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.
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
Comments 15
I’ve been taking methadone for 15+ years with clean u/a s the whole time…because of my clean record I get or was getting 27 take homes a month.
last month when I took my dose at the clinic it had no effect, neither did the next 4 in a row…I contacted the clinic and told them from day 1 now they have taken my carries and are blaming me, I’m back to coming in every day! 15 years of clean U/As, !!! in that time I’ve went to college, got custody of my son by being my own lawyer, raised a 18 year old child,
I need some help in how to get my voice heard!
i am curious which methadone clinic you are going to. I recently was going to a clinic where 4 employees were involved in stealing methadone and replacing it with something else. They try to say oh no one can steal it methadone weighs different so we would know by the weight. omg i thought these people are suppose to be professionals and are really this stupid to think it can’t be replaced with something else. Long story short the clinic shit down however they did not fire or even repremand the 2 nurses who were the first thieves. I also been in methadone 20years so I know my stuff as well. I’m just wondering because i know the one girl is working at another methadone clinic . I am sure she still stealing the methadone I mean she did at the 2 previous clinics she worked at so y not the 3rd clinic. It’s bull crap because addicts are suffering Loosing lives their family’s jobs I mean how can shit like this be going on and she can just keep getting jobs because if the clinic fires her for stealing the methadone it’ will cause them a bunch of trouble that they done want. So this is how they keep addicts in suffering who cares what we loose and who cares if people die as long as they’re names aren’t ruined as s medical facility and can continue to operate in other states. I am just at my end as well. i’m dealing with the clinic kicking my son out for going thru a mental breakdown and being disruptive as they put it. there’s more to this story but I just mentioned it to show how these clinics are doing people and there not only a methadone clinic but they’re suppose to be educated in the medical field. So i would think they have common sense and what is kicking someone off who is suffering mentally going to do This is why people commit suicide or end up in prison How is this shit normal.
I need help ASAP!! BEEN ON A CLINIC IN PHILADELPHIA WHO IS ALOWING NURSING STAFF TO MISHANDLE MEDICATION. WHEN WE REPORTED IT , THE SECTION CHIEF FROM THE STATE, CONTINUOUSLY KEPT TELLING ME TB”HANG IN THEE, UNTIL I CAME OUT AND ASKED HER, “Why Can’t I Get a Transfer”, SHE FINALLY , AFTER A YEAR OF THIS SLIPPED AND SAID HER AND HER BOSS DIDN’T THINK IT WAS A HOOD IDEA I TRANSFER!! I HUNG UP ON HER!! I KNOW IM NOT GETTING MY DOSES. I KNOW THE PROCEDURES, IM AN EX FEDERAL EMPLOYEE, SO I KNOW ABOUT REGILATIONS, AND IVE BEEN ON METHADONE FOR 20 YEARS!! THESE NURSES ARE LOCKING CLIENTS OUT ON THE BUILDING WHEN THE MEDICATION IS DELIVERED!! I HAVE NEVER USED OPIODS WHILE ON METHADONE EVER, UNTIL I GOT TO THIS CLINIC , AND HAD NO XHOICE!! THEYRE MAKING SURE I CANT TRANSFER!! I JUST GOT TURNED DOWN AGAIN, AFTER OFFERING TO GO INPATIENT FIRST!! THIS IS CRININAL, AND I NEED HELP PLEASE!! P S IVE CONTACTED THE DEA TOO!! THEY DONT CARE EITHER, WHO IS IN CHARGE HERE!! THE CORRUPTION IS RAMPID!!
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.
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!
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.
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
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!
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….
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..
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
I need a lawyer for all types of violations committed at the methadone clinic I go to.
I’m trying to find a lawyer because of malpractice.
I’m looking for one in Philadelphia, PA. They murdered my son.
I’m trying to find a lawyer in Pittsburgh PA who is dealing with methadone mismanaged treatment. Can someone please help me finding one?