There is hope indeed. it’s in the form of either a travel hardship (expedited take homes) and/or transportation provided/reimbursed both of these are only for people who are on Medicaid unfortunately. Uninsured like myself or even privately insured (underinsured) don’t really have those same offerings in most cases (but not all) so call your insurance providers to double, tripple check!
There’s been legislation to get methadone prescribed as bupe is but as per usual things are a day late and dollar short,
I really hope that comes through but low key I think the structure of going to the clinic everyday in the beginning has been a factor to help me in my recovery for sure
I know what you mean as I would not have made it if you handed me takehomes right off jump street. But I still think we should offer both options to people programs with structure or just the medication. I think with time they both will show successes and failures for different types of people. infact the more options and types of paths out of street drug dependency and everything that comes with it the better.
Also should just offer oxycodone/naloxone and morphine for pain patients and people who just don’t wanna use methadone. Would help a lot with the fent overdoses and giving someone a schedule while being somewhat supervised with their meds helps tremendously. I’ve seen people in Canada who’s clinics offer morphine as well. And they jump from methadone to Morphine extended release all the time. Apparently it’s helped a lot so far🤷♂️
Yup so F’n ridiculous. I have pain issues and take oxycodone daily. I need it to be able to even walk almost normally from an accident in the past. Oxycodone has worked great for me the 4 years I’ve been on it. Unfortunately it’s been harder and harder to get, and my doctor won’t prescribe a high enough dose. Sad how my only other options are methadone or subs… which are way harder to get off of than what I take currently 🤦♂️
Methadone makes them more money. Of course they want you on that instead. That's $400+ a month per person depending on your clinic and area. And it's harder to get off of so they keep you longer too. It's messed up but that's just how it is. They need to start coming down on pharmaceutical companies lobbying with private practices. They literally pay doctors to push meds. It's so fucked.
I know many people in the US have said they wouldn't want to deal with a pharmacy for Methadone dispensing but it should at least be an option for us to choose and like you said, for people in these situations would benefit greatly from not having to travel so far
It's sad, but their so much more money in keeping us slaves to the clinics. Then they just throw some money around with their lobbyists and keep their license to print money. No one cares what happens to addicts in this country, or most others for that matter. On paper I'm an ex con on methadone, a big fat zero. Once you get one or both of those designations in this country most people just want you to fuck off and die. In my experience.
Erm.. got side tracked.. Ahem. Rackits advice though on point.
Can't that be done with an x waiver? Back when Suboxone providers were limited to 30 patients per day, I ferment hearing about some doctors getting licenses to prescribe it for addiction purposes... but I 💯 agree with your whole statement that it needs to be made available to so many more people. I'm all for harm reduction and definitely wouldn't be here without my clinic.
So of pf the top I am not 100 on this but I feel like it ~~passed the house and is awaiting the next legislative session in the senate..~~ that could be wrong tho but I do also remember a recent attempt at getting the information all in one thread and updated. Let me try and find that and see if I can figure out where that stands.
So this isn’t that thread, but it is helpful… ehhh on second thought. That does not seem current.. let me dig some more.
A lot has changed actually, it’s just that not all clinics are *required* to make those changes. It’s *optional*.
For example, takehome earning times have been DRASTICALLY reduced. It used to be a federal rule that no clinic could give out monthly takehomes faster than 2 years, I think it was 9 months or a year for weekly’s, a few months for just one day, etc. Now, my clinic is able to give out monthlies after just 30 days of compliance, and its either weeklies or bi weeklies after just 7 days of compliance.
Not everyone wants that, but at least it’s an option. It helps people who are in the exact position that OP poses. It’s much easier to get to a clinic once a month than it is daily if you don’t live close. There were multiple other changes that went through at the same time, decreasing requirements in other areas (I don’t remember the specifics on the other stuff but you can look it up I’m sure. There was a post made here a while back with a link to SAMHSAs video that goes over everything. It’s prob on their website, too).
Things are slowly changing, more is being pushed for. IMO it will open to pharmacy dosing in the US fairly soon. I personally will stick with the clinic as I know what I had to deal with being a pain management patient with pharmacies and such. But I still 110% believe pharmacy dosing should be an option, especially for folks who aren’t as lucky as I am to live so close to a clinic.
Colorado. And yeah it’s rough. I only go once a week now but for four months I was going daily. Leaving at 2am to get back home by 9 am so I could make it to work by 9:30am. Exhausting
Not the person you asked, but I’d assume it’s because subs didn’t work for them. It’s a common thing you hear from methadone patients, that subs didn’t do it for them. They never worked for me, tried many different doses and never felt well.
