Florida and have been in MMT for 7 years now. The entire time I've been in treatment the clinics I've been to all use the red liquid for dosing and Take-Homes. Well a few days ago it came time to graduate my Phase up to a Phase-7 (AKA Partial Maintenance or 13 TH's). Problem is the clinics down here switch to the Disolving tablets in water once you enter this particular Phase. I don't like the tablets, they make my throat sore cuz most of the tablet doesn't dissolve and is left in the cup as a nasty-tasting chalky yuckyness! On top of that I don't like the way my body reacts to the tablets, they give me a headache, actually make me drowsy and knod-out even tho I'm at the same equivalent dose, they speed my pulse up, I really think my body doesn't like whatever fillers or buffers they use in the tablets. I went to my clinic and spoke to the Nurse, they refuse to let me see the Doctor to try and get a medical exemption to go back on the liquid... I feel that's totally wrong and possibly border lines on neglect/malpractice... If you dispense medication to a patient and their body rejects or adversely reacts to it, you have a duty to act and medical obligation to try and correct that patient's situation. Has anyone else had my situation or had to switch from liquid to dissolving tablets and absolutely hate the tablets?? And do I have any sort of legal or medical repercussions since I can't even be allowed to see the doctor that prescribes me this crap?? I will finish by saying I am very stable on my dose for many months now, I have a very good job and make great money, and I am working the program doing the right thing, staying away from Bad habits, no dirty urines, and I don't give the clinic any problems ever... Thanks!

•• David
South Florida


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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Fri Jan 01, 2016 8:40 am 
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The clinic cannot refuse to let you see the Dr. Ask again, and if they still say No, file a grievance and speak with the clinic director about it, and also how you were refused access to the Dr (who is the person ultimately responsible for your wellbeing as he signs the scripts).

It does sound more like you may be some kind of intolerance to one of the additives/preservatives/fillers in the diskettes, as the actual active ingredient is the exact same in all the formulations.

Come back and tell us what they say. Zac might have something to add to this.......

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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Fri Jan 01, 2016 6:45 pm 
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Joined: Tue Dec 29, 2015 10:56 am
Posts: 5
Location: West Palm Beach, FL
I have been to the clinic 2 different times in the past week, including 1 time the Nurse took my blood pressure & pulse and it was 180/104 and pulse was 140... It was painfully obvious I was having a reaction you can't fake high B/P and pulse... Even after that the Nurse STILL wouldn't let me see the Dr. The Doc is only at the clinic 2 days a week and I asked to put in a "Sick Call" to see the Doc the next time he is here and the nurses refused. Like they can't see what's going on inside of me, what right do they have to refuse my request to see the Doc. Isnt that borderline Malpractice or Patient Neglect? After all it's his ultimate responsibility being it's HIS name on my prescription bottles!! If something happens to me medically he will be responsible for making me stay on a medication that's causing an adverse reaction. I just don't know where else to turn to. It's not like I am asking to increase my dosage or special treatment, I simply just want to inquire about switching back to liquid because the diskettes are making my body react badly and I don't like it. What pisses me off royally is I've been in MMT for just shy of 8 years in a row, I've never had not 1 dirty or questionable urine, I've always worked the program and maintained employment at a good job, I've always followed the rules and never had an issue, I always see my counselor for appointments, hell when I had an abscess tooth I even was honest and showed them the antibiotics I was taking so there was no questionable urine. If I was one of these ppl that go to the clinic and still get high I would understand them acting this way to me but I am just dumbfounded at the treatment I'm getting... Thanks for reading my long-winded rants! :)


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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Fri Jan 08, 2016 8:17 am 
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I would at least file a grievance. It's the Dr that's signing your prescriptions, and has ultimate responsibility and a duty of care to you, so to deny you access is unethical. I would speak to the clinic director/file a grievance.

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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Sun Jan 24, 2016 4:03 pm 
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Joined: Sun May 04, 2014 9:54 pm
Posts: 196
Location: North Georgia
It's actually a Florida state regulation that bi-monthly and monthly take homes (aka "medical maintenance" under the FL state regs) must be solid medication. It's not really something the clinic can do anything about because that's mandated by the state in Florida. Weird, I know, but it's a state regulation there. So liquid CAN'T be given for bi-monthly and monthly take homes in the state as a matter of state regulations. You would think there's a way to make an exception, though. You could always write the Florida State Methadone Authority (SMA)/State Opioid Treatment Authority (SOTA) and explain to him/her what's going on and see if there's a process your clinic could ask for an exception to the state regulation requiring solid medication for your phase level. Here's a list (alphabetical by state) of all the SMAs/SOTAs... just find Florida's and shoot him/her an email. LINK: http://dpt2.samhsa.gov/regulations/smalist.aspx

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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Sun Jan 24, 2016 5:34 pm 
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Joined: Tue Dec 29, 2015 10:56 am
Posts: 5
Location: West Palm Beach, FL
Well there's a Clinic in Pompano Beach that told me an exemption could be made so long as I provide a physician note excuse saying the medication is adversely affection my health. I mean that's basic medicine that if a medication is causing a patient to have a reaction you can't continue to force them to take it... At least I think...


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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Mon Jan 25, 2016 8:59 am 
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I did not know that Zac, that if you are on monthly/bi-monthly TH's in FL that you've got to have solid meds. I guess it makes sense actually, as having that amount of liquid meds is a recipe for disaster what with people likely to spill it, bottles to leak etc. I wonder if part of it has anything to do with a diversion control program?

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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Mon Jan 25, 2016 10:03 pm 
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Joined: Sun May 04, 2014 9:54 pm
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Location: North Georgia
Not sure what exactly the rationale is in Florida for requiring dry medication for bi-montly and monthly... but it's in the regs.

@DavidFL78, I would email the state SOTA - find his/her contact info via the link I posted in my last comment. The CLINIC physician should be able to request that exception for you I would think.

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Email | zac@tnmethadone.org

Chief Operating Officer | Counseling Solutions Treatment Centers
Comprehensive Opioid Treatment Programs
Program Director | Counseling Solutions Treatment Centers - Chatsworth


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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Mon Jan 25, 2016 11:05 pm 
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Joined: Tue Dec 29, 2015 10:56 am
Posts: 5
Location: West Palm Beach, FL
Actually the Clinic told me THEIR Physician won't do that for me, that the medical doctor's excuse has to come from a private Primary Physician, which I thought was odd...

As far as the state mandate to have solid medication for the bi-monthly and monthly, I would think it would be the other way around and mandate the medication be the liquid. Because let's face it the diskettes are scored 4-ways and can easily break off each one into 10mg doses; The liquid would be a little more difficult to measure out and abuse being it has to be converted from mg/mL... Just saying it doesn't make sense but oh well...


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 Post subject: Re: Liquid vs Disolving Tablets??
PostPosted: Tue Jan 26, 2016 7:37 am 
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So if they're just telling you that's what the Dr would say, that's not strictly accurate. If you saw the clinic physician yourself, and asked him about this, he might say something completely different.

Kind of sounds like they're putting words in his mouth and assuming what he's going to say, when in reality he could have a completely different opinion.

I would ask to see him/her yourself, so you can explain the situation first hand without other people muddying the waters.

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Please email me if you have any issues with the board, be that logging in, spammers, or anything else at all!!


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