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.


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.


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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.


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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Patrick Stoneking

Patrick Stoneking, an experienced litigator at Robins Kaplan LLP, is dedicated to helping people who have been permanently and severely injured by others’ mistakes. He has represented hundreds of people across the Midwest in claims that have often involved complex medical issues and insurance coverage matters. He is an active member of the American Association for Justice and the Minnesota Association for Justice, where he serves on the board of trustees. He frequently presents on some of the more complicated aspects of medical malpractice litigation, including loss-of-chance, methadone prescription liability, and the several procedural requirements that are unique to medical malpractice claims.

Comments 12

  1. Jessica Minder says:

    I’ve just posted a very important comment that anyone on methadone should be aware of. It’s pending moderation.
    I’m curious to see if my comment will be censored. Because what I’ve written is the truth.
    These methadone clinics are not helping anyone. These programs are not helping.
    We will continue to suffer and fail by systems that on the surface pretend as if they are to help when in fact they are specifically designed to do the opposite. By our Government. Until everyone stops stuffing their heads in the sand, see the truth and stands up to make these things do what they are supposed to do. Nothing will change. We will continue to be kept down, incarcerated, addicted, undertreated and ignored. When we deserve better. It’s our right to have better. But it won’t happen until we make it happen.

  2. Jessica Minder says:

    But clinics aren’t using real methadone. If they were they wouldn’t have such low success rates. They use methadose or other watered down generics. That don’t have the efficacy as real methadone. Hence why most people, atleast at my clinic are still using drugs and are forced to take 2 or 3x the normal dose. It’s useless basically and set up for dependence and eventually failure. The states and counties are collecting money currently from opioid settlements. WHY? They aren’t the victims. Pain management patients who became drug addicts due to thr medical systems failing and continuing to fail them, essentially creating more drug addicts which are funding these supposed “rehabilitation programs” and prisons. It’s a set up and vicious cycle that is only hurting society. They aren’t helping anyone. They are specifically keeping people down. Discrediting by throwing the “drug addict” label and stereotype into their files. Assuring no doctor will take them seriously. Making them a target for the justice system. Enslaving them with addiction and the justice system while sitting back knowing they absolutely could DO better and purposely refusing to do so. The Government profits too much from allowing these poisons into our country. Don’t think for a second anyone but you cares about your well being. This is all specifically designed to disable citizens. Not to help. Plain proof is the fact that opioid victims settlements aren’t going to any victims. It’s going to line the pockets of the people in the positions of power as they spew false promises of action. Until we all see the reality, stand up and make it about us. Make these systems actually help us. Nothing will change. We will continue to be at the mercy and victimized by our own government. People will continue to die. We will continue to be incarcerated and killed. That’s the reality of it! Tell me I’m wrong!

  3. Curtis Cuvelier says:

    I need help with the clinic I’ve been going to. I have medicaid and they are charging them and me as well. They are getting paid twice for crappy service.

  4. tammy Worsley says:

    I was forced on methadone when I became pregnant w my second child, she lived n was healthy, but suffers ADHD, depression, constant sneezing, restless legs, night terrors. My 3rd child wasn’t so lucky, she died 2 days before her 5 month bday, I found her cold n stiff, doctor said she was healthy said there wasn’t a spot on her said the cause of death was natural she was released from the hospital 3 weeks after I gave birth from her she had to come off the methadone with morphine she always trembled but never cried she was an angel her death was uncalled for my whole life was turned upside down when she died my husband cheated on me and left me with my two children I had to start tricking to get by to support them soon DSS came and took them I’m on the verge of killing myself if I cannot get Justice for Kayla Denise kiger she didn’t deserve to die

  5. Tommy and Mary Jo Perry says:

    I’ve been in mmt for I don’t even know how many years.only time out was the time spent in prison for trafficking. My wife 20 years in same clinic.This clinic here in Albany Ga. Just kicked me and my wife out cause we weren’t able to pay inflated fees that we didn’t owe because of employee embezzlement. Proven fact. Then again in December of last year we recieved a letter stating all accounts had been hacked so they had to shutdown the system so they had no proof of payment.Then we finally weren’t able to pay after all these years.So when we got behind they put us on financial tapering ,ha ,which almost killed us,I don’t see how dropping us 30 mg in one week is considered tapering. After being in M.M.T. My wife 20 years me about that long. It’s literally destroyed us.. Need an attorney.After reading federal guidelines for M.M.T.. This clinic has violated them all and before I die, ld really like to see that they are held accountable . Help!

  6. jeremy reisner says:

    i need a attorney for medical malpractice against a methadone clinic. in the end i ended up crashing my car and completely totaling it and almost dying….

  7. Greg Demeter says:

    All I Need is a Certificate of Merit to sue my Expired doctor…Then I can Sue myself…I’m in Pa. and it seems out of County is the Only way…So…Please help ,me..

  8. 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

  9. David Sanchez says:

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

  10. isaias ramos says:

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

  11. Gale Z. Cardwell says:

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

  12. 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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