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- Demonstrate that this has not been their first treatment experience
- Must be at least 18 years of age.
- Urine analysis results must test positive for the presence of opiates (exceptions may be considered by medical director supported by other data
In accordance with federal regulations priority for access to treatment will be given to applicants who are pregnant or have tested positive for HIV. Female patients, who are pregnant at admission or become pregnant during treatment, may remain at THW as long as they show proof of prenatal care at Jefferson Hospital or any other Maternity facility. If the patient chooses to go to The Family Program at Thomas Jefferson Hospital or if in treatment be transfer to Jefferson Hospital arrangements will be made. After delivery, the patient may return toTHW with clearance by the medical director.
- You MAY NOT wear Sun Glasses inside the building at any time
- You may not bring Soft drinks to the window
- You may not bring Bags to the bathroom
- Children are not allowed in the medication line or window
- Patients may not take with them the cups after medication, it must be properly disposed at the window
Methadone maintenance is a federally regulated treatment used to help those who traditionally do not respond to an inpatient setting. It is closely supervised to ensure the use of treatment in a safe and practical way to fight the daily struggles of opiate addiction. Methadone is used to stabilize you from suffering the effects of painful withdrawal so you can concentrate on addressing the surrounding is sues that may cause you to use opiates as a tool to cope and deal with daily problems. Methadone comes in a liquid form consumed orally. It is prepared and dispensed daily by our licensed and trained nurses. The most common cause of methadone overdose is combining it with other narcotics. Methadone is a narcotic, that, if used incorrectly, can be dangerous and life threatening. Because methadone is a narcotic, it can produce the following side effects:
- Weight gain
- Decreased or increased sex drive
- Slowed breathing
- Euphoric feeling (in the beginning of treatment)
- As with heroin and other narcotics, it is never safe to drink alcohol when using methadone. Excessive use of alcohol combined with methadone can cause breathing to stop, resulting in coma or death; therefore we will not provide methadone to you if we believe you are under the influence of alcohol.
If you suspect that you are overdosing, contact 911 or go directly to the nearest hospital. Symptoms of an overdose from Methadone may include, but not limit to the following:
- muscle spasticity
- difficulty breathing
- slow, shallow and labored breathing
- stopped breathing (sometimes fatal within 2-4 hours)
- pinpoint pupils
- bluish skin
- bluish fingernails and lips
- spasms of the stomach and/or intestinal tract
- weak pulse
- low blood pressure
- Any patient observed attempting to remove methadone with the exception of the take homes are grounds for disciplinary detox.
Patients who work must provide proper documentation to counselor in order to be given priority when getting medicated. Those patients who provide proof of employment will be allowed in front of the medication line once they arrive unless they have been scheduled to attend an individual session, group or appointment with the medical director.
The admission procedure at THW is conducted as follow and it may require three visits:
- Initial interview, assessment and orientation by intake counselor (approximately 2 ТН hours).
- Laboratory testing (urine sample and blood work).
- Physical and determination by program physician.
- Monday - Friday
- 6:00 am to 3:00 pm
- Saturday and Sunday
- 6:00 am to 9:30 am
- Dosing hours
- 6:00 am to 9:30 am
Holiday Hours: 6:00 am to 9:30 am
Hours of operation are subject to change and will be posted throughout the Program. Every effort will be made to ensure that patients receive advance notice if any changes occur.
THW will observe the following holidays:
- New Years Day
- Good Friday
- Independence Day
- Labor Day
- Yom Kippur
The services provided at THW are:
- Group therapy
- Individual therapy
- Couples and family therapy
- Case consultation
- Aftercare and follow-up
- Upon admission each patient receives a physical examination, lab work and itт??s medically monitored for medication adjustments every six months.
- Female patients are tested for pregnancy every six months.
- THW operates with language diversity including Russian, Ukrainian, and Spanish-speaking counselors and staff to assist those who do not speak or understand English.
- THW is a for profit program. Treatment will be provided on a fee scale.
- All fees are posted in the reception area of the program and are explained at the time of admission and reviewed on an annual basis or as needed if patient requests such.
- Drug testing is done on-site
- Testing is conducted on a monthly basis, but may be conducted randomly if there is a suspicion of illegal substance use.
- Drug testing is mandatory and is required as part of treatment.
- If a urine sample is requested, you will not be medicated until one is provided
- If you cannot give a urine sample, you will be allowed to wait in the lobby until a urine sample is provided.
Patients are required to come to the program daily for their methadone medication. Failure to do so will result in the following:
- 1 day will not interfere with medication, no show will be documented.
- 2 days will require patient to meet with counselor to be cleared for medication.
