D-Met With The Womens Group Summary

Dr. Perry Kendall’s stated in a report that the mortality rate for people in opioid substitution treatment is about half of what it is for those using street heroin. (“globeandmail”) Another doctor, who has been administering the program as part of his family practice for several years states the rate of success is poor, the nature of the work often frustrating and the paperwork required under new rules is daunting. But the reward is the amazing transformation of those who are helped by methadone, says Dr. Jeff White. (“thetelegram”) Equally, a confident experience is expressed from a recovering addict himself, Jared stated to a Newfoundland based newspaper, The Compass that the methadone program had a super positive impact on his life. Going on to say in a separate interview with The Advertiser, that the first year everything went as well as it could have with him not doing any drugs. (“Advertiser”) This is just a few examples on how the methadone program has continued to play a positive impact on lives when given the

Xavier then reported, the applicant recovery is up and down and the reason the patient was transferred and admitted to the Norwich location was due to an altercation as the Hartford Dispensary has zero tolerance for physical violence. Since May of of this year, the applicant's UDS results are negative. Last positive result was in April for cocaine, according to the counselor. Please note, during the applicant intake, he was asked about other illicit drugs and only confirmed for use of heroin and THC, not the cocaine. The applicant's current dose at the Hartford Dispensary is 105mgs as he is being detoxed daily. His highest dose was at 145 mgs before his detoxification. The physical altercation was the applicant's first behavioral incident at the clinic. He was also on a 90 Probation for his illicit use and it would have expired in August, but due to the recent incident, he was removed from the clinic, not discharged, but transferred as mentioned before. Counselor Xavier only concern of the applicant is maintaining his

2. The patient was provided with weekly sessions, random UDS testing, group sessions if needed, and any other case management the patient needed. The patient came to the clinic in need of treatment for his opioid dependence and was compliant with his treatment.

During the last seven months whilst working at a men’s shelter (Cornerstone Community Association, in the heart of Oshawa, which some may say is the drug capital of the Durham Region) many of the shelter guests (men who stay in the shelter) have disclosed being on the methadone maintenance program, stating as a result of being addicted to opioid drugs. I have chosen to write about this psychoactive drug because I want to explore, become more knowledgeable and more confident when talking about this complex drug.

ICM met with Mr. Hurley at New Start one located at 3653 N. 15th street t to assess Mr. Hurley’s needs and to complete paperwork for his activation. Mr. Hurley is a 41 year old Caucasian male who self- reports using Heroin since the age of 25. Mr. Hurley denied a history of other substance use; however, his referral noted a history of Cocaine and Marijuana use. Mr. Hurley is currently residing at New Start 1 and has been there for approximately two weeks. He stepped down from a level 3B care at Miracles in Progress. Mr. Hurley shared with ICM that his longest period of abstinence was for 8 years, but he could not recall details of his sobriety. During, this encounter Mr. Hurley was very talkative and engaged well with ICM. Mr. Hurley stated that he was hospitalized in the past on multiple occasions

A psychiatrist in a methadone clinic in Northeast Washington, D.C. works with patients who are addicted to drugs. Some of her patients suffering from addiction

The patient reports, " I am stable with my dose." However, this writer addressed with the patient about her UDS and dosing history. This writer addressed concerns about this patient results of testing postive for opiates and cocaine. The patient

D-The patient arrived on time for her appointment. Reported stable on her new current dose. Deny craving and withdrawals. According to the patient, her weekend was good and again, happy to have her take home bottles. Then the patient reported, she continues to keep all appointments with her mental health provider and its going very well. This writer then discussed with the patient about the next step to her recovery. The patient reported, she wants to continue with her methadone until she's ready to start tapering off on the methadone. The patient has some fears to tapering off on her methadone because she does not want to experience any craving and have a relapse.

Problem # 5 Illicit opiate use Goal(s): to be free from illicit drugs. Status: Active Objectives/Progress: Pt. has struggled with continued use of illicit drugs (marijuana, opiates and amphetamines) and his last quarter UDS reflect a pattern of heavy substance use. Pt. was encouraged to work with the medical staff to achieve a stable dosing level. Pt. is regularly taking his medication as prescribed by AMS Doctor and he stated his current prescribed methadone 90 mg is working "well". During the last quarter, Pt. made progress on developing a therapeutic relationship with his new AMS counselor for the upcoming quarter. Also, Counselor focused therapy session on establishing rapport and building trust with him. Pt. is currently in the contemplation stage of change because he more open to receiving information about his negative habits and willing to use educational interventions which he agreed with this assessment. Pt. was reinforced for any statement that reflected acceptance of his chemical dependence and acknowledgment of the negative consequences that opiates has had on his life. During the upcoming quarter, Counselor will assist Pt. to discuss and weigh the pros and cons of continuing his addictive

D-The patient arrived on time for her appointment. Reports stable on her dose and denies the need for a dose increase when offered by this writer. This writer commends the patient complying with daily dosing; however, this writer addressed the patient UDS result patterns of positive and negative. The patient last two urines were positive for cocaine. According to the patient, a lot has been going on in her life. The patient's father has had a heart attack this past month. Also, the patient has an estranged relationship with her mother and her 17 year old daughter. During the course of the session, the patient discussed her drug history and her dysfunctional family. Alternatives and suggestions were discussed as well.

D-According to the patient, he went to Blue Hills because first, he needed a place to stay during the cold weather as to why he bgan to drink. The patient then says he was also going through some depression dealing with the lost of his mother. When asked about much alcohol he consumed before his admission to Blue Hills, his response was, " I had 2 nips to drink." Since the patient had left the program, he admits to relapsing and using heroin by smoking, " It was a lace by a cigarette." The patient is aware about the need to go to Wheeler Clinic to address the need to seek mental health services, at which he plan to do so today. Furthermore, this writer addressed the criteria needed for the patient to be reinstated into the program. This writer

D-The patient reports he is not stable at his current dose to the point he want to taper off. He expressed the need to want to get off on methadone. This writer listened to the patient vent about issues in his personal life and problematic issues with his transportation to ensure he dose daily. This writer then proceeded to discuss with the patient as to why he had entered treatment, his aspiration for his recovery process, and addressing alternatives to his barriers. The patient then reports he hasn't used any illicit drugs for three days, at which this writer commended the patient. When asked about what strategies to used to refrain from illicit drugs, he reports keeping himself busy and continue to care for his parents. The patient was

Today I visited a treatment facility in Dayton OH. On James H Mcgee Blvd. This is a methadone based facility that has more than 800 clients currently receiving a daily regime of methadone; this is an agonist substance used in the treatment of opiate addiction. My interview today is with Lakisha Russell, a Licensed Social Worker: she also carries a MHT degree and a LCDC III. Furthermore acquiring a portion of this education at Sinclair.

Objectives/Progress: Pt. developed and shared personal plans to avoid triggers, to break the cycle of procrastination and stay on his successful path of recovery. Pt. has made excellent progress on maintaining his commitment to abstinence as indicated by his clean UDS results since his admission and always attending scheduled AMS therapy groups. Pt. indicated that he is responding as expected to his prescribed 8 mg of subutex medication.

D-The patient reports nothing has changed since his last encounter with this writer. The patient reports he is stable on his current dose, completed his Methadone Stabilization today, and looking forward to his take home bottle, at which is pending for determination by the clinic's TEAM. During the course of the session, this writer discussed topics that was addressed in group and what he have learned.