(Admission to our program)

New Clients
The “intake” process is an evaluation you will receive by the clinic representative and the medical director or staff physician.  You will be interviewed for
necessary medical, psychiatric, substance abuse and psychosocial behavior.  You will also have a physical examination where blood will be collected for
laboratory testing for metabolic and infectious diseases and a tuberculosis skin test.  A urine sample is requested of all patients at the time of admission in
order to verify drug use. It is imperative that you give the nurse, counselor and the physician accurate and truthful answers during this interview process
about your health habits, drug use and medical history. The counselor, physician and federal guidelines will all be taken into consideration to determine
whether you are a candidate for methadone treatment.  Within the federal guidelines, the physician or other qualified person will evaluate your history to
determine what dose will be appropriate to start.

Transfer Clients
Once you have decided that you would like to enter our program and leave your prior program, we require a release of information authorization to be
signed by you so that we may obtain your medical records from your previous program including but not limited to:  drug screen results, counseling notes,
physical exam results, laboratory results, progress notes, medication type and dose and other information related to your treatment.

All Clients
There are a number of consent forms you are requested to sign before you complete admission into our program.  Many of these consents are required by
federal and state authorities; the remainder is clinic policy.  PRIOR to signing any form, you are expected to read the consent form and ask questions about
anything you do not understand.  Since this is a voluntary program (that is to say you wish to participate on your own free will), we require that you are
making an informed decision about joining our program.  Methadone does cause physical dependence and you will have withdrawal symptoms if you
abruptly discontinue its use.

COUNSELING
Upon admission you will meet with an intake counselor, who will assist you with the process of being admitted to our program.  You will be assigned a
counselor based upon availability and your preferences.  We will make every effort to notify you of any changes in the assignment of your primary
counselor in advance of the change or as soon as possible.

Within 30 days of admission a formal plan for your treatment will be developed with your primary counselor to begin addressing your treatment issues and
goals.  You are expected to meet with your counselor a minimum of twice per month during the first year in treatment and once per month in the second
year of treatment.  Assuming you are progressing as expected, starting the third year of treatment you may only be required to meet with your counselor
every six months.  Your counselor may require you to meet with him/her more often than the minimum.

All requests should first involve you primary counselor.  Your counselor should be made aware of any significant changes and problems in your life.  Please
bring all your requests to your counselor first including a need to be seen by the physician.  You are expected to make and keep all appointments with your
counselor.  If you are going to be late or need to reschedule, please call and inform us of the delays.  

As professionals, our staff of counselors, nurses and doctors are mandatory reporters.  The means in certain circumstances we will notify the proper
authorities without your consent.  These situations include:
1.        If you verbalize an intent to do bodily harm to someone or yourself,
2.        If you admit to current child or elder abuse,
3.        If you have a medical emergency, and
4.        If you are diagnosed by us as having a reportable disease.

CLIENT RIGHTS
When you receive services in a substance abuse program, your rights are protected by the law; Code of Federal Regulations, chapter 20-4-9 and
Department of Human Resources in chapter 290-4-12-7.  Below is a simplified outline of those rights.  Your rights are also protected by state regulations.
These are also included at the end and some may overlap the federal regulations. The rules and regulations describe any limitations to these rights and other
provisions, which may apply and should be consulted when there is a question regarding your rights.  Your rights include:

  1. To be treated with dignity and respect,
  2. To be free from:
  1. Abuse,
  2. Neglect,
  3. Exploitation,
  4. Restraint or seclusion, of any form, used as a means of coercion, discipline, convenience, or retaliation,
  1. To a safe, sanitary, and humane physical environment that:
  1. Provides privacy, and
  2. Promotes dignity,
  1. To receive treatment services free of discrimination based on the client’s race, religion, ethnic origin, age, disabling or a medical condition, and ability to
    pay for the services,
  2. To privacy in treatment, including the right not to be fingerprinted, photographed, or recorded without consent, except for:
  1. Photographing for identification and administrative purposes, or
  2. Video recordings used for security purposes that are maintained only on a temporary basis,
  1. To receive assistance from a family member, designated representative, or other individual in understanding, protecting, or exercising the client's rights,
  2. To confidential, uncensored, private communication that includes letters, telephone calls, and personal visits with:
  1. An attorney,
  2. Personal physician,
  3. Clergy,
  4. Department of Social and Rehabilitation Services Staff, or
  5. Other individuals unless restriction of such communication is clinically indicated and is documented in the client record,
  1. To practice individual religious beliefs including the opportunity for religious worship and fellowship as outlined in program policy,
  2. To be free from coercion in engaging in or refraining from individual religious or spiritual activity, practice, or belief,
  3. To receive an individualized treatment plan that includes the following:
  1. Client participation in the development of the plan,
  2. Periodic review and revision of the client’s written treatment plan,
  1. To refuse treatment or withdraw consent to treatment unless such treatment is ordered by a court or is necessary to save the client’s life or physical
    health,
  2. To receive a referral to another program if the licensee is unable to provide a treatment service that the client requests or that is indicated in the client’s
    assessment or treatment plan,
  3. To have the client’s information and records kept confidential and released according to state and federal guidelines,
  4. To be treated in the least restrictive environment consistent with the client’s clinical condition and legal status,
  5. To consent in writing, refuse to consent, or withdraw written consent to participate in research, experimentation, or a clinical trial that is not a
    professionally recognized treatment without affecting the services available to the client,
  6. To exercise the Metro’s grievance procedures,
  7. To receive a response to a grievance in a timely and impartial manner,
  8. To be free from retaliation for submitting a grievance to a licensee, the Department of Social and Rehabilitation Services, or another entity,
  9. To receive one’s own information regarding:
  1. Medical and psychiatric condition
  2. Prescribed medications including the risks, benefits, and side effects,
  3. Whether medication compliance is a condition of treatment, and
  4. Discharge plans for medications,
  1. To obtain a copy of the client’s clinical record at the client’s own expense,
  2. To be informed at the time of admission and before receiving treatment services, except for a treatment service provided to a client experiencing a crisis
    situation, of the:
  1. Fees the client is required to pay, and
  2. Refund policies and procedures, and
  1. To receive treatment recommendations and referrals, if applicable, when the client is to be discharged or transferred

NOTE:  Privileges, unlike patient rights, can be lost through violation of program rules or a failure to demonstrate progress in treatment.

CONFIDENTIALITY
The confidentiality of your records is protected by federal and state law.  You have the sole right to have this information released to whomever you wish
or to have the release restricted at any time. We will require your signature before releasing confidential information.  Without a signed authorization,
information about your enrollment in this program will not be made available to a significant other, employer, lawyer, insurance company, or another
client.  Confidentiality is strictly enforced and your understanding in this area is greatly appreciated.  If you feel you have witnessed a breach of
confidentiality of your or another client’s information, please inform the program director.  In emergency situations where serious medical harm is
potential, our staff is required to release only medically necessary information about you to emergency medical workers and/or facilities.  This will be
limited to medical information necessary for you to receive appropriate emergency treatment.

