Methadone Clinic Liability

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By now, most people have learned how the opioid crisis has ruined countless lives. As addiction and dependency have spread at a record pace, communities have struggled to keep up with the direct and indirect challenges that have come along with the epidemic. One of the main ways that the medical community has battled opiate addiction is with replacement therapy, often with methadone as a part of methadone maintenance treatment (MMT).

Methadone is a dangerous drug of its own, and MMT involves its own set of challenges, some that will give rise to significant risks and liability. When MMT is working, an addicted person can take a daily dose (usually first thing in the morning) and then goes about a normal and productive day, free from cravings. A person might continue in an MMT program for years and years, often working his or her way up to taking many methadone pills home for unsupervised use.

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As the opioid epidemic persists, attorneys in the personal injury, medical malpractice, and health care spaces can all expect to encounter methadone in cases from time to time. Aspects of methadone treatment that are likely to give rise to risks or liability claims in an MMT setting include a lack of medical oversight, inadequate counseling, and mismanagement of take-home medication.

LIABILITY FROM LACK OF MEDICAL OVERSIGHT

MMT is governed by Federal regulations within 42 C.F.R. §8.12. Each opioid treatment program needs to have a medical director, who under federal law, assumes responsibility for administration of all medical services provided by the clinic. 42 C.F.R. § 8.12(b). Before a person begins treatment, they must have an initial medical examination. This is incredibly important because of how deadly methadone can be. To put this in perspective, under federal regulations, an initial dose of methadone for a new patient in MMT can be as high as 30mg. 42 C.F.R. § 8.12(h)(3)(ii). For a person who is not addicted to methadone, this is a lethal dose right out of the gate.

With this level of toxicity, a high degree of medical attention is required and the medical oversight must continue over the course of the program. Liability can arise when a clinic opts for one-size-fits-all approaches and goes extended periods of time without medically evaluating its patients. Shortcuts in medical oversight can lead to significant problems, including overdose, relapse, and failure in the program.

LIABILITY FROM COUNSELING NEGLIGENCE

Another required piece of the MMT program is counseling, which can also be another source of risk. Counseling sessions are required by the federal regulations and when done right, are immensely helpful to patients. Counseling sessions cover the whole patient, and often involve discussions about stressors outside of the limited world of drug addiction. Counselors are expected to inquire about family, job, and any other stressors in life to potentially identify issues before they arise. Methadone programs will run into trouble when counselors are not communicating with medical personnel about problems that come up, because counselors are often privy to the early warnings. Sometimes this information is recorded and never ends up going anywhere, which is a major risk. Clinics with no back-and-forth between the counseling and medical personnel can cause major red flags to be overlooked.

LIABILITY FROM TAKE-HOME MEDICATION

For obvious reasons, the biggest risk of all comes in the form of take-home methadone. Patients begin MMT coming into the clinic six days a week to receive a dose under direct medical supervision. This can be burdensome for the patient, but the rules require it until the patient can build up trust, which is also defined under the federal regulations. The regulations lay out eight criteria that all must be met for patients to receive any take-home medications at all. The criteria speak to abstaining from alcohol and drugs, regular clinic attendance, length of time in the program, but they also look at stability of home life and relationships. They are intended to make sure patients are safe, that they can be trusted to administer their own medication, and that the medication will not fall into the wrong hands. Clinics who take shortcuts in the take-home assessment process endanger not only the patient, but innocent people at home and in the public as well. Clinics must take this responsibility seriously and be consistently vigilant, watching for any signs that the eight-point criteria are no longer being met in their take-home patients and be ready to dial them back and require regular clinic attendance when necessary. Patrick Stoneking

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Comments 11

  1. Maria Gil says:

    Hello I need an attorney ASAP I was prescribed norcos from my dr. Kaiser for 15 years every month 3 years ago Kaiser cut me off cold turkey and I attended a methadone clinic because of the withdrawal every thing was fine until last month my dr died and the person who took over not a doctor she cut me off my monthly take homes because I missed a phone call she abused me verbally when I complained the nurse had to get her off from me and calm her down I refused to go back I’m afraid to go back and Kaiser claims they cannot help I need my medicine

  2. Luke dunn says:

    Sounds like class action to me, I was hit by car and sufffered stroke I can’t walk to get to clinic they won’t give any take homes, without methadone I will return to active addiction and die. Fed guidelines relaxed for COVID my clinic totally ignored that and has come in everyday thruout pandemic.what has to happen to me to get a couple take homes so I don’t have another stroke. The more weight I put on ,eg the worse my chances.I had clean urines leading up to this excepting the. This is truly cruel and unusual. These clinics must be reeled in they are an outdated and ineffective drug war influenced modality

  3. lynnann yaroscak says:

    needed Lawyer for 62 yr old woman who only goes 1 day a week. was taken off of 560 to 600 milligrams a month with out telling her.she been on since 1987. The doctor was fired. and she suffers alot of disabilitys from the shock to her body.This is a genuine case. imagine 600 milligrams a month.not being told why except they forgot to give her a EKG paper last year,so they took her off no weening. she could of died.please any Lawyers text 724 503 9912. to get case facts. That is all True and Legit.she suffers dementia tremors alot of health issues thank you

  4. Tina Kish says:

    Need an attorney referral for Personal injury or medical malpractice against a MAT clinic in Cleveland Ohio.. Regarding medication dose after knee surgery & billing for counseling & never received services.. Take home medication return bottles not accurately document.. Need State & Feds to investigate!!! Need help before someone dies!! They have caused severe duress tobmy husband..

