This is my first post, so please excuse me if I am breaching any forum etiquette. I am currently in TPAPN and have been since March 6 of this year. I was fired from my job for diverting dilaudid. I was also using heroin but never disclosed that to my employer when I was fired. I went to detox, then to a 30 day treatment center. Now I am in IOP and have been since March 6th (same day I officially started TPAPN). I have been severely struggling with lethargy, apathy, anhedonia, and just a complete disinterest in life. A friend I met in recovery stated I may be suffering from Post-Acute Withdrawal Syndrome. It also doesn't help I was taking Vyvanse every day (as prescribed...I never abused this medication) for the past 5 years and before that I was prescribed Ritalin since I was 15 (I'm 29 now). So pretty much acute withdrawal from stimulant medications and opiates. So, essentially, I feel like ass. I have no energy or motivation to do anything...even though I'm on a non-stimulant ADHD medication (Straterra) and an SSRI (Trintellix). This same friend suggested I try a supplement called Kratom. Yes, I know, it is not allowed through TPAPN but I figured it wasn't tested for since it is not on a standard drug panel and only 2 labs in the United States test for this supplement (stupid addict thinking, I know). So...I tried the Kratom and lo and behold I had energy, motivation, didn't feel high...just felt rested and motivated. I used this daily for about 2 weeks. What I didn't expect was that my IOP tests for Kratom. Today I was called in by my counselor at my IOP and informed I tested positive. I did a UA for TPAPN March 29 so I'm assuming they do not test for this...if they do, I will have to face my case manager. But...I'm assuming they don't here...with that assumption...do I need to inform my case manager that I tested positive for Kratom while I am still in treatment? What I am worried about is being open and honest with my CM and it completely backfiring on me vs not telling her and hoping it never gets brought up. I'm just really not sure what to do here. You can belittle me and tell me how stupid I am...I already know. I'm honestly hesitant to even post this on here because I've seen so many nurses posting just looking for help and getting completely berated. I'm just looking for some advice. Obviously, if my UA for TPAPN comes back dirty, I know I will have some explaining to do. But for now, I'm just not sure what to do. I feel so hopeless.
I'm like 99% sure you have the IOP people sign a release so they can discuss your care with your CM. They will tell them about your UDS, there's no doubt about it. Talk to your IOP counselor and see if/when they're sending the UDS report. I wouldn't expect to get in too much trouble since you're just starting out in the program. If you were months in then it would be a different story
Your story sounds familiar to me- I won't go into the details of my struggles through treatment- but what eventually worked for me is yoga, and more specifically hot yoga. I had anhedonia, lethargy, the works. When you are able and medically cleared to look into joining a yoga studio- you get community- much needed exercise- and mindfulness.
So I thought I would post an update. TPAPN only requires specific information from rehabs and IOPs. These are specific forms I have to turn in at due times. They do not contact the rehab/IOP demanding results for all your Is a. They mainly just require an assessment form, updates regarding prescriptions, and discharge summary. My therapist told me she will not report me to TPAPN and will not mention my positive UA on any of my paperwork to be turned in. I'm just posting this update in case this happens to any other nurses in TPAPN. I can't vouch for any other states.
So I thought I would post an update. TPAPN only requires specific information from rehabs and IOPs. These are specific forms I have to turn in at due times. They do not contact the rehab/IOP demanding results for all your Is a. They mainly just require an assessment form, updates regarding prescriptions, and discharge summary. My therapist told me she will not report me to TPAPN and will not mention my positive UA on any of my paperwork to be turned in. I'm just posting this update in case this happens to any other nurses in TPAPN. I can't vouch for any other states.
That is absolutely the best news possible! You have no idea how happy I am for you!!