By reading and signing that you have read this handbook, you indicate that you understand that in certain circumstances our licensed/certified staff is
legally required to report suspicion of child/elder abuse.

Any crime committed against the clinic or observed by staff, by law, nullifies the confidentiality of the person committing the crime.  Any theft of clinic or
another’s personal property, destroying or damaging property, threat to or assault of staff or others, the sale or purchase of illicit substances will remove
your right to the confidentiality of certain information.  In particular, name, address, date of birth, social security number, gender, hair color, eye color or
other identifying information will be released to the proper authorities for prosecution.

If your take-home medication is lost or stolen it should be reported to the police by you for your own protection.  Once you accept take-home medication
at the dosing window it is your responsibility the clinic will not replace this medication.

MEDICAL INFORMATION
Methadone is a man-made (synthetic) opiate, which is given by mouth in our program.  It produces physical dependence.  It is used in our program to
block the effects of other opioid medications and prevents withdrawal symptoms from the discontinuation of other opioids. We do NOT treat pain with
methadone from our program.  A properly prescribed methadone dose will decrease or stop the desire to use other opioids.  It will, at the proper dose, not
cause sleepiness or intoxication (a “high”).  Various medical and environmental changes can change your dose requirements.  Your methadone dose can be
adjusted specifically to accomplish these goals, so your dose may increase, decrease or remain constant while you are in treatment.  For your safety once
your dose is at 60 mg/day or higher, you will be required to wait 14 days before requesting another medication dose increase.

BIRTH CONTROL/PREGNANCY
We encourage patients not to become pregnant during methadone treatment.  All women who could become pregnant will have a urine pregnancy test
conducted at intake.  However, a woman who becomes pregnant while taking methadone should NOT discontinue methadone until after the baby is born.  
Women who wish to prevent pregnancy should use an effective birth control method.  Our staff can meet with you to recommend places to receive birth
control and family planning services.

Drug abuse, physical illness and stress can all interfere with regular menstrual cycles, so you CANNOT count on menstruation to tell you if you may or
may not be pregnant.  If you become pregnant or suspect you may be pregnant, please inform your primary counselor so that an appointment can be made
to meet with our physician.  We will provide urine pregnancy tests at a minimal charge at your request.  The clinic does not furnish contraceptives, but we
can direct you to where contraceptives may be obtained at reasonable costs.  If you become pregnant, you should meet with our medical director as soon as
possible.  We will request that you sign a release of information so that we can verify that you are receiving prenatal care.

No drug or medicine is absolutely safe during pregnancy, but through research methadone has been shown to be generally safe for the woman and unborn
fetus.  Methadone treatment is the preferred treatment for women who are opioid dependent and become pregnant.  It can be extremely dangerous to
withdraw from opioids during pregnancy including methadone.  Withdrawal from street opioids, prescription pain medications or methadone may cause
harm to the fetus and miscarriage or premature delivery.

If you become pregnant while on methadone, inform our program medical director as soon as possible.  Our physician will follow you closely during your
pregnancy, helping with referrals to obstetrical services, providing information to your obstetrical services, providing information to your obstetrician
about pregnancy and methadone, and monitoring your dose to make sure it remains adequate for your needs.  Our physician will require that you give
consent to share information with your obstetrician so that your pregnancy treatment can be well coordinated.  In addition, our physician will want to
communicate with the pediatrician that you choose for your child before you deliver.  There are issues regarding the breastfeeding of your infant and
prenatal treatment with methadone that should be discussed by all of the involved doctors.  Pregnant women in the program may be required to have
additional blood or urine testing to monitor their treatment if it is necessary for the mother or baby’s safety.

As with any pregnancy, patients on methadone should be prescribed prenatal vitamins by their obstetricians and should be encouraged to avoid any
medications not prescribed by a physician.  Avoiding any illicit drugs, keeping regular attendance for stable dosing of methadone and having early prenatal
care are the best ways to maintain a healthy pregnancy.

Because pregnancy can produce more emotional, social and financial stresses, a pregnant woman in treatment will be encouraged to meet more frequently
with her counselor and develop strategies to cope with the life changes she is facing.  Goals leading towards a healthy pregnancy will be incorporated into
the treatment plan.  When indicated, female patients anticipating detoxification from methadone should receive a pregnancy test before starting voluntary
detoxification.

BLOOD TESTS
Upon acceptance into our program and each year thereafter, you are required to have a blood test and routine medical examination.  You will be asked to
meet with a physician or other qualified staff if your laboratory results are abnormal.  A copy of any blood work can be sent to your primary care doctor
with your written authorization.  You will be charged for all blood work required for general medical care.  We do not routinely test for exposure to the
human immunodeficiency virus (HIV) or for exposure to hepatitis but this testing is available upon request, additional cost maybe incurred.

HIV/AIDS

Human Immunodeficiency Virus (HIV) is the virus which causes Acquired Immune Deficiency Syndrome (AIDS) is spread by sexual contact with an
infected person, by sharing needles and/or syringes (primarily during drug injection) with someone who is infected or less commonly through transfusions
of infected blood or blood clotting factors.  Babies born to HIV-infected women may become infected during delivery or through breast-feeding following
delivery.

In the health care setting, workers have been infected with HIV after being stuck with a contaminated needle or less commonly when HIV-infected blood
gets into another person’s open wounds or mucous membrane.  HIV has been detected in saliva and tears but in extremely low quantities.  Contact with
saliva, tears or sweat has never been associated with the transmission of HIV.

Some people fear that HIV might be transmitted in other ways. However, no scientific evidence to support any of these fears has been found.  There is no
risk of HIV transmission to co-workers, clients or consumers from contact in industries such as food-service establishments.  There is no known instance
of HIV transmission through tattooing or body piercing. There have only been a few cases of HIV transmission related to acupuncture all of these have
been associated with practitioners not sterilizing/disinfecting the needles between clients.  Casual contact through closed-mouth or “social” kissing is not a
risk for transmission of HIV. The risk associated with open-mouth kissing is believed to be very low.

Tuberculosis

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air.  TB usually affects the lungs, but it can also affect
other parts of the body.  A person with TB can die if not treated.

The general symptoms of TB include feelings of sickness or weakness, weight loss, fever and night sweats.  The symptoms of TB in the lungs include
coughing, chest pain, and coughing up blood.

There are two tests that can be used to help detect TB infection: a skin test or a special TB blood test.  The Mantoux tuberculin skin test is performed by
injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm.  A person given the tuberculin skin test must return within 48
to 72 hours to have a trained health care worker look for a reaction on the arm.  A positive test for TB infection only tells that a person has been infected
with the TB germs.  It does not tell whether or not the person has progressed to TB disease.  Other tests, such as a chest x-ray and a sample of sputum, are
needed to see whether the person has TB disease.