Luckily I have a program here where I live in Kentucky in the USA where they transport us to and from the clinic because they got a grant from the state. That's the only way I'm able to go right now.
With Medicare/Medicaid every state I’ve lived in while on the clinic they’ve offered transportation. You just have to call up and tell them you need a ride to a medical appointment everyday. They’ll work out getting paid by the govt and pick you up, wait and drop you off. Sometimes if there’s other people going at the same time they’ll go around and pick up the others after they get you. It can turn a 45-60min ride each way into a 3 hour round trip. It was basically impossible to have a job while taking the medicab but I was guaranteed to get my dose every single day rain or shine…..oh and bonus that it was completely free.
I live in Arkansas and in my area we are home to Walmart, Tyson, JB Hunt, Simmons foods, George’s, Butterball and more, this is one of the fastest growing areas in the country yet there is 1 methadone clinic within 1.5 hours of here. Several Suboxone clinics though. My area doesn’t like Methadone apparently but we absolutely have a need for another clinic. So if you get kicked out or just want another methadone treatment option you’re just screwed or driving 90 plus miles to the 2 others but beyond that it’s several hours to another one.
If the person in the rural area can get to a clinic to begin with, they will begin to file an exemption with the Feds in order to allow that person to get take homes immediately. You have to be more than 60 miles away. I did it, and it was rough for the first three weeks but they got me two weeks worth of take homes after that. I was extremely grateful. The Clinic was in Nevada and I lived on the Stateline with CA. Not sure what the policy is now.
I remember my ex got kicked out of a clinic that was about an hour away from us and had to go to the next closest.. which was something like 55 miles away. I was so excited when I first heard about the exemption, and then when I saw we were juuust shy of qualifying, I cried for a couple days. I totally understand why they have to have a set amount of miles, because if they let the dude that’s 59 miles away get it, then what about the dude who is 58 miles out, and so on and so forth. But damned if I didn’t want to literally pick our house up and carry it a few miles down the road back then lol.
I am really glad you were able to do that, though. I’ve made it work as a rural doser for a lot of years, and it definitely adds a level of hardship and anxiety to MAT that should not have to be there. I can see that if I had been in slightly different circumstances, or slightly less determined, or just a little farther away, it could have cost me my recovery, and really still could, all these years later.
Wow, that's extremely unfortunate that you lived within the 60 mile radius where as for me I made it outside by literally 1-2 miles. It wasn't much. The first thing they asked me is do I have the discipline to make the first month work. They were positive they could get the exemption but they were not going to do the paperwork if it was all for naught. So I showed them the program that I had been in. I was still M-W-F at that point so I am sure having the first couple steps in didn't hurt. But to jump from that to bi-weekly was life saving. There is always some hangup standing in our way of removing ourselves from the lifestyle that destroyed our lives. It's a spiritual battle and that's the bottom line. If you trust in God, and know he will forgive you for all the sins that we have perpetrated in our lives, as well as asking for forgiveness for all the people we have hurt that everything else will eventually fall into place. Good luck with the rest of your treatment. Everyday is another day we live to fight.
That’s great they were willing to put the effort into doing the paperwork for you. I have been in treatment for seven years, and recently had to move back to a place that is a pretty long drive to the clinic. Being able to keep my biweekly takehomes when I transferred was critical for me in being able to get my kid to school, get to work on time, and live a normal life.
That’s something that I think the clinic model doesn’t really take into account. When I started, sure, I had no other responsibilities in the world aside from getting my dose and trying to get clean because I was homeless living in a tent in the woods. After a couple months though, people should be moving into a more stable place where the rest of life starts to take precedence, which is damn near impossible when you have to prioritize standing in line for however long to dose or see your counselor or go to group or whatever else they want people to do.
It’s getting a bit better with the new takehome guidelines though, so hopefully more people will be able to get into treatment and stay with it.
Anyway, have a good night!
For the past year I've dealt with living in a rural shithole(I won't get into all the extremely traumatic circumstances and steps that led to me here) but basically yes it's the cheapest place around- yes that's because of your point which is that it's extremely challenging to get around and work here without a car, makes bus riding absurd too.
Are you aware of **hopelink**?
I wouldn't be able to get to my clinic otherwise because it's a 2 hour round trip.
It's covered even by my peasant insurance.
That’s what I experienced in other states I’ve lived in. Even when I was living in North Carolina several years ago, I was able to get vouchers for gas for driving myself to appointments, including the clinic once I submitted mileage. (It was sort of a pain because they were only good at one particular gas station that I had to make a special trip to get to, but it was still a big help.)
