I have edited this post numerous times because I keep forgetting points I want to make. Please note that my post refers specifically to one particular group of methadone maintenance clinics...this information may be different than state-sponsored clinics in states such as New York. I HAVE NEVER DONE HEROIN-NOT EVEN ONCE. I turned to methadone maintenance when my physician abruptly stopped prescribing MSContin and Demerol. I enrolled in 1995 and quit the program in late 2002, but I have been on methadone every day of my life since 1995 and am currently receiving my prescriptions from my pain management physician. I am simply trying to offer this information based on my experience with years on the maintenance program. Sadly, many chronic pain patients have turned to methadone maintenance programs when physicians fail to adequately medicate these patients and they have nowhere else to turn. My situation is far from unique.

Sorry to disabuse you of this notion, but you do not necessarily have to be opiate-positive to be accepted into a methadone program (at least not the ones managed by Colonial.) You DO have to know enough about opiate addiction to answer the questionnaire and doc's questions appropriately.

In fact, if you have the money (you must pay for a week's worth of methadone up front plus the lab fees,) you get dosed the first day you come in...yes, you have to give a urine and blood sample (the blood sample tests for HIV, liver and kidney functions and other labs including syphylis and Hepatitis--this is repeated annually.) You watch a video on HIV/Hepatitis transmission and fill out tons of paperwork.

The Colonial methadone clinics will NOT allow opiate addicts who concurrently use any benzodiazepines to remain enrolled. And cocaine/methamphetamine positive clients are sanctioned as are opiate-positive clients after the initial UA. Finally, they don't even test for THC. You are "randomly" drug tested once every month (but if that random date falls on the 2nd of the month, addicts have the whole rest of that month to use and not get caught!)

Also...addicts notoriously exaggerate their opiate usage (fearing they will be undermedicated.) The Colonial clinics (which are all over the US) ALWAYS start at 30mgs PERIOD. You have the 1st 30 days to adjust your dose according to your desire (you are allowed to increase it 5mgs a day until you get to 50 and then 10mgs a day up to a maximum dose of 130mgs a day--unless blood tests reveal an unusually high metabolism of methadone.) The upper limit is higher in states with stronger heroin such as Texas and California. After the 30 days is up, all dose adjustments require the clinic doctor's approval (including dose DECREASES!)

The sad fact is, it's a FOR PROFIT BUSINESS. They really don't care WHY you want to be on it if you can pay their daily fee (which was $12/day when I was on it.) Nor do they care what dose you want to be on or how long you stay enrolled. If you can pay, you can dose. Alternately, if you CAN'T pay (and you are already a client) you DON'T get dosed! And you must come to the clinic each day for your dose (except Sunday and holidays) and work your way through the "phases" to get "take-out" privileges. Clean UAs and regular attendance plus time and you can eventually earn the privilege to get up to 30 days supply at once (but you are randomly called for a medication check each month and must bring all your empty and full bottles in within 24 hours.) That is Phase 5 (you must have been on methadone maintenance with clean UAs for 3 continuous years to qualify.)

PLEASE do not use the term "meth" to describe methadone. METH is the term for methamphetamine. I HATE being associated with such a destructive drug.