Bacille Calmette-Guérin (BCG) is a vaccine for TB disease.  BCG is used in many countries, but it is not generally recommended in the United States.  
BCG does not completely prevent people from getting TB.  It may cause a false positive tuberculin skin test.

TB disease can be treated by taking several drugs for 6 to 12 months.  It is very important that people who have TB disease finish the medication, and take
the drugs exactly as prescribed.

Syphilis

Syphilis is caused by the bacterium Treponema pallidum. It is passed from person to person through direct contact with syphilis sores.  The sores mainly
occur on the external genitals, vagina, and anus or in the rectum.  They also occur on the lips and around the mouth.  Syphilis cannot be spread through
contact with toilets seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing or eating utensils.

Until the sores appear there are few signs or symptoms of having the infection.  If untreated, syphilis may go on to more advanced stages, including a
transient rash and eventually, can cause serious involvement of the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.  Chancres caused by
syphilis make it easier to transmit and acquire HIV infection sexually.

A simple blood test can be used to screen for syphilis and to diagnose it.   In the early stages, syphilis is easy to cure. A single intramuscular injection of
penicillin remains the most effective drug to treat people with syphilis.  For persons having had syphilis for longer than one year, a longer course of
treatment may be required.

Gonorrhea

Gonorrhea is a very common infectious disease caused by Neisseria gonorrhea.  Gonorrhea is spread through contact with the penis, vagina, mouth or
anus.  Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread from mother to baby during delivery.  

In the United States, the highest reported rates of infection are among sexually active teenagers, young adults and African Americans.

Some men with gonorrhea may have no symptoms at all. Those that do have symptoms usually have them within 2 to 5 days after infection but may take
up to 30 days to appear.  Symptoms include burning sensation when urinating, or a white, yellow or green discharge from the penis.  Sometimes men may
have painful or swollen testicles with gonorrhea infection.

In women, the presentation of symptoms is more common and is often mistake for bladder or vaginal infections.  Symptoms may include painful urination,
increased vaginal discharge or vaginal bleeding in between menstrual cycles.

Symptoms of rectal infection in either men or women may include discharge, anal itching, soreness, bleeding or painful bowel movements.  Infections in the
throat may cause a sore throat but usually causes no symptoms.

Laboratory tests are available to diagnose gonorrhea.  Several antibiotics can successfully cure gonorrhea.

Chlamydia

Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. It is caused by the bacterium, Chlamydia
trachomatis. Chlamydia can be transmitted during vaginal, anal or oral sex.  Chlamydia can also be passed from an infected mother to her baby during
vaginal childbirth.

Persons who have a greater number of sex partners have a greater risk of being infected.  Anyone can be infected with Chlamydia and unknowingly transmit
the infection.  

Three quarters of infected women and about half of infected men will have no symptoms.  If symptoms occur, they usually appear within 1 to 3 weeks
after exposure.  For women, some symptoms include abnormal vaginal discharge, burning sensation upon urination, lower abdominal pain, low back pain,
pain during intercourse or bleeding in between menstrual periods.  Pelvic Inflammatory Disease (PID) is a serious complication of Chlamydia and is a major
cause of infertility among women of childbearing age.  For men, symptoms include discharge from the penis or a burning sensation when urinating, burning
or itching around the opening of the penis or pain and swelling of the testicles.

There are laboratory tests to diagnose Chlamydia.  Chlamydia can be easily treated and cured with antibiotics.  All sex partners of a diagnosed person
should be evaluated, tested and treated.  Persons with Chlamydia should refrain from sex until they and their partners have all completed treatment,
otherwise re-infection is possible.

Viral Hepatitis

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV).  HAV is spread from person to person by putting something in the mouth that has
been contaminated with the stool of a person with HAV.  Fewer than 5% of HAV infections are transmitted during sexual contact.  Two products are used
to prevent HAV infection: immune globulin shots and hepatitis A vaccine shots.
Hepatitis B is a serious disease caused by a virus that attacks the liver.  The virus, which is called hepatitis B virus (HBV) can cause lifelong infection,
cirrhosis (scarring) of the liver, liver cancer, liver failure and death.  HBV is spread when blood from an infected person enters the body of a person who is
not infected.  Two products are used to prevent the spread of HBV: immune globulin shots and hepatitis B vaccine shots.

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV).  HCV is spread primarily by direct contact with human blood, including sharing of
needles for injection drug use and sex with someone with HCV.  There is no vaccine to prevent hepatitis C.

Hepatitis D (delta) is a liver disease cause by the hepatitis D virus (HDV), a defective virus that needs the hepatitis B virus to exist.  HDV is found in the
blood of persons infected with the virus.  Infection occurs when blood from an infected person enters the body of a person who is not immune. Since HBV
is required for a person be infected with HDV, the hepatitis B vaccine should be given to prevent HDV infection.

Hepatitis E is a liver disease caused by the hepatitis E virus (HEV).  It is transmitted in much the same way as hepatitis A virus.  HEV is not common in
the United States.

There are no specific treatments available for the acute symptoms of viral hepatitis.  Doctors recommend bed rest, a healthy diet and avoidance of alcoholic
beverages.  Interferon alpha is used to treat people with chronic hepatitis C. Some studies also show the usefulness of interferon alpha in treating HBV as
well.

STIs and Pregnancy

Pregnancy does not provide women or their babies any protection against sexually transmitted infections (STI).  The consequences of an STI can be
significantly more serious, even life threatening, for a woman and her baby if the woman becomes infected with an STI while pregnant.  It is important that
women be aware of the harmful effects of STIs and know how to protect themselves and their children against infection.

A pregnant woman with an STI may have early onset of labor, premature rupture of the membranes surrounding the baby in the uterus, and uterine
infection after delivery.

The harmful effects of STIs in babies may include stillbirth (a baby that is born dead), low birth weight (less than five pounds), conjunctivitis (eye
infection), pneumonia, neonatal sepsis (infection in the baby’s blood stream), neurologic damage, blindness, deafness, acute hepatitis, meningitis, chronic
liver disease, and cirrhosis.

Chlamydia, gonorrhea, syphilis, trichomoniasis, and bacterial vaginosis can be treated and cured with antibiotics during pregnancy. There is no cure for viral
STIs, such as genital herpes and HIV, but antiviral medications may be appropriate for pregnant women with herpes and definitely is for those with HIV.  
For women who have active genital herpes lesions at the time of delivery, a cesarean delivery (C-section) may be performed to protect the newborn against
infection.  C-section is also an appropriate option for some HIV-infected women.  Women, who test negative for hepatitis B, may receive the hepatitis B
vaccine during pregnancy.