  5. Paul Swoboda says:

    I desperately need help I desperately need a lawyer who will defend me against this horrific situation I am in this Clinic has never done anything to help me get off of these drugs all they have done is taking my money and they have never helped me in any way whatsoever to try to stop that they have never given me any kind of counseling or anything I need help

    • Lilley Toole says:

      Until I read the comments here, I honestly thought that I had suffered a grave injustice and the worst part of all was believing that I was the only one to experience malpractice/negligence at the hands of the methadone clinic. Everything that other’s are saying is true. And when a clinic misuses methadone a person is forfeiting their free will. It’s rather difficult to pursue legal action when you’re so obviously over medicated that you can barely stay awake long enough to drive home every 24 hours after dosing. I couldn’t work, I was constantly being pulled over by police and firefighters who could see something was clearly wrong. I was terminated repeatedly since I was so lethargic. I couldn’t stay awake long enough to even complete a request for legal advice. My brain has been permanently rewired. I was evicted three different times. I had to drop out of college. It was simply overwhelming. But the longer I was there,(16 years) the more my body needed it’s fix. Since I hadn’t been physically dependant on opioids until admitted to the clinic, my tolerance was almost zero. I weighed 89lbs when I began dosing. It was a cash based operation back then. Community hospitals are generally serving the poor. A single mother not receiving child support was advised to get addicted to something that’s four times stronger than heroin and pay weekly fees for years. Money was the only real requirement. Clients could not dose without every penny of their money. I saw a man four dollars short, he attended 27 years, but was denied methadone until he has what they wanted- his last dime. How is this legal? And if a professional, who neglects his duties & then can use a powerful narcotic to ensure that you can’t fight back, get away with this behavior? My physician was actually sanctioned after I spent years attempting to draft a formal compliant. Then the attorney general, another “professional” allowed my name to be revealed when the doctor was sanctioned. As to be expected, the furious doctor abruptly terminated my treatment. After 16 long hellish years, after I was forced to steal from my own family to pay for the only opioid my body could even feel, I was discarded like trash. $125,000 in the fees ALONE. He knew that I had no other methadone options left. I ended up homeless and the isolation and frightening withdrawals were agonizing. It’s not mind over matter. I’d commit suicide without a second thought if I had to suffer like that again. It lasted months. Ended up pan handling and living outside, even in winter. Heroin was the ONLY option left for me. I had never even seen heroin prior to battling the withdrawal from methadone. Is it possible that the constitution which promises me I have the right to life, liberties and pursuit of happiness doesn’t recognize that I had no possible way to formally press charges? Is this truly not disturbing? How could I pursue a damn thing? I didn’t attend medical school. I had no idea that methadone pervades everything you want out of life. He knew I couldn’t defend myself. When he kicked me out he told me it was due to my compliant. He even requested that I recant or say I wasn’t mentally stable when I accused him of hurting me. I thought I still had the right to petition without fear of redress? But God I was so wrong. It’s hopeless and good luck asking anyone to listen because stigma will prevent anyone from believing you. Oh, by the way, it’s been 4 years since my exit. I’m STILL opioid dependant even today. I’ve lost everything. There’s nothing I can do but try to move on. I don’t think manufacturing junkies is constitutional. No way to formally argue I didn’t have the capacity to meet statue of limitations. Ironically it’s the reason I couldn’t. Good luck for those who realize that it’s not alright for doctors to abuse their intimate medical knowledge? It’s a specialized weapon. It’s a drug deal disguised as treatment for profit and it’s not likely to be challenged in the system. I’m on Suboxone but it’s still a drug that I have to have. I received the Hotel of California in medical care. I did indeed check out, but I’ll never LEAVE. I’m damaged goods. I do have three legal questions but I don’t think anybody will answer me. If there’s a person who actually wants to answer, please don’t delay contacting me. I’ve been waiting long enough. Thank you very much.

  6. Lina Marie says:

    I was on the methadone clinic for 7 years for a heroin addiction. I was told time and time again to not come off because I would relapse and if it’s not broke to fix it. I’m sitting here today with 11 years clean from opiates and alMost 5 years off of methadone, I was a walking zombie that was completely isolated for 7 years. I went through the worst pain of my life coming off that drug. The clinics do NOT PROVIDE any type of counseling what so ever and was given dirty looks or insults if I wanted to come off. I am looking for a lawyer to talk about my situation

  7. David Sanchez says:

    I need a lawyer for all types of violations committed at the methadone clinic I go to.

  8. isaias ramos says:

    I’m trying to find a lawyer because of malpractice.

  9. Gale Z. Cardwell says:

    I’m looking for one in Philadelphia, PA. They murdered my son.

  10. Daniel Doerr says:

    I’m trying to find a lawyer in Pittsburgh PA who is dealing with methadone mismanaged treatment. Can someone please help me finding one?

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