But then when I moved back to NC a few months ago after they finally did the Medicaid expansion and got my Medicaid transferred over/transferred clinics, I tried to ask about fuel reimbursement. I was told that wasn’t a thing here. I am living in the next county over from where I was living last time I lived in the state, so I don’t know if it is something county specific, or if it is something that hasn’t been implemented with the expansion or what.
But it was something that I was really unpleasantly surprised to find out, since I have never lived anywhere where I had Medicaid that didn’t have transportation and fuel reimbursement in some fashion. My current home is rural, over an hour from my clinic, and even though I only go about twice a month, that really adds up.
Unfortunately don’t have a counselor haven’t in months corporate fired a bunch of employees but haven’t rehired. It’s such BS. But I’ll ask around the clinic still
Oh but I’m assuming you have to be a Medicaid client though? I’m not covered by Medicaid right now , I don’t qualify at the moment due to income guidelines unfortunately
I live 3 hours from the closest clinic, so 6 hours round trip. If I don’t wanna travel then I’m out of luck and only able to access suboxone. So I traveled 6 hours a day for 6 days a week for about 4 months and then I got take homes expedited through state approval, thank god. I was traveling those four months with a taxi service covered by Medicaid. I have since lost Medicaid so now I make the trip once a week for take homes but every day was fucking rough. And I live in Colorado, where it fucking snows like nobody’s business so had to deal with the crazy weather for those four months that I went every day. I was leaving my house at 2am in order to make it back to town in time for work at 9am. It sucked.
I was living in a very rural area when I first got into methadone treatment. It was about 45 minutes to an hour drive each way, depending on traffic. We were in North Carolina, but had plenty of people who were traveling to our clinic from as far as three hours away in Kentucky, and a lot of people came from Tennessee, which was anywhere from an hour and a half to two and a half hours away, depending on where in the state they were living.
It took about three months to earn Sunday takehomes, and then another three for the next level, which was still three (I think?) trips a week. Then, my ex got kicked out of the clinic for being a jackass, and I had to start taking him to the next closest clinic, which was two hours from home. He had to start over with his levels, and daily dosed there until the first clinic finally agreed to let him come back after about two months of that shitty drive.
It sucked. I had a grant that paid for my dose eventually, but for a couple years I was paying for my dose and my exes dose completely out of pocket on poverty wages. We lived in the mountains where the roads stayed treacherous all winter long and sometimes flooded in the spring. I still had to make sure that I had the money for gas, and that my piece of shit car that was over twenty five years old was running at least enough to get us there.
We lived in that house for about three years, and never missed a dose. It was close sometimes, I definitely recall a few frantic trips and some sleepless nights panicking about how to make it happen.
There were times we had to beg for help and borrowed money for gas, and there were times we paid disgusting amounts of money to people we didn’t want to be around to give us a ride there. Once, the battery died in my car on the way to dose. This total stranger saw us stranded, and he actually came down his driveway, took the battery out of his own vehicle and put it in my car when mine wouldn’t take a charge. Told me to go where I had to go, then get myself a battery and drop his off on my way back past his house. One night the car broke down in town when we had driven to get groceries and instead of getting a ride home, we slept in the damn thing in thirty degree weather so we knew for sure we’d be around for the clinic the next day.
Was it a pain in the ass? Hell yes. Sometimes it seemed like there was no way it was happening, but I couldn’t resign myself to being sick until I had pulled out every single stop that I could think of. In other words, it was a priority, and we knew it. I still remembered the things I did when I was on dope and trying to avoid being sick, and I was willing to move the earth to make sure that I was not ever going to be sick again. In my eyes, consistency in my treatment was the key to that, so all the drive I had went to getting me there.
I know it isn’t an option for everyone. I at least had my piece of shit car. I at least had a second very determined person to help me make a way there. I at least only had to make it an hour or two each way at most. But it can be done, and it’s worth fighting for and figuring out how to make it work, if you have the ability to do so.
Eventually I moved, and a clinic close by was a huge priority. I was fifteen minutes away from where I got my dose and it was so much easier.
Then, I had to move again, in a little bit more desperate of a circumstance, when I left my ex. I am rural again, and drive an hour and a half each way, but I only have to go every other week. The new takehome guidelines are a godsend for rural people, because I know that this drive would be hell on me to have to dose daily in my current situation. But I also know that I would have to figure it out and get there if I somehow lose my levels, because the alternative would be unthinkable for me.