Risk Reduction

Condoms are classified as medical devices and are regulated by the Food and Drug Administration.  Condom manufacturers in the United States test
condoms for defects, including holes, before it is packaged.  The proper and consistent use of latex or polyurethane condoms when engaging in sexual
activity—vaginal, anal or oral—can greatly reduce a person’s risk of acquiring or transmitting sexually transmitted infections including HIV.

Long term mutually monogamous relationship with a partner who has been tested and is known to be uninfected will help to reduce your risks as well.

For more information…

Centers for Disease Control and Prevention                                                     CDC National AIDS Hotline
1600 Clifton Rd.                                                                                                1-800-342-AIDS
Atlanta, GA 30333                                                                                            Spanish:        1-800-344-SIDA
1-800-232-4636                                                                                                 Deaf:                1-800-243-7889
http://www.cdc.gov/nchstp/od/nchstp.html
http://www.cdcnpin.org/scripts/std/std.asp


GENERAL MEDICAL CARE
Your primary care provider should continue to provide general medical care.  However, if you have a need to see our clinic physician regarding your
methadone treatment, please make an appointment. If you receive a prescription for a controlled substance, in order to progress in our program, you will be
required to provide copies of the pharmacy filled prescription.  We will also require that you sign a release of information for the prescriber so that we may
notify him/her that you participate in our program and receive a prescription for methadone from us.  You are not allowed to receive a prescription for
methadone from another prescriber while in our program.

HOSPITALIZATION
Your daily dose may be provided to you by the hospital, if you require hospitalization.  Notify the hospital physician caring for you that you are a client
at Metro Treatment Center.  The hospital may require you to authorize the release of information of your medication from our program.  If authorization is
not able to be obtained we will make every effort to verify the person contacting us is genuinely involved in your care at the hospital before releasing
information about your medication.  Upon discharge from the hospital, you will need to provide documentation of your hospital stay and evidence of the
last day that methadone was provided to you from the hospital.  Documentation of controlled substances provided to you from the hospital will also be
required to verify positive drug screen results.

METHADONE MAINTENANCE
Methadone maintenance is intended to do three things for our clients.
  1. Keep the client out of withdrawal.
  2. Keep the client comfortable and free from craving/using other opioids.
  3. Improve your life such as prevent criminal behavior related to substance abuse.



Dosing Policies

NEW CLIENTS—First Month Orientation
Once you enter our program, you will be provided your first dose of methadone by our staff.  The dose will be ordered by a physician or other qualified
staff which is medically safe and in compliance with federal guidelines.  After your first dose, you are asked to remain in the clinic for half-an-hour to see
that no serious adverse reactions occur.  You will be asked frequently in the first month of treatment about how your dose is affecting you.  You will be
able to request medication changes of up to 5mg per day until you reach 60mg per day total.  Once at 60mg/day you will be required to meet with a
counselor who will submit a form for the physician to review and approve/deny medication changes.  Once your first 30 days in treatment has ended you
will not be allowed to make request medication changes except via your counselor.

You should know what to look for regarding overmedication and under-medication.  Signs you are overmedicated include feeling sleepy, sedated, or short-of-
air.  These are serious signs of overmedication and you should notify the clinic as soon as possible.  Signs of under-medication include frequent opioid
cravings, achiness, diarrhea, and restless sleep.  Typically the best indicator of appropriate dosing is your ability to sleep through the night.

TRANSFER CLIENTS
If you transfer from another methadone program, your dose level and attendance schedule will be transferred with you.  We are required to verify this
information with the clinic you are leaving.  We will attempt to make the transition as seamless as possible.  You will be required to be seen by our
physician prior to receiving medication as a client of our program.

CHILD CARE
We do not encourage bringing children to the clinic during dosing hours.  However, if it necessary to bring your child/children to the clinic, you must NOT
leave your child/children in the car without adult supervision.  Inside the clinic, your child/children must accompany you and be supervised by you at all
times.  We will not and do not assume responsibility for your child/children while at the clinic.

DOSING RULES
Our clinic has specific time during which you may enter the facility for medication.  These dosing hours are 5:30AM-9:30AM and Noon-1:30PM,
Monday through Friday, 5:30AM-9:00AM Saturday.  The clinic is
closed all Sundays and many state and federal holidays.  We will notify you of any
holiday or special closing at least 30 days prior to the closing.  If you are late to the clinic, even by a few seconds, you will not be allowed into the facility.  
If you have an ongoing problem with regular dosing hours because of travel or employment, special arrangements may be considered, please discuss the
problem with your counselor.  Documentation of your circumstances and illicit-substance free drug screen(s) will be required for state and federal approval
for additional take-home medication.

When you are at the dosing window, appropriate behavior is expected.  This includes not talking on cell phones or wearing sunglasses.  When taking a dose
of medication observed by our staff, you must speak to the medicating nurse prior to leaving the dosing window, so that we are assured the dose has been
swallowed.  All cups used for medication may not leave the dosing window.  If you require a cup of water to be able to provide a urine drug screen, you
need to speak with a counselor; we can provide you with a non-medicating cup.  Following consuming your dose at the medicating window, please do not
wait or socialize at the dosing window.

CALL BACK POLICY
As a part of our diversion control plan (take home dose control plan), any client with take-home doses may be contacted and required to return to the clinic
for a check of the take-home medication.  If you are contacted via phone call or voice mail at a number you have provided, you will have 24 hours to return
to the clinic with your remaining take-home doses and any empty bottles. It is your responsibility as a client to insure that the phone number and contact
information that is on hand is accurate. On the day you return, you will not ingest that day’s dose until after your medication has been inventoried by a
staff nurse.  A drug screen may also be performed at this time to verify methadone and methadone metabolite are present in your system.  If you fail to
return within the 24 hour window, you will lose your take-home status (down phased to Phase 1) for 30 days, after 30 days you will be allowed to regain
that level of take-home privileges through urine drug screens and attendance.

FIT FOR DOSING
All clients are required to be “fit for dosing”.  This includes but is not limited to zero signs/symptoms of intoxication from alcohol or other substances.  
You may be asked to provide a drug screen based on clinical observation of intoxication.  Failure to provide drug screen samples upon request may
jeopardize your enrollment in our program.  By federal law, we may medicate you at half your dose for signs of intoxication.  We reserve the right to refuse
to medicate any client who appears to be under the influence of any substance (prescribed or illicit).

ALERT FLAGS
Our computer system has “alert flags” so that the medicating nurse may notify you which specific staff member needs to see you prior to or following
dosing.  Please cooperate with clinic staff at all times during this process.  We will do our best to speak with you prior to reaching the medicating nurse and
removing the alert.  Please do not speak rudely to the medicating nurse if the alert was not removed appropriately, they are not capable of removing the
alert.  Another staff member will have to do this for the nurse.

DOSE CHANGES
After medication changes please allow 72 hours to completely feel the effects of the new level (increase or decrease).  Do not expect a dose change to be
effective during the first day.  Methadone blood level tend to be consistent for 24-36 hours, which is why it can be dosed only once per day.