- 3 days or more will require patient to meet with the medical director to be cleared for medication.
- 7 days or more will require patient to provide a urine sample and see the medical director before reinstated. A drug test is also required before the patient may be reinstated.
- The Medical Director makes the final decision in the re-instatement process. All absences must be reported to counselor in advance to avoid the above actions or possible discharge from the program.
- If admitted to a hospital, please ask the nurse or physician to contact THW so you can be properly medicated while hospitalized.
- Discharge documentation from hospital must be presented at THW upon returning for treatment, which will include the last day you were medicated, dosage and medications prescribed while hospitalized. Failure to provide this information/documentation may delay reinstating you to treatment and medication at THW.
In order to clear a patient from a hold and allow medication, a session with the person placing the hold must take place. Medical staff, counselor or administration may place your medication on hold for any of the following reasons:
- Missed medical appointments
- Missed appointments with counselor
- Missed group sessions
- Disregard any of THW rules or regulations
- Ignore financial obligations
- Window Time is an hour within the programs schedule at which time you may receive your medication. This is the only time you may be medicated. The program director reviews all holds and requests forwindow time. Ifyoucannot make the window time you have been placed on, arrangements could be made, but you must inform your counselor in advance.
After 90 days in treatment patients may apply for take-home privileges. Take-Home Privileges do not exempt you from program responsibilities. There are certain criteria to be met before a patient can be considered eligible for take homes, including:
- Free of illicit drugs and alcohol for 90 days
- Regular program attendance
- No recent criminal activity
- No behavioral problems
- A stable and safe living environment
- Meets all financial obligations
- Demonstrates responsibility with the safe storing of take home medication
- If the treatment team believes the risk for take homes is too great for the patient, THW reserves the right to deny the privilege despite meeting the criteria above. Violation of any the above mentioned criteria may result in the immediate loss of the take-home privilege. The use of illicit drugs (as determined by a positive drug sample) or selling or buying drugs on program property can result in immediate termination of the privilege.
- The programs physician may award the privilege to a patient in medical need, and may withdraw the decision at any time with any violation of the rules above. You may apply for an additional bottle after every 90 consecutive days of meeting program requirements. The maximum number of bottles allowed for take-homes is six (6)allowing you to participate in treatment on the days you pick up your medication.
You must meet the following criteria to qualify for six take-homes:
- Documented medical reason
- Free of illicit drugs
- Have a full-time job or attending school full-time
- If you are planning a vacation, you must give your counselor enough notice to consider granting your request. Please keep in mind you must meet the criteria above. If not eligible for take home,guest medication could bearranged if the counselor is given ample time upon request. You must present your counselor with information regarding the program traveling to along with documented proof of destination(airline,train,orbus tickets, hotel reservations). All take-home bottles must be returned in the condition that they were given to you. They cannot be tampered with in any way. Anyviolation(s) will be addressed immediately. Remember,you can lose the privilege of take-home status with any violation of the rules above.
You must report and supply your counselor or medical director with documentation on any medications prescribed by any doctor outside of THW so they could be noted in your file. Any drug screens that are positive for drugs other than those prescribed by THW doctors will be considered a violation, unless documented in the patient file. Side effects to the medication or, in some cases, medications can cause an adverse reaction when combined with Methadone. It is highly recommended that you tell all outside doctors and pharmacists that you are on Methadone to ensure your safety at all times.
Alcohol use while receiving methadone can be fatal. There is ZERO tolerance for the use of alcohol while being maintained on methadone. A Breathalyzer reading above 0. 0 will result inreceiving NO medication for the day.
Discharge from THW may be based on the following:
- Completion of treatment which is based on agreement between staff and patient.
- Voluntary or AMA (against medical advice. )
- Transfer (to inpatient or another Methadone maintenance clinic. )
- Disciplinary (due to behavior harmful to the patient or to other patients or staff at the program. )
- Keep in mind that for some patients methadone maintenance is a life-long treatment. Your personal treatment success may not include discharge.
Abrupt termination of methadone maintenance is dangerous. It can cause severe withdrawal symptoms and will almost certainly cause you to return to drug abuse. If you believe you have a problem or concern which migh tcause you to leave abruptly please see your counselor as soon as possible for assistance.