You know I've been thinking about this. It certainly makes sense if you look at the relationship between your IOP and TPAPN in a different way. We've come to view TPAPN as all powerful and all knowing, and that can be true, we've signed all the disclosure forms to allow them to know everything about us if they so choose. BUT the IOP is treating you, you are their patient, and they want a good outcome, to show their success. And TPAPN is sort of like a doctor who refers a patient to them. If they get a new patient referred to them by a doctor, they'd agree to keep the doctor in the loop about the patient's progress, but they just don't have the time to write a journal for every patient they have to every doctor that referred them about all the specifics of their treatment, their successes and failures. So they agree to send the highlights. No one has time to share all those details with an outside party, and if it's not contractually required (as in part of their reporting) then they aren't going to do it. Also, TPAPN patients may be a source of significant revenue. So why would they want to show that they've had a "failure" in treatment? They'd risk losing future referrals, if TPAPN lost confidence in their success rates.
Just a thought. Maybe it's not accurate, but it helps me to think that not everybody is running around telling TPAPN all the details of my whole life!
I agree with Recovering's thoughts. Aside from program participants being a significant source of revenue for these IOPs it is also possible that you have an IOP counselor that actually gives a **** and wants to see you succeed and does not see any point in kicking you when you are down. To these programs, regardless of why we present to them are nothing but a file number. We may speak to a CM on the phone or have email contact but that is it. These people that pull so many strings in our lives? Wouldn't know any of us if they ran over us in the street.
An IOP counselor that at least has laid eyes on you and might have an iota of scruples still would understand that there is nothing to be gained by running to TPAPN and tattling.
I'm super happy your IOP didn't f- you! It's nice to hear not everyone related to these programs are out to punish and berate those of us in this hellish situation... I mean- the whole situation is hard enough already... besides.. kratom is legal. This is going to sound silly, but do you know which labs test for kratom? I took kratom Sunday and had a urinalysis Monday ( today) - not even thinking it would be a big deal since it's a legal herbal supplement. Then my paranoia set in. I started some research and now I'm nervous. My argument to them is going to be that I had no idea it was banned ( truely didnt- but it worked so well... I figured they might not like it being used after the fact ) I never got a list of meds that are banned and my addictionist seemed more concerned with taking away my non narcotic muscle relaxer (since I like to use it to sleep), and some strange CPS situation her daughter for herself into, than going over which items were safe and unsafe to take. -.- anyway- needless to say I wanna kick myself now, but damn it! It felt nice to quit crying for a day... it's also been suggested by some AA folks that I'm suffering from some post acute withdrawal syndrome. I used to drink kava and knew kratom was kind of similar... tell ya what- it works, boy. Lol. Anyway- I'm in Michigan. I'm not in any IOP. Just generic HPRP drug testing. I hate feeling like a criminal over using a legal herbal supplement. My criminal probation hasn't banned it and If they don't want to throw me in jail for it- I'm not sure why the monitoring program would care.. then again, they are *just a little* unreasonable. ( I think they're extremely unreasonable and punitive- I'm being sarcastic)
I totally understand. I had a cold about a year ago and really wanted to take a decongestant, my nose was so stuffed up I couldn't breathe through it at all. All sudafed products are banned, of course, I kinda get that, but Afrin nose spray is too! I'm seriously not allowed to take a nasal spray, how ridiculous is that! And of course I took it anyway, and then afterwards I thought, "hmmm, maybe I should double check that list again" and sure enough Afrin was on the list where I needed a doctor's approval. So yeah, I was paranoid and felt like a criminal, until enough time went by where I was pretty sure it wouldn't show up in a drug screen. Benadryl too, of course. I don't take it a lot because it makes me so sleepy, but sometimes I WANT to be sleepy! A perfectly legal OTC med that we aren't allowed to take without a doctor's prescription.
Most labs are able to test for Kratom. I know quest does for sure. The problem is that add on test is very expensive.. so I found out that my program does NOT test for kratom.. but you'll find out soon enough, good luck.
RickG85
65 Posts
I'm like 99% sure you have the IOP people sign a release so they can discuss your care with your CM. They will tell them about your UDS, there's no doubt about it. Talk to your IOP counselor and see if/when they're sending the UDS report. I wouldn't expect to get in too much trouble since you're just starting out in the program. If you were months in then it would be a different story