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 Post subject: Something Weird
PostPosted: Thu Jun 22, 2017 5:49 am 
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Hey, everyone! Hope you are all doing good. Anyway, I just wanted to share with you something kind of weird at the clinic I go to for my Suboxone.

The staff recently informed me, and everyone else, that they have a new policy in place that if you have to change your appointment for any reason when you return for your next one you are required to take a breathalyzer test.

This makes zero sense to me. Are they thinking that if we have to change our appointment that means we're going out and getting drunk instead? And what exactly would a breathalyzer test prove if your next appointment is more than 24 hours later?! And I haven't found out yet if they require the breathalyzer test if they have scheduling issues and have to change your appointment for you!

Is this something that other places have implemented, or have any of you heard of it before, or is it unique to my clinic? I would be curious to read your replies and theories on the reasoning for this as, to me, it just seems like such a random reason for an alcohol-scale-reading test.

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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 6:40 am 
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Hi skayda,

I hope things are going well in squirrel town. :D How are the public schools there? Tax rate reasonable?
Sounds like a nice place to live!!

I did some checking and there's evidently a urine test that can detect alcohol usage some days afterward.

"EtG is a direct metabolite of alcohol (ethanol). Its presence in urine may be used to detect recent ethanol ingestion, even after ethanol is no longer measurable. The presence of EtG in urine is an indicator that ethanol was ingested and can be detected in urine for up to 80 hours after ingestion."

I think there's also a blood test.

So maybe it's one of these they have in mind. Don't know of course. And yes, it seems other clinics do check for alcohol, at least according to google.

I honestly can't fathom drinking on bupe. And I'm a lifelong alcoholic (age 14 onward). But my desire to drink is just gone. I've heard others talk about this sort of cross substances repression of cravings with bupe.

Still many of course do abuse other drugs while on bupe. (I've always though it dumb to make a distinction between drugs and booze.) You can certainly argue it's in the patients best interest to be tested....as long as they don't kick you out, especially without second and third chances. It's like getting kicked out of the intensive care unit because your pneumonia got worse. :)

I realize that's not a perfect analogy. But as Dr. J. recently observed, clients who cheat need more help, not less.

Best wishes,
Godfrey

P.S. I might consider making the title of your post a little more specific. The topic is interesting. On the other hand, what you've got now is so general people might be even more inclined to check it out. "Something Weird" seems worth investigating.. It did to me. So on second thought, maybe your instincts were right.


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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 7:54 am 
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That does seem like an odd thing to do, although I'm sure there's a reason. Meh, I wouldn't care either way but I still would want to know why this is being implemented


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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 9:03 am 
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This brings up something I found out during my suboxone meeting yesterday. I was talking with an older gentleman. I've saw him at my clinic off and on for the last year but hadn't ever met him personally, until yesterday and I'm very privileged to have met him.

We split into groups and he was in my group of 3. He started telling me a little of his history at our clinic. He said he'd been discharged from our clinic once before and finally came bk for his second time. The reason he was discharged was he'd drank 1 beer before coming to his appointment that day. I asked how the doctor knew and he said it showed up in his urine test. I had no idea that we were checked for alcohol and I also had no idea we weren't allowed to drink either. I don't drink a drop anyway so maybe that's why I didn't know about this rule. But he was discharged for it. I think he's probably 73-75. But I have to admit, it was totally bad judgment to drink a beer as ur leaving for ur addiction doctor appointment. This is his story, there could be more to it, I have no idea.

This man had to leave early because he'd been diagnosed with lung cancer recently. He had to go to his cancer treatment center for some results to see if his radiation had done any good. I felt like there was a reason I met him after seeing him all this time but never speaking to him. It was like I was meant to hear his story and I'm very happy I did. He needed someone to listen to his journey. He has no wife and he mentioned how guilty he felt for not being a good father over the years. I really hope I see him again and he has a good report from his cancer doctor.

Sorry I went on and on, but I wanted to mention it since I was just discussing this topic yesterday. So skayda, it does seem like places are checking for alcohol use now. I've not hear of the breathalyzer but I'm thinking maybe they test when u reschedule in case it's because ur drinking and trying to get out of taking the drug test?? Not sure on that one.

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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 9:24 am 
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Quote:
He said he'd been discharged from our clinic once before and finally came bk for his second time. The reason he was discharged was he'd drank 1 beer before coming to his appointment that day.


Sometimes I wonder if a lawsuit could be brought in such situations. Suppose a guy or gal who's been doing well in treatment for a year or more, suddenly gets kicked out because they test positive for weed. Three weeks later the person's found dead of a heroin overdose. Seems to me there's a good probability that had the person been allowed to stay in treatment, they'd still be alive.

If it's not possible to sue for negligence in such a situation, it seems to be it should be.


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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 10:15 am 
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I'm not sure what to make of the situation. Is it possible that the message was misunderstood-- for example that two points were made, one about changing appointments, and another about checking for alcohol?

I don't use breathalizers at my office, but sometimes I wish I had one, for example if I think I smell alcohol on the person's breath and the person insists that it is from their 'mouthwash.' Of course if a clinic checks BAC, they must act on the results. If a person is over 0.08 and the clinic allows the person to drive home, the clinic could be liable to injuries from an accident.