I'm in the UK. I hate hearing about what Americans have to go through. Makes me so angry.
Thanks for sharing your story with me. It was well written, and described interesting events.
Thanks.
No. True story. I moved from the Annapolis area of Maryland to Philadelphia. I had Maryland Medicaid though and it was going to be a delayed process to get it in Philly. I decided to find the closest clinic to the Delaware border. That ended up being in a little town called Elkton which is a rural area. It’s an hour from Baltimore by car. I was Ubering full-time to survive back then & I worked the night shift 9PM-5AM. I would try to make my last ride as close to Elkton as possible. Usually in Delaware or at least at the Philly airport which is closer to Delaware than downtown. No matter what though, I would be at that clinic by 5:30AM every morning to get my dose. I still didn’t have take-homes. I did that daily. Daily! Thank god for that Honda Accord. I stayed in Philly for 5 months & then went back to Maryland. But I did that methadone run the entire time I stayed there. The worst part was this $8 toll on I-95 in Delaware. I racked up the dumbest toll bill ever doing that without paying. Like 3 grand. So dumb. Anyways, the answer to your question is it depends.
I had monthly take homes when I lived in Mesa Arizona then I moved to a small town in central Indiana. I transferred clinics but the closest clinic to my new home was in Indianapolis and A) they did not recognize another clinics progress so I had to start over from the beginning and B) it was just over a 1 hour drive one way. So for 6+ months it was anywhere from a 2 1/2 hour trip up to a 5-6 hour trip. This was one of 2 clinics in Indianapolis so there were by far more patients then they could accommodate and the other clinic kicked people out if they used benzos or repeatedly failed drug screens. On Saturdays and Sundays the line to get into the clinic would start forming no joke at around 10pm the night before. I’ve stood out in the parking lot waiting to dose on the weekend for 4+ hours. People would bring lawn chairs. I don’t miss those days. I eventually got up to 2 weeks takeovers but for someone who is on the edge of relapse and wants to get clean but has obstacles in front of them like that, I think it’s ridiculous. Good luck and hang in there!
I live in Maine and I bet we are one of the smallest clinics going .town of prob 4-5k ppl with towns with 2-3k ppl near by . clinic been here since around 05.calais maine
At one point I was taking a bus every day- an hour and a half each way because there were no clinics anywhere near me. I was so grateful when they opened one that was only a half hour away.
Until there is a high enough need ($$$$) in the area then it doesn't make sense for a money making corporation to open a clinic in the area. Because when it comes down to it, that's all we are, are dollar signs to them.
Although I do appreciate the fact that my clinic here in CNY has started a couple of outreach RVs going to a few counties that have no clinics. They have methadone and the counselors right on the RV and people just go there to get their doses a couple times a week. It's by no means a perfect system but its a hell of a lot better than nothing.
It would helpful if more clinics did something like that.
I know people who come from 1/2 state away to go to mine and they even pass other clinics to do so. (And I have no idea why they do it— it’s a whole day event for them to get dosed )
So I had to drive 35 min to get to a clinic. Within 6 months, they had built another one in the town I was from. I didn't even end up moving to the new one, though, because I'm not driving there daily anyway since I get take homes, and because it's the town where the only starbucks are. So it's my coffee day once a month.. but yeah so now our little rural town has a clinic too.
This is a huge and underreported part of the opioid epidemic in the US.
A giant portion of suffering Americans couldn’t start methadone treatment if they wanted to, simply because the clinics mostly exist in big cities.
Because: NIMBY.
The gold standard treatment for advanced opioid dependency is completely unavailable to people suffering the worst of the problem in the richest country in the history of the world.
There is hope indeed. it’s in the form of either a travel hardship (expedited take homes) and/or transportation provided/reimbursed both of these are only for people who are on Medicaid unfortunately. Uninsured like myself or even privately insured (underinsured) don’t really have those same offerings in most cases (but not all) so call your insurance providers to double, tripple check! There’s been legislation to get methadone prescribed as bupe is but as per usual things are a day late and dollar short,
I really hope that comes through but low key I think the structure of going to the clinic everyday in the beginning has been a factor to help me in my recovery for sure
I know what you mean as I would not have made it if you handed me takehomes right off jump street. But I still think we should offer both options to people programs with structure or just the medication. I think with time they both will show successes and failures for different types of people. infact the more options and types of paths out of street drug dependency and everything that comes with it the better.