  • When to increase:  Moderate to severe physical withdrawal experienced 4-16 hours after the observed dose.
  • When to remain:  Comfortable during the first 2-8 hours after dosing with mild withdrawal such as simple anxiety and insomnia for the remainder
    of the 24 hours.  You may experience even moderate withdrawal towards the end of the 24 hours (in this case more time in treatment, not more
    medication is indicated).
  • When to reduce dose:  Any sensation, no matter how mild, of being sedated, high or loaded during the first seven days after a medication increase.  
    Remember the dose response/effect will be more pronounced after the next dose, assuming a steady state has not been reached yet.

Vomiting your dose:  We may not be able to replace a vomited dose due to federal regulations.  At a minimum the vomitus must be observed by a staff
member inside the building such that we can verify the appearance of methadone in it.  You may be asked to wait half-an-hour prior to being re-medicated
to partially determine the possibility of methadone previously ingested being absorbed.  Doses vomited at home cannot be replaced.  

DRUG TESTING
Each client is required to submit a drug screen specimen when requested (urine or saliva based).  According to state standards, we will collect a minimum of
one drug screen per month.  At our discretion you may be required to provide an observed urine based drug screen.  In such case, a same sex staff member
will observe the collection of a urine drug screen specimen.  If you wish to provide an observed oral drug screen instead of a standard urine drug screen, you
will be charged a fee for the oral drug screen. In addition, state regulations require additional weekly drug screens if the client test positive for illicit
substances in their previous drug screen. Once the client provides one licit drug screen they will be removed from the required weekly drug screens and
allowed to progress in phases as long as they continue to provide licit drug screens

NOTE:  Failure to provide a drug screen specimen upon request is considered a serious infraction of our rules which seriously jeopardizes your enrollment
in our program.

MISSED DOSES
Metro discourages missing any dose which you are scheduled to take.  It is our position that continued and consistent dosing is a necessary part of your
treatment.  This is why when you have been absent; you may be required to be evaluated by a staff member prior to dosing.  A regular pattern of missed
dosing may result in the loss of ALL take home privileges including Sunday.  After missing several consecutive days, your dose may be reduced as
medically indicated in order to protect your health and well-being.  Any day that you miss your dose we request that you contact the clinic to notify us of
the reason for missing (this is a courtesy).   After fourteen days of continuous, unexcused absences from dosing, you will have to be evaluated by a
physician or other medical staff for continued participation in our program.  After twenty-one days of absences, you will be discharged from our program.

TAKE HOME MEDICATION
Take home medication is a PRIVILEGE that must be earned.  This is done by demonstrating to the program that you can safely handle the take home
dose.  This is accomplished through providing drug screen free from illicit substances and positive progress in treatment.  The recommendation for
additional take home doses originates with your primary counselor but must be approved by the physician.  The physician will determine your eligibility
based upon federal criteria.  A requirement of getting take home medication is that you must have a lock box when you pick up the take home medication as
well as your previous/empty take home bottles.

TAKE HOME BOTTLES
ALL empty bottles used for take home medication MUST be returned to the clinic with the proper label when you return to take more take home doses.  
Client who fails to return take home bottles may have to attend the clinic more frequently until to missing bottle(s) is returned.  You may be denied
addition take home medication until the bottle(s) is returned.  The label must be intact and legible on the bottle including your name and the appropriate
date which it was given to you.

LOST OR STOLEN DOSES
Methadone is a Schedule II narcotic and should be considered dangerous.  It can be fatal if consumed by a child or someone not tolerant to opioids.  Your
take home medication is a privilege and should be considered a trust given to you in your treatment.  Methadone and all medicines should be stored under
lock and key so unauthorized persons will not have access.

If your take home medication is lost or stolen, you should report it to the police.  Since methadone is a state and federally regulated narcotic and your
bottle is labeled with your name, a lost bottle could result in a loss of confidentiality about your treatment or in harm to another person that you would be
liable for.  Lost, stolen or spilled take home dose cannot be replaced by our program and could result in the loss of regular take home privileges.

Regular take home medication will be permitted if:
  1. Amount of time in treatment (see below)
  2. Drug screen results which must show methadone, methadone metabolite and only approved prescription medications
  3. Attendance is per your approved schedule
  4. No serious behavior problems or known criminal activity
  5. Medication is not suspected to be sold or transferred to another person especially not children
  6. No illicit alcohol or other drug abuse
  7. Stability in home environment and social relationships
  8. Transfer records, if applicable, are on file and meet with all other requirements
  9. Intake/admission process has been completed
  10. All other rules of the program are followed including payment of account to no more than $40 worth in the arrears.

Maximum number of take home doses permitted by federal law is based upon time in treatment.  We are permitted to provide take home doses for days
that the clinic is closed such as state holidays and Sunday.  
Therefore, according to federal law the maximum number of take home doses is:
Level                      Number of take home doses                                Time in treatment needed
Phase 1:                Sunday only per week                                                 Available upon intake
Phase 1A:             Sunday plus one (1) other day per week                     Minimum 14 days
Phase 2:                Sunday plus two (2) other days per week                   Minimum 3 months
Phase 3:                Sunday plus three (3) other days per week                 Minimum 6 months
Phase 4:                Sunday plus five (5) other days per week                   Minimum 9 months
Phase 5:                Maximum thirteen (13) at a time                                 Minimum 12 months
Phase 6:                Maximum twenty-seven (27) at a time                       Minimum 24 months

If you transfer from another clinic, you get to keep your time in treatment from your previous program.

Special take home doses or emergency doses may be approved by the physician, the state methadone authority and SAMHSA.  You must have a recent
illicit substance free drug screen, and have completed 90 days in treatment, prior to being able to apply for special take home doses.  Reasons that would be
considered for special take home doses would include but not limited to personal/family crisis, travel, employment or other exceptional circumstances.  
Generally, a request for special take home doses will need to be made a week in advance.

Individual dose reduction (IDR) or tapering

Medically Supervised Withdrawal
In accordance with the program’s goals and federal consent for treatment, the goal of opioid treatment is total rehabilitation of the client.  The eventual
withdrawal from the use of ALL drugs is an appropriate treatment goal.  This includes methadone.

Every client is evaluated for the feasibility of methadone tapering at regular intervals as well as upon request.  The decision to begin methadone tapering is a
serious and important decision.  It will depend upon:
  1. Your progress in counseling.
  2. The absence of any non-prescribed drug use for a minimum of three (3) months prior to beginning the tapering.
  3. You are gainfully employed or have stable income and stable relationships.
  4. Additional items may be identified after completing the Tapering/Detoxification checklist.
We expect that a medically supervised tapering schedule will last at a minimum six (6) months to be most successful.