We DO check BAC at the methadone program where I work. Methadone, as an agonist, is more dangerous in combination with alcohol than is buprenorphine.

Godfrey, I would love to be a juror on the case you describe, and I would vote to reward damages. But in reality, a doctor puts him/herself at much greater risk for NOT discharging such patients, than for discharging them. Doctors who prescribe psychotropic substances to people who use THC are roundly criticised by other doctors, at least in states without decriminalization.


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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 9:28 pm 
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you should ask them at the clinic next time you go?
is that to check for alcohol?
why only test when an appt is rescheduled?

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 Post subject: Re: Something Weird
PostPosted: Thu Jun 22, 2017 10:23 pm 
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I have same questions as Sis. And if the breathalyzer is positive, the person can't drive home?? I'm w the others wondering if the staff misconnected info. For ex. maybe it was said to be a breathalyzer test but its really a urine test or blood test (BAC) that is sensitive days later for alcohol. Maybe the appt has to be rescheduled w in a few days to catch alcohol in someone's system. Let us know what you find out.

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 Post subject: Re: Something Weird
PostPosted: Sat Jul 01, 2017 3:19 pm 
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suboxdoc wrote:
I'm not sure what to make of the situation. Is it possible that the message was misunderstood-- for example that two points were made, one about changing appointments, and another about checking for alcohol?


Nope. I asked flat out after hearing another patient complain about having to take a breathalyzer test after having to change appointments due to the long wait and them having to pick up their kids and the staff answered; "If you have to change your appointment then at your next appointment you have to take a breathalyzer to test for alcohol."

The other patient shared this with the people in the waiting room about her experience;
"I had to change appointments because it was over two hours and I still hadn't been seen! So, I told them I had to go pick up my kids but could I come back later? They switched my appointment for later in the day and when I came back for the new appointment they were like "You changed your appointment so we need you to preform a breathalyzer test." I was like "But, all I did was change my appointment because you guys were taking so long and I had to go get my kids!" and they said "That's the new policy now; changing appointments means a breathalyzer test."

Anyway, I'm not concerned about it, just curious. Lol.

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Last edited by skayda on Sat Jul 01, 2017 3:44 pm, edited 1 time in total.

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 Post subject: Re: Something Weird
PostPosted: Sat Jul 01, 2017 3:29 pm 
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godfrey wrote:
Hi skayda,

I hope things are going well in squirrel town. :D How are the public schools there? Tax rate reasonable?
Sounds like a nice place to live!!

I did some checking and there's evidently a urine test that can detect alcohol usage some days afterward.

"EtG is a direct metabolite of alcohol (ethanol). Its presence in urine may be used to detect recent ethanol ingestion, even after ethanol is no longer measurable. The presence of EtG in urine is an indicator that ethanol was ingested and can be detected in urine for up to 80 hours after ingestion."

I think there's also a blood test.

So maybe it's one of these they have in mind. Don't know of course. And yes, it seems other clinics do check for alcohol, at least according to google.

I honestly can't fathom drinking on bupe. And I'm a lifelong alcoholic (age 14 onward). But my desire to drink is just gone. I've heard others talk about this sort of cross substances repression of cravings with bupe.

Still many of course do abuse other drugs while on bupe. (I've always though it dumb to make a distinction between drugs and booze.) You can certainly argue it's in the patients best interest to be tested....as long as they don't kick you out, especially without second and third chances. It's like getting kicked out of the intensive care unit because your pneumonia got worse. :)

I realize that's not a perfect analogy. But as Dr. J. recently observed, clients who cheat need more help, not less.

Best wishes,
Godfrey

P.S. I might consider making the title of your post a little more specific. The topic is interesting. On the other hand, what you've got now is so general people might be even more inclined to check it out. "Something Weird" seems worth investigating.. It did to me. So on second thought, maybe your instincts were right.



Life is quite nutty here in Squirrel Town. Reasonable taxes and great schools, though! Haha! Okay, on to the topic at hand. I know they test for alcohol via urine, blood, etc testing, but I am talking about the breathalyzer test only. If you have to change your appointment at the clinic I go to the next time you come in at your next appointment they make you take a breathalyzer test for alcohol. I don't think I can change the title of my post. But if I could I would change it to "Breathalyzer For Changing Appointments?!"

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 Post subject: Re: Something Weird
PostPosted: Sat Jul 01, 2017 3:34 pm 
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HTOWN wrote:
That does seem like an odd thing to do, although I'm sure there's a reason. Meh, I wouldn't care either way but I still would want to know why this is being implemented


Yeah, it's not that I'm worried or anything; I don't even drink. But, I AM curious as to the reasons behind this new policy. I understand the need for alcohol testing especially in a chemical dependency recovery clinic, but, it's the why and how that's got me wondering. It just seems so random to be given a breathalyzer test just for changing your appointment! I could see if you showed up looking wasted, loss of balance, slurred speech, etc, but just for having to come in at a different time than was previously scheduled?! I don't know. Things that make you go "hmmm".

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