Rules and regulation are needed for the safety of the patients and staff. They are necessary for the clinic to be effective in its treatment approach. All rule violations are subject to:
- Case consultation
- Window time
- Discharge (by detoxification)
- The following is a summary of some of the major violations that will be addressed with immediate attention:
- Bringing a weapon to the program
- Drugs, drug paraphernalia or alcohol Stealing from patients, staff or THW
- Appear intoxicated (high) or giving positive alcohol Breathalyzer
- Threats or acts of violence on patients or staff
- Tampering with or attempting to switch a urine sample requested by staff
- Misuse of methadone (all methadone must remain at the nurseт??s window until you drink it. Methadone is a dangerous narcotic if not use as directed by the clinic doctor)
- Damaging program property
- Loitering or failing to leave the program when asked
- The use of loud, profane or abusive language to either patients or staff
- A pattern of arriving late for scheduled appointments or group.
- THW reserves the right to contact the police if necessary. Please note that if a crime is committed at the program and the police are contacted, the violator may lose his/her right to confidentiality.
All patients have the right to be treated with respect and dignity. All persons receiving treatment are protected under the provision of Section 7 of the Pennsylvania Drug and Alcohol Abuse ControlAct(71P. S. 1690. 107). You have the right to:
- Have your complaints heard in considerable time
- Practice or refrain from religion
- Be part of the development of your treatment plan to meet your needs and review it at any time.
- To receive treatment in an accommodating environment
- You have the right to be discharged at any time
- Look at your clinical record during any part of your treatment although the clinical team reserves the right to temporarily remove any information that may seem harmful to you.
- Have your treatment tailored to your needs and abilities according to accepted clinical practice
- Not be exposed to physical or sexual abuse, sexual harassment or bodily or psychological punishment
- Not be exposed to fiduciary abuse
- Be informed of crisis intervention procedures
- Obtain written measures for any special treatment interventions and restriction
- Be informed of boundaries of confidentiality
- Without the fear to report any instances of abuse of self or others
- Give your input into the policies of the clinic through patient surveys
- Have program policies be written or explained in a manner you can understand
- To appeal any decision that may seem unfair to you.
You have the right to submit a written complaint/grievance to the program director. Grievance forms may be found at the front desk. Within 48 hours of receiving the grievance/complaint the program director will meet with you to address the issue or complaint. If the program director or patient cannot meet a written explanation will be made to the complaint/grievance within the 48 hours allowedto explainthe delay. After the meeting takes place, the program director will document on the complaint/grievance form resolution. If you do not agree with the decision, the program director willrefer you to the program president for intervention in the matter. If you still disagree with the decision, you may contact The Coordinating Office of Drug and Alcohol Programs, which has the responsibilityof supervisingthis program. Whenyoufile a grievance you will in no way be subject to reprisal in any form because you filed a grievance. No client will ever be penalized or the object of negativeactions because theyhave filed a grievance.
All patient records shall remain confidential at all times. THW respects and honors the Health Insurance Portability Accountability better known as HIPAA. No information will be given to anyoneor anyfacilitywithoutthewritten consent of the patient. If a patient agrees to disclose information, it must be voluntarily. No one can be forced to sign consent involuntarily. Informationmay be released without consentunderthesecircumstances:
- Medical emergency
- Verbalized or suspected child abuse
- Crime committed on clinic property
- Court order
- Government officials conducting audits in benefit of the patient have exclusive rights to all records without prior notification given to the program or patient.
All patients stipulated to THW through the court system must be aware that information may be released to:
- The judge who imposed the sentence.
- The probation officer assigned to the case.
- Pre-sentence investigation requested by either the judge or probation officer.
All documentation released must be fully documented in the patients record. The patient must be made aware of the disclosure and may request a chart inspection to read the information. Onlythe followinginformationcanbereleased with patient authorization:
- Type of treatment
- General description of progress
- Whether relapse has occurred
- Discharge from clinic
In order to provide a safe environment for person in recovery and staff a random search will be performed in collaboration with security. Our intention is to prevent weapons, sharp objects, illegal drugs,drug sales or purchasing in or around the program. This search will be conducted making every effort to preserve privacy and dignity. Any person refusing the search will have to meet withthe program director. Any contraband deemed as harmful will be confiscated. If anything is found on patients such as contraband or weapons security will have to complete an incident form.
If you have an emergency that will keep you from attending the program, please call your counselor to explain your absence. If your counselor is not available, ask to speak with the program director. Or leave a message with the receptionist. If you require medical or psychiatric attention during these hours you should report to the emergency room of the nearest hospitals.
Kensington Hospital St. Josephs Hospital
136 Diamond Street 16th and Girard Avenue
Philadelphia, PA 19122 Philadelphia, PA 19130
North Philadelphia Health System Albert Einstein Hospital
Girard Division 5501 Old York Road
8th and Girard Avenue Philadelphia, PA 19141
Philadelphia, PA 19122 215-456-6666
4641 Roosevelt Blvd.
Philadelphia, PA 19124