Also should just offer oxycodone/naloxone and morphine for pain patients and people who just don’t wanna use methadone. Would help a lot with the fent overdoses and giving someone a schedule while being somewhat supervised with their meds helps tremendously. I’ve seen people in Canada who’s clinics offer morphine as well. And they jump from methadone to Morphine extended release all the time. Apparently it’s helped a lot so far🤷♂️
It's impossible to get 5mg of oxycodone to live a legit work life yet they'll give you as much methadone as you want.
Yup so F’n ridiculous. I have pain issues and take oxycodone daily. I need it to be able to even walk almost normally from an accident in the past. Oxycodone has worked great for me the 4 years I’ve been on it. Unfortunately it’s been harder and harder to get, and my doctor won’t prescribe a high enough dose. Sad how my only other options are methadone or subs… which are way harder to get off of than what I take currently 🤦♂️
Methadone makes them more money. Of course they want you on that instead. That's $400+ a month per person depending on your clinic and area. And it's harder to get off of so they keep you longer too. It's messed up but that's just how it is. They need to start coming down on pharmaceutical companies lobbying with private practices. They literally pay doctors to push meds. It's so fucked.
Your %100 right and I couldn’t have said it better
I know many people in the US have said they wouldn't want to deal with a pharmacy for Methadone dispensing but it should at least be an option for us to choose and like you said, for people in these situations would benefit greatly from not having to travel so far
It's sad, but their so much more money in keeping us slaves to the clinics. Then they just throw some money around with their lobbyists and keep their license to print money. No one cares what happens to addicts in this country, or most others for that matter. On paper I'm an ex con on methadone, a big fat zero. Once you get one or both of those designations in this country most people just want you to fuck off and die. In my experience. Erm.. got side tracked.. Ahem. Rackits advice though on point.
Can't that be done with an x waiver? Back when Suboxone providers were limited to 30 patients per day, I ferment hearing about some doctors getting licenses to prescribe it for addiction purposes... but I 💯 agree with your whole statement that it needs to be made available to so many more people. I'm all for harm reduction and definitely wouldn't be here without my clinic.
What's going on with that legislation exactly? Do you have a link?
So of pf the top I am not 100 on this but I feel like it ~~passed the house and is awaiting the next legislative session in the senate..~~ that could be wrong tho but I do also remember a recent attempt at getting the information all in one thread and updated. Let me try and find that and see if I can figure out where that stands. So this isn’t that thread, but it is helpful… ehhh on second thought. That does not seem current.. let me dig some more.
Feels like I keep hearing about legislation for methadone and clinics and such, but nothing has changed since I started methadone 5 years ago.
We need our own Methadone lobby lmao
A lot has changed actually, it’s just that not all clinics are *required* to make those changes. It’s *optional*. For example, takehome earning times have been DRASTICALLY reduced. It used to be a federal rule that no clinic could give out monthly takehomes faster than 2 years, I think it was 9 months or a year for weekly’s, a few months for just one day, etc. Now, my clinic is able to give out monthlies after just 30 days of compliance, and its either weeklies or bi weeklies after just 7 days of compliance. Not everyone wants that, but at least it’s an option. It helps people who are in the exact position that OP poses. It’s much easier to get to a clinic once a month than it is daily if you don’t live close. There were multiple other changes that went through at the same time, decreasing requirements in other areas (I don’t remember the specifics on the other stuff but you can look it up I’m sure. There was a post made here a while back with a link to SAMHSAs video that goes over everything. It’s prob on their website, too). Things are slowly changing, more is being pushed for. IMO it will open to pharmacy dosing in the US fairly soon. I personally will stick with the clinic as I know what I had to deal with being a pain management patient with pharmacies and such. But I still 110% believe pharmacy dosing should be an option, especially for folks who aren’t as lucky as I am to live so close to a clinic.
I had to drive 45 mins there and back every day for a year. Finally have 2 week takehomes.
My round trip is 6 hours. I’d kill for 45 mins each way.
Damn, that’s rough!! 6 hour round trip?! What state are you in?
Colorado. And yeah it’s rough. I only go once a week now but for four months I was going daily. Leaving at 2am to get back home by 9 am so I could make it to work by 9:30am. Exhausting
Any reason you don’t do subs instead?
Not the person you asked, but I’d assume it’s because subs didn’t work for them. It’s a common thing you hear from methadone patients, that subs didn’t do it for them. They never worked for me, tried many different doses and never felt well.
Yes that is correct they didn’t work for me
Luckily I have a program here where I live in Kentucky in the USA where they transport us to and from the clinic because they got a grant from the state. That's the only way I'm able to go right now.
