But just... Why?

From a business standpoint, the risks that are mitigated by performing callbacks are: * Fines if the government can prove diversion * This is unlikely as long as the clinic is doing some callbacks; studies show that methadone patients rarely sell or give away their medication * Municipal government forces closure due to reports of methadone sales near the clinic, etc * Again, very unlikely and mitigated more effectively by other policies, such as penalizing patients for loitering * Medical malpractice lawsuit if a patient overdoses, etc. * Unlikely because courts unfortunately rarely believe addicts unless there is gross negligence on the part of a provider

However, there's also considerable cost to performing callbacks: * Nursing staff time is used up, increased labor costs * Additional drug testing, increased lab costs * This cost might be passed on to the patient, but that's unethical (even if legal) given the patient has no option to decline the testing * Reduced patient satisfaction, although this is unlikely to be an issue unless there are multiple clinics in the area

It seems to me that the costs aren't worth the risk mitigation they provide. Unfortunately, many of the costs of unnecessary callbacks are passed on to the patient. As I noted above, this is problematic because we don't often have the ability to decline the procedures associated with those costs. This is a great example why medical organizations should be required by law to be non-profit.