The client determines that they have successfully completed his/her treatment.  And client believes that he/she has reached his/her goals and objectives and
is ready to begin a medically supervised tapering schedule from the methadone.  The dose changes and the pace of the tapering are individually determined
with the assistance of the medical director.  During medically supervised tapering, you (the client) retain the option of asking for a dose change within the
boundaries of the schedule or to return to maintenance status at anytime.  It is imperative that you, your counselor and the physician take your journey of
tapering together.

As a part of your ongoing success, we offer free counseling services up to one month for those clients who successfully complete a medically supervised
tapering schedule or up to one month for those client who complete an administrative/against-medical-advice tapering schedule.  We recommend that as a
part of this clients submit drug screens (at the cost of the client) to demonstrate to themselves that they have been successful.

Administrative/Against-medical-advice Tapering
The client will not be provided an opportunity to return to maintenance or adjust the tapering schedule.  Once discharged for this type of tapering the
client will have to wait a minimum of thirty (30) days before reapplying to the program.

Drug interaction and abuse

PRESCRIPTION AND OTHER DRUGS
Methadone can interact with other prescription and non-prescription medications and herbals.  Every prescription medication and over-the-counter
medication or herbal should be discussed with medical staff and counseling staff.  This is for your safety.  Copies of all prescriptions must be supplied to
the program every 60-days at a minimum. Clients will have 7 days after intake or annual physical exam to provide a copy of all current prescriptions they
are receiving or they will be placed on a “stop dose” until they do so.  We also require a signed consent to contact the prescribing practitioner to consider
your drug screens as “licit”.  If you refuse to comply with this request, you will be ineligible for additional take home doses.  

Combining methadone and anti-tuberculosis or anti-seizure medications may cause some unpleasant side effects.  Let all physicians and pharmacists know
if you are taking these substances at the same time.

Using certain types of medications may precipitate serious withdrawal symptoms when taking methadone, some of these include naloxone (Narcan®),
naltrexone (ReVia®), butorphanol (Stadol®), pentazocine (Talwin®), nalbuphine (Nubain®), tramadol (Ultram®) or buprenorphine (Buprenex®).  Do not
accept these medications while on methadone except in the case of an overdose.

Methadone in combination with any of the following may cause serious injury up to and including death:  other opioids, tranquilizers, sleeping pills and
alcohol.  Our medical staff will be glad to discuss any prescription medications as they pertain to methadone.

DRUG ABUSE
Methadone is a synthetic opioid analgesic with multiple actions and side effects similar to other opioid compounds (such as Dilaudid®, heroin, morphine,
codeine, Darvon®, Demerol®, Percodan®, etc.), the most prominent of which involve the central nervous system (the brain and spinal cord) and the
structures composed of smooth muscle (intestines).  Although the potencies and specific adverse side effects of various opioids differ, the overall effect
upon the brain and its vital centers, such as breathing, is as a depressant.

Methadone alone or combined with other opioids or benzodiazepines may cause SEVERE SEDATION, RESPIRATORY DEPRESSION, WHICH CAN
LEAD TO RESPIRATORY ARREST, CIRCULATORY COLLAPSE AND CARDIAC ARREST.    If you experience ANY BREATHING
DIFFICULTY or if others notice you are overly sedated such as abnormal snoring, you MUST visit an emergency room for evaluation immediately.  
Contact emergency service personnel and explain the situation, this may be LIFE THREATENING!  The treatment is use of naloxone (Narcan®), this will
induce withdrawal symptoms but it may save your life.

Methadone is also a long acting narcotic. Methadone should not be combined with any other long acting central nervous system depressant such as
diazepam or OxyContin®.  This type of combination may be fatal.

A positive drug screen for cocaine will lead us to assume cocaine was used.  Drug such as Lidocaine®, Benzocaine®, and Procaine®, should not cause drug
testing to show positive for cocaine.

An illicit drug screen result can potentially result in the loss of take home privileges and may result in six days per week attendance.  Continued illicit drug
screens may indicate treatment failure and lead to administrative tapering or discharge from our program.  If you are unable to demonstrate a reduction in
the harmful side effects of substance abuse within a reasonable time frame, you may be administratively discharged.  We will make every effort to assist
you in preventing this outcome.

Drugs that are generally detectable by drug screen used in our program are listed below.  Many of these substances interact with methadone and may cause
serious, possibly even fatal, reactions.

OPIOIDS                                
Bancap        Lortab        Hycotuss        Percocet        Tussionex
Codeine        Fiorinal w/ codeine        Methadone        Percodan        Tylenol w/ codeine
Darvon        Heroin        Novihistine DH        Propoxyphene        Tylox
Demerol        Hycodan        Nubain        Robitussin AC        Ultram
Dilaudid        Hycomine        Opium        Roxanol        Vicodin
Donnagel PG        Hydrocodone        Oxycodone        Stadol        
Fentanyl        Hydrocet        OxyContin        Talwin        
               
BARBITURATES                                
Amytal (amobarbital)        Dannatal        Nembutal        Seconal (secobarbital)        
Butisol (butabarbital)        Fiorinal        Phenobarbital                
               
BENZODIAZEPINES                                
Ativan        Dalmane        Serax        Valium        
Klonopin        Halcion        Tranxene        Xanax        
               
STIMULANTS                                
Adderall        Cocaine        Cylert        Exstacy (MDMA)        Ritalin
Amphetamine        Concerta        Desoxyn        Methamphetamine        

WARNING:  Over the counter stimulants (white crosses, ephdra, ephedrine, etc.) may result in a positive drug screen for amphetamines and will be
counted as illicit.  Certain herbals may test positive as benzodiazepines, these will also be counted as illicit.

If you believe that a drug screen is incorrectly reported, you have 30 days to request that confirmatory testing be completed.  Since this is your request,
you have to pay for the confirmatory testing prior to it being ordered.  If the original result is shown to have been incorrect, we will credit your account the
cost of the confirmatory testing you had already paid.

Benzodiazepine Protocol
The maximum allowable daily dosage for clients that provide illicit drug screens for benzodiazepines will be 80mg/day.

Those clients whose daily medication dosage is greater than 80mg, and who test positive for an illicit benzodiazepine, will immediately have their
medication level decreased to 80mg/day.

If the client wishes to challenge the results as a false positive by having it retested by the lab (GCMS/ETG test), the program will not reduce the clients
medication level until the re-test results have been received.  The client has 7 days from the date that they are notified of the illicit drug screen, to determine
if the will have the specimen retested.  

Clients must provide three consecutive benzodiazepine free drug screens before they will be considered for a medication increase above 80mg/day.

A physician must authorize any medication increase above 80mg/day for those clients that have a prescription for benzodiazepines. The counselor must
complete and submit a benzodiazepine checklist for the physician's review with the request for a medication increase.

Clinic policies and Client expectations

PROBLEM RESOLUTION
The program director is the person responsible for the day to day operations of the clinic.  If you have a problem with any of the policies or procedures or
any staff member of the program, you are encouraged to speak with the program director to resolve any misunderstanding or problem.  All conversations
with the program director will be kept confidential up to the point where disclosure is necessary to conduct an investigation of allegations.  Problems
concerning your treatment should first be addressed with your counselor, before being brought to the program director.  