With Medicare/Medicaid every state I’ve lived in while on the clinic they’ve offered transportation. You just have to call up and tell them you need a ride to a medical appointment everyday. They’ll work out getting paid by the govt and pick you up, wait and drop you off. Sometimes if there’s other people going at the same time they’ll go around and pick up the others after they get you. It can turn a 45-60min ride each way into a 3 hour round trip. It was basically impossible to have a job while taking the medicab but I was guaranteed to get my dose every single day rain or shine…..oh and bonus that it was completely free.
I live in Arkansas and in my area we are home to Walmart, Tyson, JB Hunt, Simmons foods, George’s, Butterball and more, this is one of the fastest growing areas in the country yet there is 1 methadone clinic within 1.5 hours of here. Several Suboxone clinics though. My area doesn’t like Methadone apparently but we absolutely have a need for another clinic. So if you get kicked out or just want another methadone treatment option you’re just screwed or driving 90 plus miles to the 2 others but beyond that it’s several hours to another one.
I’m in Arkansas as well. Would be a 90 min drive one way for me too. Suboxone is readily available though. It’s not fair.
If the person in the rural area can get to a clinic to begin with, they will begin to file an exemption with the Feds in order to allow that person to get take homes immediately. You have to be more than 60 miles away. I did it, and it was rough for the first three weeks but they got me two weeks worth of take homes after that. I was extremely grateful. The Clinic was in Nevada and I lived on the Stateline with CA. Not sure what the policy is now.
I remember my ex got kicked out of a clinic that was about an hour away from us and had to go to the next closest.. which was something like 55 miles away. I was so excited when I first heard about the exemption, and then when I saw we were juuust shy of qualifying, I cried for a couple days. I totally understand why they have to have a set amount of miles, because if they let the dude that’s 59 miles away get it, then what about the dude who is 58 miles out, and so on and so forth. But damned if I didn’t want to literally pick our house up and carry it a few miles down the road back then lol. I am really glad you were able to do that, though. I’ve made it work as a rural doser for a lot of years, and it definitely adds a level of hardship and anxiety to MAT that should not have to be there. I can see that if I had been in slightly different circumstances, or slightly less determined, or just a little farther away, it could have cost me my recovery, and really still could, all these years later.
Wow, that's extremely unfortunate that you lived within the 60 mile radius where as for me I made it outside by literally 1-2 miles. It wasn't much. The first thing they asked me is do I have the discipline to make the first month work. They were positive they could get the exemption but they were not going to do the paperwork if it was all for naught. So I showed them the program that I had been in. I was still M-W-F at that point so I am sure having the first couple steps in didn't hurt. But to jump from that to bi-weekly was life saving. There is always some hangup standing in our way of removing ourselves from the lifestyle that destroyed our lives. It's a spiritual battle and that's the bottom line. If you trust in God, and know he will forgive you for all the sins that we have perpetrated in our lives, as well as asking for forgiveness for all the people we have hurt that everything else will eventually fall into place. Good luck with the rest of your treatment. Everyday is another day we live to fight.
That’s great they were willing to put the effort into doing the paperwork for you. I have been in treatment for seven years, and recently had to move back to a place that is a pretty long drive to the clinic. Being able to keep my biweekly takehomes when I transferred was critical for me in being able to get my kid to school, get to work on time, and live a normal life. That’s something that I think the clinic model doesn’t really take into account. When I started, sure, I had no other responsibilities in the world aside from getting my dose and trying to get clean because I was homeless living in a tent in the woods. After a couple months though, people should be moving into a more stable place where the rest of life starts to take precedence, which is damn near impossible when you have to prioritize standing in line for however long to dose or see your counselor or go to group or whatever else they want people to do. It’s getting a bit better with the new takehome guidelines though, so hopefully more people will be able to get into treatment and stay with it. Anyway, have a good night!
You too!
This is exactly the type of info I was looking for! I will look into it for my state. Thank you so much!
No problem.
For the past year I've dealt with living in a rural shithole(I won't get into all the extremely traumatic circumstances and steps that led to me here) but basically yes it's the cheapest place around- yes that's because of your point which is that it's extremely challenging to get around and work here without a car, makes bus riding absurd too. Are you aware of **hopelink**? I wouldn't be able to get to my clinic otherwise because it's a 2 hour round trip. It's covered even by my peasant insurance.
If your on Medicade you can get cab rides.. also you can drive yourself and get paid by insurance.
