Summary Of P-Next Placement

D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this

The client is an 18-year-old African American female presented to Norfolk State University Substance Abuse Center after a positive urine test for cocaine and marijuana. The client tested positive for both psychoactive drugs during a mandatory routine screening administered by her employer at a local grocery store. She indicated smoking marijuana (pot) every day and uses cocaine typically on the weekend. However, the client has an increase tolerance level of cocaine as evidence by her stating she is using "more and more cocaine to maintain the same effect. She reported in the past snorting only one line of cocaine, but this has increased to five lines of cocaine in the last past 12 months. In addition, she stated she occasionally smokes a couple

Assessment: The patient continues to comply with the clinic's intervention, but continues to test positive for illicit drugs. According to the patient, she bases on her relapses on stupidity. This writer strongly advise the patient to take her recovery serious due to the length of time in treatment and the ongoing positive result as no changes have been made. Please note, the patient appeared to be alert and oriented. No evidence of

This writer reviewed one of Cherron treatment-patient #3012. Cherron shared with this writer about the barriers of the patient’s treatment as the patient is currently on Step 3. This patient is attending the Cocaine Group on Thursdays from 10-11am. This writer recommends for Cherron to discuss inpatient treatment with the patient as an intervention and assist the patient with the referral. Furthermore, this writer advised Cherron to elaborate more in his general note (treatment plan).

D-This writer met with the patient as she requested to see a Supervisor. According to the patient, she cannot stay to see her assigned counselor, Janice. When questioned as to why she is unable to see her counselor, the patient response was, " My mother is in a wheelchair and left alone with my son.....I have to go home." Supervisor reviewed the patient's alerts as the patient have a scheduled BAC and tested positive on 5/16/2017. This writer questioned the patient about this matter. The patient then says, " I am aware about this and the need to attend the alcohol group. I am willing to do the group session tomorrow." Supervisor called the patient assigned counselor to seek permission about releasing the HOLD on her behalf whereas it can be

D/A: There were no medical appointments for Mr. Brown this week. Mr. Brown attended dialysis twice this week on 01/03/17 and 01/7/17 at the Fresenius Medical Center and received treatment on 01/5/17 at the Kent General Hospital. On 12/31/16, Mr. Brown was admitted to the Kent General Hospital and was discharged on 01/07/17 at 7 pm, where he was diagnosed and treated for Pneumonia and Congestive Heart Failure. Consumer has a new addition medication “Prednisone,’’ that he will be taking once in the morning for three consecutive days. Consumer did not meet with his Psychiatrist Dr. Capiro this week because he was admitted at Kent General Hospital.

D-This writer discussed with the patient about the expired script. The patient reports her RX script is as needed; however, this writer informed the patient about the program policy that every medication must at all time validated by Nursing. Also, if the doctor changes the script to the point the patient no longer needs it that also need to be validated with a letter. The patient then says, " Okay, Charlene. I will get it next week, I promise." Addressing her illicit use, the patient reports that she haven't used any illicit drugs and does not want to use anymore because she says, " Man, Charlene.....I am sooo focus right now, I want to apply for my take home bottles and be good...you know." This writer commends the patient comment and further

D- The patient reports she is stable at her current dose and haven't used any illicit drugs. This writer discussed about the 5th take home bottle application and informed the patient about when her 4th bottle was approved, which was on 03/9/2016. This writer informed the patient that she has to wait 30 days to apply for the next bottle, which will be completed on the patient next bi-weekly scheduled appointment. Furthermore, the patient informed this writer that she has to leave as she has to be at work at 8:30am and apologized for arriving late to her session.

D-The patient was placed on HOLD and this writer cleared the HOLD. This writer addressed with the patient about her recent AWOL, referring to yesterday. According to the patient, she missed her medcab and did not have any other form of transportation. The patient was in tears as she also reported that she used crack cocaine (smoking) from 8/1/2016-08/4/2016. When asked as to how much she used, she says, " I spent $300 worth......I was doing so good, so good. I didn't want to use. It's too much." This writer asked the patient to what happen recently because during the last individual counseling session, the patient was clean from illicit drugs for a week and 3 days. According to the patient, her son had turned against and lied to her sister

D-The patient arrived on time for her scheduled appointment to meet with this writer. The patient reports she is stable at her current dose and haven't used any illicit drugs. The patient reports that she is currently prescribed with Xanax and her psychatrist hasn't lower her dose with Xanax because of the patient's panic attack. The patient reports she is still engaging in therapy and is willing to bring in a letter to address her progress and attendance with treatment to assist with the take home bottle application.

D-The patient received his dose increase today from 35mgs to 40mgs. According to the patient he was doing okay at 35mgs, but feels 40 mgs will do better. The patient admits to using heroin last night, 2 bags by IV. This writer stated he did not use due to cravings, but to help him sleep as he going through withdrawals. The patient further believes with the new dose, he will be able to sleep better at night. This writer then asked the about the outcome of his blood works with Brownstone Clinic. The patient then admits that he hasn't follow up because he did not have any minutes on his phone, but will follow up today and update this writer during the next scheduled session. This writer then proceeded to discuss with the patient about his goals for his treatment during the remainder of the session.

D-The patient arrived on time for her session and immediately requested an decrease on her dose as wish to be stabilize on a lower dose. According to the patient, she is not using any opioid and says, " The urine I did today will be a negative." This writer noticed the patient demeanor as she appeared to be upset about her experience at this clinic. The patient discussed with this writer about producing her hospitalization over the weekend and the difficulties with waiting on a medical order before she can dose. This writer informed the patient about the clinic policy and procedure, but the patient expressed that she waited over an hour and left and came back to dose. The patient then discussed how her experience affected her livelihood as

D-The patient was placed on HOLD to meet with this writer for counseling session. Reports stable on his dose and denies the need for a dose increase when offered. The patient admits to using heroin last night-1 bag by inhalation due to stressors in his life. This writer discussed the stressors in the patient life, referring to his family, transportation issue, and lack of recovery support. Alternatives and suggestions were discussed. This writer addressed with the patient that if he continues with his AWOLs, it will lead to a treatment violation. The patient understood this writer's position and says, " I am trying, but its hard, you know. I hope Logisiticare sends me the metro cards."

D-The patient arrived on time for her counseling session. The patient attended the cocaine group today and briefly discussed as to what was discussed in the group. Addressing her AWOL on 01/19/2017-The patient could not remember what occurred on that day and as for 01/12/2017, the patient was at the Hartford Court with a friend as translator. This writer issued an AWOL notice of the patient missing two days of dosing. The patient admits to relapsing on the 01/12/2017 and also, this past Sunday- 1/2 bundle of heroin by IV. Alternatives were discussed. Addressing her Hep.C, the patient has scheduled an appointment with UConn Medical Center for 01/26/2017, whereas she will be assigned with a PCP. Patient signed an ROI.

Please be advised that he tested positive for Cocaine on 6/18/15. In view of that, the client’s treatment schedule has been revised accordingly and it will include relapse prevention and anger management group counseling, as well as intense individual treatment sessions. The client will also participate in community based Narcotics Anonymous meetings on a regular basis. In addition, the client has been given homework assignments pertaining to relapse triggers and anger management