Grievance Policy

It is the policy of Metro Treatment Center, Inc. that the clients are encouraged to state complaints and/or grievances if they believe their rights have been
violated, and to pursue a resolution to their concerns in a formal, structured format that provides fair and equitable results through due process. Metro will
cooperate with KDADs in completion of any inquiries related to client grievances.

  1. PROCEDURES:
  1. Clients will be fully informed of the grievance procedures during their orientation to services. In addition, they will receive a client handbook that will
    provide an overview of this process for later reference.
  2. A grievant shall in no way be subject to disciplinary action or reprisal, including reprisal in the form of denial or termination of services, loss of
    privileges, or loss of services as a result of filing a grievance
  3. Day-to-day issues affecting clients shall be resolved informally between the client and the client’s primary counselor. If the problem or complaint is
    not resolved to the satisfaction of the person served, the primary counselor will adhere to the guidelines contained in this policy and assist the client in
    accessing the procedures necessary to resolve the concern.
  4. Clients have the right to due process with regard to grievances, and the organization will afford every reasonable opportunity for informal and/or formal
    resolution of the grievance.
  5. Persons who may bring grievances include, but are not limited to:
  1. The client.
  2. The legal guardian of the client if deemed legally incompetent.
  3. The attorney, designated representative, or a representative of a rights protection or advocacy agency of the person served.
  1. Notices summarizing a person’s right to due process in regard to grievances, including the process which grievances may be filed and copies of forms to
    be used for such purpose, shall be available at the facility.
  2. Each client will be informed of his/her right to grieve and the right to be assisted throughout the grievance process by a representative of his/her choice,
    in a manner designed to be understandable to the person served.
  3. During a formal grievance procedure, the person served will have the right to the following:
  1. Assistance by a representative of his/her choice.
  2. Review of any information obtained in processing the grievance, except that which would violate the confidentiality of another client.
  3. Presentation of evidence of witnesses pertinent to the grievance.
  4. Receipt of complete findings and recommendations, except those that would violate the confidentiality of another client.
  1. In all grievances the burden of proof shall be on the organization to show compliance or remedial action to comply with the policies and procedures
    established to ensure the rights of clients.
  2. All findings of a formal grievance procedure shall include:
  1. A finding of fact.
  2. A determination regarding the adherence of the organization, program, or employee, or the failure to adhere, to specific policies or procedures
    designed to ensure the rights of persons served.
  3. Any specific remedial steps necessary to ensure compliance with organizational policies and procedures.
  1. The steps of a formal grievance are as follows:
  1. Formal grievances shall be filed first with the Program Director in which the grievance arises.
  2. A copy of the grievance shall be forwarded to the Program Sponsor.
  3. The Program Director will meet with the grievant, and/or representatives, immediately following the filing to brainstorm resolution of any related
    issues that may get in the way of full participation in services. Actions may include, but not be limited to, a change in direct care providers or an
    adjustment in schedules and/or program environments.
  4. The organization will issue a formal written response to the grievant, and/or the designated representatives, within five working days, excluding
    weekends or holidays, of the complaint.
  1. The steps to appeal a written response to a grievance:
  1. If the grievant is unsatisfied with the findings of the written response to a grievance, he or she may appeal the decision to the Program Sponsor
    within five days, excluding weekends or holidays.
  2. The Program Sponsor will issue a formal written response to the grievant, and/or the designated representatives, within five working days,
    excluding weekends or holidays, of the complaint.
  3. If the grievant is unsatisfied with the findings of the written response, he/she will be referred to a third party outside of the organization. Third
    parties may include organizations such as professional licensing boards or other appropriate organizations that may serve as an advocate for the
    client.
  1. All staff members of Metro Treatment Center, Inc. will be trained in the implementation of this policy and procedures during orientation, and will
    receive ongoing training of the procedures to ensure the process is applied in a comprehensive manner if a grievance is filed.
  2. Grievances regarding the actions of specific staff members will be handled in accordance with personnel rules and contract provisions. No disciplinary
    action may be taken, nor facts found with regard to any alleged employee misconduct, except in accordance with applicable personnel rules and labor
    contract provisions.
  3. A Grievance Log will be maintained by the organization detailing the nature of the complaint, relevant information obtained in the investigation, and the
    outcome of the process. All information contained will maintain the confidentiality of the participants in the process. This record will be reviewed
    annually by the Executive Director to determine if there are trends in the complaints, and to identify areas to initiate performance improvement
    activities.
  4. Grievances may be filed at any time at the request of the client with the following:

Stacy R. Chamberlain, M.A., L.A.C.                                                                         
Director of Addiction Services
Behavioral Health Services Kansas Department for Aging and Disability Services                                      
503 S. Kansas Ave.                                                                                                                           
Topeka, Kansas 66603                                                                                                                     
Phone (785) 296-6807          Fax (785)296-0256                                                   
stacy.chamberlain@ks.gov       

AND/OR
CARF International                                                                                                      
6951 E Southpoint Rd                                                                                                 
Tucson, AZ 85756                                                                                                       
Phone# (520) 325-1044                                                                                                    
Toll-free/TTY#(888) 281-6531                                                                                       
Fax#(520) 318-1129

We also encourage all clients to offer suggestions and recommendations on how we can better serve you and our community.  We provide a suggestion box
with paper and pens for anonymous comments.  We also conduct semi-annual satisfaction surveys at which time comments are requested.

TOBACCO
Absolutely no smoking or any other use of tobacco is permitted inside the facility. You may be asked to step outside to finish with a tobacco product.  We
expect your cooperation with these requests.  There are designated smoking areas outside of the facility.

E-CIGS and VAPOR INHALERS
The use of e-cigs and vapor inhalers is prohibited within the clinic. As a courtesy we ask you to refrain from using these devices.  

FEES
All accounts are expected to be paid at the time of service.  Clients are allowed to maintain a balance of owing up to $40 worth of medication after attending
the clinic for 30 days.  Each billing and payment is recorded within Methasoft.  You may request a balance history and review this with a counselor should
you have any questions.
These fees may change without notice.  These fees are based upon the cost of the product offered by the laboratory. If they increase their price we may
increase our price accordingly.

Delinquent accounts will be expected to be paid even if you as the client leave our program, voluntarily or involuntarily.  Past due bills may be handed over
to a collection agency at our discretion.  An important aspect of your recovery is to accept the responsibility for paying for your own treatment in a timely
manner.

At the time of discharge from the program, if the client has money on their account, Metro will provide a check for the remaining balance to the client or the
payee.