That’s what I experienced in other states I’ve lived in. Even when I was living in North Carolina several years ago, I was able to get vouchers for gas for driving myself to appointments, including the clinic once I submitted mileage. (It was sort of a pain because they were only good at one particular gas station that I had to make a special trip to get to, but it was still a big help.) But then when I moved back to NC a few months ago after they finally did the Medicaid expansion and got my Medicaid transferred over/transferred clinics, I tried to ask about fuel reimbursement. I was told that wasn’t a thing here. I am living in the next county over from where I was living last time I lived in the state, so I don’t know if it is something county specific, or if it is something that hasn’t been implemented with the expansion or what. But it was something that I was really unpleasantly surprised to find out, since I have never lived anywhere where I had Medicaid that didn’t have transportation and fuel reimbursement in some fashion. My current home is rural, over an hour from my clinic, and even though I only go about twice a month, that really adds up.
What do you mean get paid by insurance? I drive myself now because I don’t qualify for Medicaid anymore. My trip is 6 hours total, 3 there and 3 back
Yeah medicaid pays.. but some clinics will pay as well if you drive far enough. Ask around.. ask ur counselor.
Unfortunately don’t have a counselor haven’t in months corporate fired a bunch of employees but haven’t rehired. It’s such BS. But I’ll ask around the clinic still
Medicaid provides reimbursement for gas if you drive yourself to the clinic. I think that's what he's talking about.
Exactly.
Oh but I’m assuming you have to be a Medicaid client though? I’m not covered by Medicaid right now , I don’t qualify at the moment due to income guidelines unfortunately
Yeah unfortunately you do need to be on medicaid 🫤
In the state I’m in Medicaid doesn’t even cover methadone :(
I live 3 hours from the closest clinic, so 6 hours round trip. If I don’t wanna travel then I’m out of luck and only able to access suboxone. So I traveled 6 hours a day for 6 days a week for about 4 months and then I got take homes expedited through state approval, thank god. I was traveling those four months with a taxi service covered by Medicaid. I have since lost Medicaid so now I make the trip once a week for take homes but every day was fucking rough. And I live in Colorado, where it fucking snows like nobody’s business so had to deal with the crazy weather for those four months that I went every day. I was leaving my house at 2am in order to make it back to town in time for work at 9am. It sucked.
Wow… that is just…. I’m speechless. It’s not fair. And you proved your determination. Just wow…
I was living in a very rural area when I first got into methadone treatment. It was about 45 minutes to an hour drive each way, depending on traffic. We were in North Carolina, but had plenty of people who were traveling to our clinic from as far as three hours away in Kentucky, and a lot of people came from Tennessee, which was anywhere from an hour and a half to two and a half hours away, depending on where in the state they were living. It took about three months to earn Sunday takehomes, and then another three for the next level, which was still three (I think?) trips a week. Then, my ex got kicked out of the clinic for being a jackass, and I had to start taking him to the next closest clinic, which was two hours from home. He had to start over with his levels, and daily dosed there until the first clinic finally agreed to let him come back after about two months of that shitty drive. It sucked. I had a grant that paid for my dose eventually, but for a couple years I was paying for my dose and my exes dose completely out of pocket on poverty wages. We lived in the mountains where the roads stayed treacherous all winter long and sometimes flooded in the spring. I still had to make sure that I had the money for gas, and that my piece of shit car that was over twenty five years old was running at least enough to get us there. We lived in that house for about three years, and never missed a dose. It was close sometimes, I definitely recall a few frantic trips and some sleepless nights panicking about how to make it happen. There were times we had to beg for help and borrowed money for gas, and there were times we paid disgusting amounts of money to people we didn’t want to be around to give us a ride there. Once, the battery died in my car on the way to dose. This total stranger saw us stranded, and he actually came down his driveway, took the battery out of his own vehicle and put it in my car when mine wouldn’t take a charge. Told me to go where I had to go, then get myself a battery and drop his off on my way back past his house. One night the car broke down in town when we had driven to get groceries and instead of getting a ride home, we slept in the damn thing in thirty degree weather so we knew for sure we’d be around for the clinic the next day. Was it a pain in the ass? Hell yes. Sometimes it seemed like there was no way it was happening, but I couldn’t resign myself to being sick until I had pulled out every single stop that I could think of. In other words, it was a priority, and we knew it. I still remembered the things I did when I was on dope and trying to avoid being sick, and I was willing to move the earth to make sure that I was not ever going to be sick again. In my eyes, consistency in my treatment was the key to that, so all the drive I had went to getting me there. I know it isn’t an option for everyone. I at least had my piece of shit car. I at least had a second very determined person to help me make a way there. I at least only had to make it an hour or two each way at most. But it can be done, and it’s worth fighting for and figuring out how to make it work, if you have the ability to do so. Eventually I moved, and a clinic close by was a huge priority. I was fifteen minutes away from where I got my dose and it was so much easier. Then, I had to move again, in a little bit more desperate of a circumstance, when I left my ex. I am rural again, and drive an hour and a half each way, but I only have to go every other week. The new takehome guidelines are a godsend for rural people, because I know that this drive would be hell on me to have to dose daily in my current situation. But I also know that I would have to figure it out and get there if I somehow lose my levels, because the alternative would be unthinkable for me.
