 This patient presents to the office today with his mom for checkup.  He used to live in the city.  He used to go to college down in the city.  He got addicted to drugs.  He decided it would be a good idea to get away from the "bad crowd" and come up and live with his mom.  He has a history of doing heroin.  He was injecting into his vein.  He was seeing a physician in the city.  They were prescribing methadone for some time.  He says that did help.  He was on 10 mg of methadone.  He was on it for three to four months.  He tried to wean down on the methadone a couple of different times, but failed.  He has been intermittently using heroin.  He says one of the big problems is that he lives in a household full of drug users and he could not get away from it.  All that changed now that he is living with his mom.  The last time he did heroin was about seven to eight days ago.  He has not had any methadone in about a week either.  He is coming in today specifically requesting methadone.  He also admits to being depressed.  He is sad a lot and down.  He does not have much energy.  He does not have the enthusiasm.  He denies any suicidal or homicidal ideations at the present time.  I questioned him on the symptoms of bipolar disorder and he does not seem to have those symptoms.  His past medical history is significant for no medical problems.  Surgical history, he voluntarily donated his left kidney.  Family and social history were reviewed per the nursing notes.  His allergies are no known drug allergies.  Medications, he takes no medications regularly.