Standard Metro Treatment Center Fees
Phase 1, 1A, 2, & 3                                                $10.00 per dose
(If on weekly drug screens at these phases, your cost will be $11.00 to cover the additional cost of the drug screen)

Phase 4, 5, & 6                                                         $9.00 per dose
(If on weekly drug screens at these phases, your cost will be $10.00 to cover the additional cost of the drug screen)

Courtesy Dosing (Clients from other clinics)
First Dose and Set-up                                                $20.00 per first dose
Subsequent Doses                                                      $15.00 per dose

Miscellaneous Fees
Admission/Readmission                                             $40.00 per event
Annual Physical                                                         $40.00 per event
Additional Serology                                                    Market Price (per item requested)
Client Replacement I.D.                                             $2.00 per i.d.
Lab-based Urine Drug Screen                                     $8.00 per drug screen
Redi-cup Onsite Urine Drug Screen                           $15.00 per drug screen
Lab-based Saliva Drug Screen                                     $20.00 per drug screen
Confirmatory Testing (GC/MS, EtG)                        $40.00 per drug tested
Serum Methadone Level                                             $75.00 per level tested
Guest Dosing Set-up                                                   $10.00 per event
Federal Exception Dosing Set-up                                $20.00 per event

At the time of discharge from the program, if the client has money on their account, Metro will provide a check for the remaining balance to the client or the
payee.


MISCONDUCT
Our program’s goal is to treat our clients with dignity and respect and help them to feel accepted.  In return we expect our clients to treat each other and
our staff with respect as well.  Loitering, abusive language, threatening language, arguing with staff or with any client at the clinic will not be tolerated.  You
are an adult, we expect you to act like it.  Be respectful of others at all times.

Physical threats, assault, carrying or concealing any weapons WILL result in immediate dismissal (administrative discharge).  Any and all violations will be
reported to the police department.  Charges will be filed if appropriate. Committing a crime on our premises or against staff or other clients will nullify
your confidentiality with respect to providing demographic information to the police.

Suspected or confirmed selling or distributing drugs to anyone around the facility may result in administrative discharge.  Selling, loaning, or providing
methadone or any other controlled substance to anyone other than the client for which it is intended may also result in administrative discharge.  

If you are administratively discharged from our program for any of the above violations of conduct, readmission to our program at a later date may be
denied at the discretion of the program director.

PARKING
Please be sure that you park in the appropriate parking spaces in front of the building.  Some spaces are reserved for neighboring businesses; please do not
park in these spaces despite the time of day.  When leaving the facility, please do not “car hop” or visit with friends in the parking lot.  This is discouraged
because it gives the impression of loitering to our business neighbors and it detracts from the professional atmosphere we are trying to maintain.  
Furthermore, in the treatment community in particular, methadone treatment program such as ours have difficulty being accepted as well as our clients.  To
help reduce the stigma of this type of treatment, please cooperate with our expectations of your behavior in and around our facility.

DRESS CODE
Please respect other as well as yourself and dress appropriately.  A general policy is “NO SHIRT, NO SHOES, NO DOSE”.  If you have questions
regarding the appropriateness of an outfit, please don’t wear it.  Please refrain from wearing clothing with statements or implications about the
acceptability of using drugs or alcohol.  This type of clothing may be counter-productive for some of our clients.  Please wear clothing that covers the
important parts of your body to not be overly revealing.  Think “casual, yet professional”.  Shoes are important; the area around of the facility may have
sharp objects such as glass or needles on the ground.

TRANSFERRING
If you wish to transfer from our program to another clinic, we will cooperate to the best of our ability assuming you have not violated any of our rules.  We
expect that you will have discussed this transition with your primary counselor prior to requesting the information be sent to a new clinic.  As a part of
this process we expect you to participate in an exit interview so that we may learn better how to serve our clients.  All accounts must be paid to zero, prior
to your records being released.  After leaving our program, if you request copies of your records, to get these copies, your account must be paid to zero
before any copies will be made.

GUEST DOSING
At your request, we will make appropriate dosing arrangements at a clinic near your destination.  Any request for travel mediation should be made at least
a week in advance to allow for physician, state and federal approvals, if necessary.

For your information

LEGAL OBLIGATIONS
Parole, probation, pending cases, outstanding charges, etc. should be discussed with your counselor and/or the physician.  Information will not be release to
any attorney, judge or court officer without your written consent or court order.  Since many probation/parole agreements require you to have weekly
counseling, all such clients should anticipate seeing their counselor on a more frequent basis.  A judge may issue a court order for drug treatment; this does
not include methadone treatment under most circumstances.

RELAPSE
Re-using after being drug free can be a temporary slip this is called relapse.  During treatment in our program, it is possible to learn skills and strategies to
prevent temporary return to substance abuse.  For each client this experience will be unique.  Our counselors will work with you to prevent the spiral
down that may start with relapse.  Your responsibility is to notify us honestly when you begin to think excessively about using illicit substances.

DRIVING
Since methadone is a Schedule II Controlled Substance and can cause impairment according to Kansas state law, you may receive a charge and be convicted
of Driving Under the Influence/Driving While Intoxicated.  If you are driving with the medication in your vehicle, the medication must be in its proper
labeled bottle.  Otherwise you may receive a drug related charge.  Please do not keep other medications in your methadone bottles because this too is illegal.

If you drive or have a job that requires good reflexes or precision, your abilities should not be impaired to prevent you from working provided that you are
on a stable, appropriate dose of methadone.  Your methadone dose, when taken appropriately, should not affect motor control or motor skills, vigilance,
concentration or thinking. Some research indicates clients improve in these areas while in opioids maintenance treatment compared to when they used illicit
substances.

FAMILY
Your family has probably suffered as a result of your addiction.  At the same time, your family may be the most help for you in recovery.  The quality of
your relationship with your family, especially your children, and the behavior you display towards them strongly influences the type of person they will
be in the future.  Studies confirm that the children of parents who drink alcohol and use drugs are at an increased risk of abusing alcohol and drugs
themselves.  Therefore, it is important that you involve your family in your treatment since they may perhaps desire help learning to adjust to your new
“recovery” behavior.  This would be an excellent time to get your family involved in drug prevention.

SEXUALITY
Loving, caring relationships begin and grow once recovery begins.  Self-esteem and self-image are in a state of flux and are central to how you relate to your
significant others.  No one likes to talk openly about a problem with intimacy, physical and mental abuse or sexual functioning, but trying to ignore the
problem is a serious threat to recovery.  Methadone may have a side effect with both men and women that may negatively affect their ability to enjoy
sexual relationships.  We encourage you to discuss any unsatisfactory aspects of intimate relationships with your counselor, your partner and/or our
physician.  In many situations, these problems have solutions that our organization can help you with.  If you wish, we can also make a referral to an
outside organization to help you investigate these problems as well

                                                   
Thank you for allowing us to provide these services for you.
                                     BEST OF LUCK IN YOUR RECOVERY
Call Us Now To Get Started (316) 263-1623