Can they do that????

[Anon33]

Ok campers....real scenario and need advice before 9.30am
Matey is in shared care and scripted 4mg Subutex a day, has mental health couldn't cope with how Bup can make things a little raw, so took some aquired Physeptone tabs=30mg and feels a bit better.....the plot thickens......an appointment turns up to see a key worker/duty GP as part of treatment agreement he rocks up to the appointment and is HONEST that the Subs were not suitable, hence aquired Methadone in tablet form (lucky for him).....then gets told that he has to give the Physeptone tabs and Buprenorphine back to the key worker at 9.30am tomorrow.....the G.P laughed and let the key lead the conversation....now the key wants him to hand over meds suffer til Thursday and the Key wants matey to start back on the Subutex on Thursday-matey wants Methadone not Subutex
There is no evidence of any care plans and as far as matey is aware he was in shared care and the GP that usually scripts him was not present, he feels he is being forced into detoxing on a substitute that does not work for him.

He wants Methadone, the key wants him to be on Subutex as he feels that matey needs to feel clarity and it's a good thing-matey does not agree.

It's like you wouldn't ask someone to bring their used Heroin paraphenalia in and as matey acquired phy tabs on the black market......he thinks he is getting set up and is scared that they will get him done for possession or something.....also if he does hand them in to him it's money wasted and he might as well go score and he would rather have 100% opiate legal Methadone prescription and certainly does not wish to withdraw and does not want an unnecessary rattle....one more thing the services are getting handed over to CRI over Christmas and all the key harped on about was recovery blah blah...
1.Is it allowed for the key to determine what suits a client-when the client has 30 years addiction experience and knows his own body and mind and HIS own GP usually supports him
2. If you are suffering with mental health,should you be forced to detox-is that not against your human rights?
3. There is no signed agreements with the client.

I know it is a bit sketchy, but the feeling I got off the poor chap is that he just wants to end it all and they are treating it like a joke....I aint laughing, nor is matey.......What should he do
Any midnight posters; feel free to add your voice
Cheerz
Anon33
x
 

[simon]

The NICE guidelines and DOH guidelines are unchanged and the patient does have the choice - Methadone has slightly better outcomes. I wonder if the key worker is aware they'd be in possession of a controlled drug that they aren't legally entitled to have?
http://guidance.nice.org.uk/TA114

[Jules]

I agree with Simon.  Use the link that he's given you and advise him to ring the Helpline and make sure he tells them he's taking advice.  Don't let him hand over any illicit medication - he's probably flushed it down the loo anyway 

[Jules]

Also, insist on seeing his Care Plan - everyone must have one and has to be agreed between client and service provider.  No argument.

[Anon33]

I thought as much, thank you Simon/Jules;The helpline opens at 10am- do you think he should speak to Alliance prior to going in, or does the fact it has been asked on the forum, it is OK to say that advice has been sought

[Jim]

Just to add that I don't quite understand this as most services prefer methadone because it is cheaper (in fact this is the reason NICE recommend it if all other things are equal).  Regarding the law I think asking someone to bring in their illicit drugs is very dodgy.  If they were to recommend anything it should have been take it to the police or destroy it.  Those are the two options they themselves have when they take possession of it (it can't be taken to a pharmacist as it is illicit) - although I think they are entering some very dodgy ground.  Certainly I would never recommend this course of action in our services.

[sapphire]

I wouldn't hand over any meds, he's under no obligation to do so, maybe he's taken them all by now anyway??!

Can he see the GP that actually prescribes him? He does have a choice, and the DSP should listen to it, defo give the helpline a call, this keyworker and doctor are not operating by the guidelines they should.

[derek d j]

Sounds like another key allows their enthusiasm and eagerness to please the boss to affect their judgment. Your friend should threaten this eedjit with an 'official complaint'. Unfortunately there's no  regulatory body for 'keyworkers' to which users can complain ( why not? ) but if your friend chooses six consonants at random, there's probably a drug organisation with those intitials he can claim to have notified. Bullies are invariably cowards and the prospect of investigation will most likely cause the offending 'key' to backtrack.

What's with such people? The 'small men of small power' syndrome is nowhere better illustrated nowadays than in U.K. Drug Treatment centres. The superficial pleasantness and the user's inclination to a quiet life paves the way for all kinds of duplicitous nonsense. 'Team meetings', where staff discuss users in their absence, should be recorded and made available for service users to hear what's said about them. Would be something of an eye opener.

And, of course, in lieu of sacking the whole useless bunch, a national qualificative standard for 'keyworkers' needs to be introduced at the earliest opportunity.

[simon]

It's likely to be about control and thinking they can force someone not to use by pushing them on Subutex. It's often inexperienced people that tend to do this, sometimes well meaning - other times not.

[usandthem]

This is very fishy. It sounds like the Pharmoceutical mafia have collered hold of CRI to opt into getting their clients to switch to Subutex. Is this type of thing allowed to happen. Surely legal rights are with the client not CRI. After all CRI is just the middle man and is doing the NHS work for them. I really don't like what this company is trying to do to users. Sounds like a dictatorship here forcing users to opt for meds they do not want and forced reductions. If they do not lose the next contract then I will lose all hope in the NHS completely.

Oh by the way Anon33, you know what i'm like for my help links (lol) Link below mate. So these guys have clout and can help you. They regulate all care services run by the NHS

http://www.cqc.org.uk/

[simon]

No it's not the drug companies they don't even market Subutex anymore.

[usandthem]

The CRI and its 'better shape up' Army of volunteers and other under-trained co-horts must be getting rewarded somehow for bullying clients into their very superficial 'quick fix to being normal' Subutex, otherwise users wouldn't have to keep fending them off everytime they say Subutex works better than methadone. Why all the keywork energy into changing users meds. Are they really concerned keyworkers?!! I think not. I stand by my earlier comment. 'Something fishy'

[simon]

http://www.m-alliance.org.uk/forum/index.php/topic,2466.msg16214.html#msg16214
Now I do recall somebody from the NTA saying that Subutex is more 'recovery orientated' and 'easier to reduce off' and I wonder if it came from these discussions in the link?
I don't believe Subutex is easier to come off from what I see with my patients.

[usandthem]

Methadone Maintenance>  Recovery/Reductions > Doctor > Psychiatrist >Subutex> Suboxone > more Reductions > Therapy > Amino Acid Treatment > Accupuncture > Ibogaine lol! Unstable Reduction > A little Gear > more Reductions Go on you are doing so well > A little more gear > Rehab > Not suitable wrong envoironment. Escape > Horse therapy > Alcoholic > See the Doctor Well done> A full on Habit > Successful Detox > On the Streets > Prison > Death/ overdose. "When does it ever end. METHADONE MAINTANENCE WORKS FFS" lol!

[Jim]

RE complaints

You can make complaints even if there is no regulatory body - most complaints are not made to regulatory bodies.  You can formally complain to the organisation.  You can complain through PALS (I think this applies to health services not run by the NHS), you can complain to the commissioners. you can go tpo the health service ombudsman.  Finally you could try the CQC.

However rather than all that bother a phone call to the alliance helpline often does the trick

A healthy service will often welcome complaints as it is sometimes the evidence you need to tackle bad behaviour/poor performance.  Sometimes its very difficult to act decisively without one.

In this case I would have started fisrt by asking to speak to the service manager, if no joy phoned the alliance.