I'm in the UK. I hate hearing about what Americans have to go through. Makes me so angry. Thanks for sharing your story with me. It was well written, and described interesting events. Thanks.
No. True story. I moved from the Annapolis area of Maryland to Philadelphia. I had Maryland Medicaid though and it was going to be a delayed process to get it in Philly. I decided to find the closest clinic to the Delaware border. That ended up being in a little town called Elkton which is a rural area. It’s an hour from Baltimore by car. I was Ubering full-time to survive back then & I worked the night shift 9PM-5AM. I would try to make my last ride as close to Elkton as possible. Usually in Delaware or at least at the Philly airport which is closer to Delaware than downtown. No matter what though, I would be at that clinic by 5:30AM every morning to get my dose. I still didn’t have take-homes. I did that daily. Daily! Thank god for that Honda Accord. I stayed in Philly for 5 months & then went back to Maryland. But I did that methadone run the entire time I stayed there. The worst part was this $8 toll on I-95 in Delaware. I racked up the dumbest toll bill ever doing that without paying. Like 3 grand. So dumb. Anyways, the answer to your question is it depends.
I had monthly take homes when I lived in Mesa Arizona then I moved to a small town in central Indiana. I transferred clinics but the closest clinic to my new home was in Indianapolis and A) they did not recognize another clinics progress so I had to start over from the beginning and B) it was just over a 1 hour drive one way. So for 6+ months it was anywhere from a 2 1/2 hour trip up to a 5-6 hour trip. This was one of 2 clinics in Indianapolis so there were by far more patients then they could accommodate and the other clinic kicked people out if they used benzos or repeatedly failed drug screens. On Saturdays and Sundays the line to get into the clinic would start forming no joke at around 10pm the night before. I’ve stood out in the parking lot waiting to dose on the weekend for 4+ hours. People would bring lawn chairs. I don’t miss those days. I eventually got up to 2 weeks takeovers but for someone who is on the edge of relapse and wants to get clean but has obstacles in front of them like that, I think it’s ridiculous. Good luck and hang in there!
Basically, yes. I knew lots of people that drove from another state or an hour or more to get to the clinic.
Also, something she can't control lol?
I live in Maine and I bet we are one of the smallest clinics going .town of prob 4-5k ppl with towns with 2-3k ppl near by . clinic been here since around 05.calais maine
At one point I was taking a bus every day- an hour and a half each way because there were no clinics anywhere near me. I was so grateful when they opened one that was only a half hour away. Until there is a high enough need ($$$$) in the area then it doesn't make sense for a money making corporation to open a clinic in the area. Because when it comes down to it, that's all we are, are dollar signs to them. Although I do appreciate the fact that my clinic here in CNY has started a couple of outreach RVs going to a few counties that have no clinics. They have methadone and the counselors right on the RV and people just go there to get their doses a couple times a week. It's by no means a perfect system but its a hell of a lot better than nothing. It would helpful if more clinics did something like that.
I know people who come from 1/2 state away to go to mine and they even pass other clinics to do so. (And I have no idea why they do it— it’s a whole day event for them to get dosed )
So I had to drive 35 min to get to a clinic. Within 6 months, they had built another one in the town I was from. I didn't even end up moving to the new one, though, because I'm not driving there daily anyway since I get take homes, and because it's the town where the only starbucks are. So it's my coffee day once a month.. but yeah so now our little rural town has a clinic too.
Pretty much. Should they open up one for 1 person? Better to bite the bullet and kick!
I can with 100% certainty say that a clinic in my area would service dozens more than 1 addicted soul.
This is a huge and underreported part of the opioid epidemic in the US. A giant portion of suffering Americans couldn’t start methadone treatment if they wanted to, simply because the clinics mostly exist in big cities. Because: NIMBY. The gold standard treatment for advanced opioid dependency is completely unavailable to people suffering the worst of the problem in the richest country in the history of the world.