Relapse Questions about relapsing in a MAT program

[kron114]

So I’ve relapsed. Been smoking H again but I never stopped taking the subutex. I don’t want to quit MAT I just stumbled. I have a doctor and therapist through the program. I get along really well with my therapist. I don’t trust my doctor. I get a judgmental know it all vibe off her. So here’s my question... if I admit the relapse to my therapist will she tell my doctor? She said whatever I tell her is confidential but does that include my doctor since they both work for the same clinic? I just don’t want to get kicked out. Obviously I’m not the first person to relapse so I feel like kicking me out for my first fuck up would be really mean. Anyone have experience with the MAT program that knows what happens in my situation?

 

[Deru]

It really depends upon the treatment program, normally you have to sign a contract that outlines how relapses are handled.

Usually, no, the first relapse is not grounds for termination of treatment.

However, it can vary, so it's impossible for anyone to tell you for sure.

 

[kron114]

It really depends upon the treatment program, normally you have to sign a contract that outlines how relapses are handled.

Usually, no, the first relapse is not grounds for termination of treatment.

However, it can vary, so it's impossible for anyone to tell you for sure.

Thanks for responding. I never signed anything. Never got a packet of info stating the rules or protocols. I started up with them after the lockdown in California was already in place. So I’ve never seen any of the staff or facilities in person. It’s all been done with phone or video calls. Do you know if the therapist will snitch me out to my doctor though?

 

[negrogesic]

Thanks for responding. I never signed anything. Never got a packet of info stating the rules or protocols. I started up with them after the lockdown in California was already in place. So I’ve never seen any of the staff or facilities in person. It’s all been done with phone or video calls. Do you know if the therapist will snitch me out to my doctor though?

I don't know, all i can say if i were you I probably wouldn't risk it (divulging that information).

 

[Deru]

Do you know if the therapist will snitch me out to my doctor though?

Is it like a treatment program all within one clinic? Where the therapist is required in order to be on the buprenorphine?

 

[kron114]

Is it like a treatment program all within one clinic? Where the therapist is required in order to be on the buprenorphine?

Yes

 

[Deru]

If so, probably. Is there any reason you want to tell them, to be honest and because you're really trying to do this right? Or is there a concern of failing a drug test and you want to tell them before they see the positive test?

 

[kron114]

I don't know, all i can say if i were you I probably wouldn't risk it (divulging that information).

That’s my first instinct. Don’t admit to shit unless I’m busted. But on the other hand I’m tryin to take this serious and they can’t help me if I’m not honest. I don’t know how to deal with the mental part of addiction now that I’ve got the physical under control.

 

[Deru]

My inclination wants to tell you to be honest, it really makes the treatment process work so much better to really dig in and figure out why and how to build coping mechanisms for the future.

But, I also understand how some clinics work, and I would hate to see you get cut off cold turkey.

I'm honestly surprised you didn't sign anything, or email or something, with rules for treatment

 

[negrogesic]

I have a feeling the therapist wouldn't tell the physician (particularly if it was the first time), but I could be wrong and the consequences could be severe for all i know.

 

[kron114]

It’s not business as usual cause of the lockdown. So under normal circumstances I’m sure I would have done a proper intake and signed stuff. And probably would have been asked to pee test a few times by now. I’ve only done one lab test in the very beginning. I really want to do it right this time and actually get the help and coping mechanisms I need to succeed.

 

[Deru]

If that's the case, I mean maybe just ride it out until you can get a feel for the policies and how they handle this situations. You could feel the therapist out next time and just inquire about rules and just ask, "What happens if at some point I relapse?" It would need to be done correctly, otherwise that in and of itself could draw red flags.

They know less than 8 percent of people in recovery stay sober - most doctors who prescribe over 8mg of buprenorphine per day already assume you will relapse - they do it to try to get as close to a 100 percent receptor blockade so if you overdose and die while in treatment their medical license isn't in jeopardy.

Some of the shadier pill mill type clinics have especially harsh rules where first relapse is instant termination because they're already practicing shady and don't want to further risk their license.

 

[kron114]

Thanks for all your advice. I think I’m gonna ask a few questions first but ultimately tell the therapist. I really hope that if I admit the relapse on my own without being busted by a dirty pee test that’ll show I’m at least trying. Bottom line is I need the help and want the help.

 

[codydion]

where i'm from they would never cut you off for relapsing you just lose your carry's. my brother used to piss dirty all the time. if your in a good program they should understand that people go through a transition period after coming into the program where they may still carry on some bad habits they have been compulsively acting on for so long. that being said maybe they won't. not everyone understands addiction and recovery even if they work in that "industry" so to speak. maybe think up a few questions. one being about the relapse policy and give them a call. can't hurt! i would hope they understand your situation it can take a long time to recover sometimes.

 

[Branggen]

Very unlikely suboxone would be discontinued due to a relapse, if anything taking suboxone daily would keep you safer so its not really a risk to them. Carriers they may want to take because if they know you are using they will assume you aren't taking all your sub takehomes.

I actually got kicked out of a program once, a few years ago but I was on methadone, and had dirty urines with fent heroin and xanax so they were pretty worried that the methadone would be a contributing factor if I died I guess. A year or so later when i had gotten back into the program the doc actually apologized and said these days they no longer kick people out for anything other than staff abuse really. The logic these days is that taking away someone's dose and inevitably reducing their tolerance is actually a lot more of a risk because they end up using the dose they previously needed to break through their methadone and now it just kills them

Keep in mind this is in BC so its a lot different most places from what I hear

 

[Jabberwocky]

if its your first fuckup that should work in your favour. unfortunately i'm in the UK so would only be speculating as to what might happen, but i really hope they are reasonable and don't impose any harsh punishment. especially right now when a lot of people are anxious about the health of their nearest and dearest and life has taken a pretty weird turn, not an excuse for using but may well be a contributing factor to slip ups.