Other drug use in opioid treatment programs

[suboxdoc]

We have a nice discussion going under the thread 'where in the world is jeff junig'. That thread has veered off to another subject that is actually much more interesting than wondering where I disappeared to! So let's see if anyone wants to add to that discussion, and we can let the thread about me disappear from the 'recent topics' section.

To catch people up, some moderators here (and myself) work in addiction treatment programs that follow a harm-reduction model. By 'harm reduction', the emphasis is on reducing death and morbidity from addiction rather than insisting on complete abstinence. Abstinence is a goal of those programs, but the programs recognize that kicking people out and back to heroin, because they used THC, is short-sighted and cruel. The hospital in my town, for example, routinely discharges buprenorphine patients for minor infractions ranging from a urine sample containing THC to missing one counseling appointment. Those patients do not suddenly disappear; their lives continue to spiral downward as the consequences of their addictions accumulate.

For people currently in treatment - office based buprenorphine or by the methadone-assisted model - how does your program or doctor approach the use of other drugs?