You’ve been attending medication-assisted treatment at one of the Georgia opiate rehab centers that offer methadone or Suboxone. You know you’ve been getting away with some negative behaviors, bending the rules to suit yourself and sliding under the radar. And then—boom! You’re caught, and the counselor makes you sign a behavioral contract. What comes next?
The Rules at Georgia Opiate Rehab Centers
The state’s Department of Community Health has the responsibility for regulating Georgia opiate rehab centers, and like policy makers in other states, those in Georgia follow the lead of the federal government’s Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA lists behavioral contracts as an effective intervention to keep clients on the straight and narrow while they’re working their way toward recovery. You may resent being asked to sign a contract, but it will help you stay focused on treatment.
Methadone Program Contract
Most Georgia heroin rehab centers require all clients to sign agreements at the onset of treatment in a methadone program. The methadone contract describes the basics that you acknowledge and agree to, such as dispensing hours, payment arrangements, medical care, the process of handling medication bottles, and other incidental rules of the program.
The most important part of the contract details the dangers of using other drugs while you are receiving methadone or Suboxone at any of the Georgia opiate rehab centers. You must communicate your enrollment in the program with other doctors who will be prescribing medications for you, and you must agree to present as requested to give urine samples for drug screens.
Most programs also insert language affirming that you will maintain respect toward other clients and toward the staff at the opiate rehab center in Georgia that you are attending. The importance of confidentiality is explained fully. You may not think that a Facebook entry about someone who annoyed you during your methadone group session could violate someone else’s right to confidentiality, but it does.
You will also understand the procedures set in place for seeing the doctor regularly or requesting changes in your medication dosage. The counselor assigned to your case will discuss everything more fully when the two of you create your treatment plan.
Types of Behavior Contracts
There are many Georgia opiate rehab centers, and they may all call their behavior contracts by different names, but the first two types of behavioral contracts address your need to engage in the treatment program and what you must do in order to stay in the program.
Think of behavioral contracts as write-ups with your employer. When you break the rules at work, your supervisor writes you up, and you know if you have three or more strikes, just like baseball, you’re out. The same goes for behavioral contracts: Each contract is meant to signify an increasing need to focus on your reasons for coming into treatment in the first place. If the counselor and doctor find additional reasons to have you sign contracts, you are endangering your continued participation at your current program.
- The Engagement Contract or Agreement usually identifies that you are not attending group or individual therapy sessions or some other mandatory aspect of the program.
- The Retention Contract states that you have not been following the rules and that you must comply with them if you want to be retained in the program.
- You may be asked to sign a “zero tolerance” contract if your drug screen shows that you have been using benzodiazepines or alcohol. Neither of those substances can be taken safely with methadone or Suboxone.
- If you’ve failed to obey specific rules of the program, you may be presented with a “deviation” contract—you’ve been skipping through the loopholes, and you’ve been caught.
Staff at Georgia opiate rehab centers can write anything necessary into the contracts. For example, if you’ve been showing up daily to take your medication but you have not been attending individual or group therapy sessions, you may be required to start showing up at those. If you have refused to attend 12-step groups—many people in the initial stages of treatment simply don’t understand their importance—the counselor can hold you accountable to show up and produce a weekly meeting log.
The conversation that takes place between you and your counselor when you are asked to sign the contract constitutes an important part of your therapy. Contracts are actually a component of cognitive behavioral therapy, and you are asked to recognize how the negative things you did affected you. For example, if you’re having positive drug screens, are you really staying away from people, places, and things associated with your druggie days? It shows the counselor that although you have presented yourself for medication-maintenance therapy at one of the Georgia opiate rehab centers, you still don’t understand that some of your problems in life are directly related to your drug use.
Just the behaviors alone can negatively impact your life, even if you’re not using drugs. Say for example that when you were actively using, you typically stayed up all night and fell into bed at dawn, and you then slept until noon or later. Now you have stopped using opiate, but you still don’t go to bed at night. You stay up and watch movies that you don’t even care about, and then you fall into bed at dawn, and you still sleep until noon or later.
The problem with that, even for those of us who are genuine night owls, is that we live in a daytime world. You may have stopped using but you’re not getting up, going to work or school, keeping your house clean, and living a full social life. Your sleeping schedule may not reflect your drug use, but it does reflect your willingness to make positive changes in your lifestyle.
Mim Landry has discussed in the book, Overview of Addiction Treatment Effectiveness, that tracking the success of people who signed contracts revealed greater success compared with those who were not asked to sign contracts. When the counselor asks you what you could have done to avoid using, they are not acting condescending toward you; they are asking you to look into yourself and answer your own questions about how you can make your life better. Once you see the effects of negative behaviors, you feel an increased motivation to change. And that’s what it’s all about.
If your behavior results in discharge, that does not exclude you from methadone or Suboxone therapy for opiate abuse. It would mean, however, your referral to another of the Georgia opiate rehab centers. So if you’ve been asked to sign a contract, it’s time for self-reflection. Put your annoyance behind you and talk openly with your counselor about the reasons you broke the rules. It’s your recovery, and only you can strengthen it.