How does a patient get increases or decreases in their dosage?
After intake, the nurse will assess the patient for two weeks to determine if increases or decreases are needed and then will get the order from the MD signed on what is the best course of action. Nurse/patient interaction continues daily to see how the patient feels. The methadone dosage should last 24 hours and be stable with no signs of cravings or withdrawals. Patients will not be given an increase in methadone dosage after any absence, on Saturdays, or before any holiday. CAP Medical Clinic recommends contacting nursing immediately if feeling drowsy but please note that the MD cannot be reached until after 7:30 am.
When and why are patients given the breathalyzer reading?
Patients are given a breathalyzer reading in 3 different circumstances: At intake, when there may be a concern that a patient has been drinking alcohol, and the following day after an initial breathalyzer reading has been taken. Since methadone and alcohol combined can cause an overdose, it’s very important that patients not drink during treatment. If drinking occurs, patients with alcohol readings may require a reduced dosage of methadone or no dosage at all for safety reasons. Patients will not be allowed to drive home if their reading is above the legal limit to drive.
What does a patient do if treatment days are missed?
If possible call ahead to receive the best advice and information from your counselor or a nurse. If 1 or 2 days are missed, we advise you to come in and a nurse will assess and assist you. You’re still considered a CAP Medical Clinic patient if you miss up to 13 days but you will still need to come into our facility for an assessment that requires a urine specimen sample and the MD will need to be called to assign a current methadone dose. Remember that doctors cannot be called until after 7:30 am so we recommend coming in at that time or after. Your dosage may be reduced after missing days and with routine daily attendance, you may be increased back to your original maintenance dose depending on what the doctor advises.
Please take note: Any patients that have carry doses and miss days may have their carry doses pulled based on attendance. Please see your counselor regarding your carry privileges.
After being absent for 14 days, you will be discharged from treatment. Should you relapse or wish to return to treatment to avoid relapse, please call us for instructions on how to return to treatment.
Who does a patient talk to if his or her counselor is off?
First, check-in at the front desk when looking to speak with your counselor. Your counselor will then be paged and if he or she is unavailable, the support staff will call an on-duty counselor to speak with you. You can also leave a voicemail for your counselor.
What does a patient do if he or she is sick and throws up their dosage of methadone treatment?
Contact the clinic immediately if you have thrown up your methadone dose. Don’t take more methadone if you have thrown up your dose. A doctor will advise you on what to do when you call the facility. MD recommendations may vary depending on the patient and circumstance.
What if a patient is too sick to come to the clinic?
The patient is advised to call the clinic to speak to their counselor. The patient will be advised on what their options are.
Can a patient be medicated in the hospital?
If a patient is hospitalized, he or she should have the hospital nurse call CAP Medical Clinic to verify his or her dose. There is no guarantee the patient will be medicated in the hospital as our doctors are not affiliated with hospitals. Many hospitals in the area have worked with us in the past and have been known to be cooperative. After the hospital stay, the patient will need to provide their hospital discharge papers when they return so all medications can be verified.
Can a patient get medicated in jail?
There is no guarantee a patient can be medicated in jail. Cook County Jail has a pharmacist on staff that may medicate the patient once he or she calls our nursing department to verify the correct dose. Typically, they will reduce the patient’s dose to get them off medication. If the patient is incarcerated, we advise him or her to call us upon release and provide any discharge papers.
Please note: The surrounding counties are not known for medicating patients: Will, DuPage, Kane & LaSalle counties. In case of pregnancy, they may make accommodations if the pregnancy is verified.
What does a patient need in order to travel or go on vacation with methadone?
As soon as a patient of ours is aware of any travel plans, he or she must contact their counselor immediately. There is paperwork involved that requires several signatures and will take time to process. If the patient has illicit drug-free urine specimens and carries privileges, typically carry doses can be provided. If the patient does not have illicit drug-free urine specimens, he or she does not have carry privileges. Depending on where the patient is traveling to the patient may have to receive a guest dose at another clinic. The other clinic will have many rules and fees to abide by. If the patient is traveling abroad, there are places that do not allow methadone into their country. It is important that the patient contacts their counselor immediately, even if it is an emergency situation, so all options can be explored. The patient will have to secure their medication while traveling and should bring a locked box while traveling.
Can I work/function while on methadone and also take employment drug screens?
Patients can work while being prescribed methadone. Some jobs may not allow a patient to be on methadone. When taking employment drug screens, methadone does not show up as positive opiates on a typical 5-panel drug screen. There is a specific methadone urine test that will need to be taken in order for the test result to be positive for methadone. Typically, the lab will call the patient to verify that he or she is on a methadone program and then will call us to verify the treatment. With the patient’s consent, we can provide the lab with a treatment verification letter. They will then tell the employer that he or she is able to work and typically will not release the urine results. Many jobs do a 5-panel drug screen to save money unless it is a city, government, or hospital job.
What does a patient do if they cannot make a payment?
Do not skip treatment if payment has not been made. Please come in and work with the support staff at the front desk. A payment arrangement can be made with the support staff and/or an administrator. If a patient can no longer afford treatment here, we advise a meeting with his or her counselor for state program options. If a patient cannot keep to their payment arrangement, he or she will be placed on the Administrative Withdrawal Schedule (AWS). AWS is a process of reducing a patient’s dose over a period of time in a medically-approved manner. See nursing for further information.
Does insurance cover any portion of a patient’s treatment?
If a patient has medical insurance, the support staff will have him or her sign a release of information, make a copy of their insurance card and contact the insurance company about reimbursement. There is no guarantee that the insurance company will cover treatment. At all times the patient is responsible for making payments on their bill and if they have medical coverage, the insurance company will reimburse for treatment accordingly. We cannot rely on insurance payments so all patients are required to pay their bills on time.