Methadone Question

[Meerkat]

It's a little complicated but I'll try not to be too long winded.

Basically, I'm displaced from the hurricane, but really double-displaced because I fled an abusive husband just before Katrina. Anyhow, he was abusing Rx drugs (fentayl, percosett, lortab, etc). I saw him for about a week throwing up, sweating, shaking, losing control of bowels...I figured it was withdrawals, and he admitted to me that he was withdrawing. Ran out of meds.

He went to his pain management doc (who he is 'buddies with') the next day who put him on methadone. That was in early June. Then he had surgery to cut the nerves to his pancreas (ganglionotomy) so he would not need pain meds.

He is still on methadone, lunesta and klonopin. I believe he has replaced one addiction for another. My concern is the custody battle. I have found him in the past, passed out on top of my 4 month old baby with a loaded gun.

Here is the question:

he has a letter from his buddy-doc saying that he is on methadone for pain managment, not addiction. HOWEVER, wouldn't the doc HAVE to write that? Because it would be illegal for the doc to administer methadone for addiction

unless it came from a methadone CLINIC? So if the doc wrote that he was treating addiction with methadone not coming from a methadone clinic, the doctor would be in trouble right? So the letter is probably not valid I think.

Any ideas?

[SmilingBluEyes]

Wow I am so sorry for your horribly bad fortune. However, this is a HUGE question not best handled by a board of nurses. This is a Board of Medicine issue, really. And despite your very clear depiction of the situation, there still could be missing pieces of the puzzle we dont' know or can't address. I feel really inadequate here, trying to help.......

I feel sickened and sad for you in your situation, and for this poor, tortured soul in his. I wish I had more wise or helpful words for you. Really sorry. I just think you will NOT find the answers you seek to this man's medical situation and any wrongdoing on the parts of these others here on these boards. I wish you well, I really do.

[Nurse Ratched, RN]

My suggestion is to focus on your estranged husband's actions when making your custody case, and let the judge figure out for him/herself what's going on. Your report of him falling asleep over the baby with a _gun_ speaks volumes.

Your lawyer may be able to answer your questions about a doctor's scope of practice in prescribing methadone in your state.

Best wishes to you as you recover your life.

[grannynurse FNP student]

Your situation is complex and complicated. You need to retain an attorney that specializes in family practice. He/she is the best person to advise you on the laws of your state. You can find one by contacting your city, county or state bar association and asking for the names of three.

Grannynurse :balloons:

[CharlieRN]

Let's see there is a question about the proper use of methadone. I can address that. It would be ok practice to put a patient on one medication that has benificial effects for two conditions. So a case could be made for putting a patient on methodone for pain and planning that it would also control his urge to use other opioid drugs. This approach has a mixed track record but is by no means bad medicine.

Re your custody fight. Good luck. The falling asleep on top of a child while holding a gun is pretty good evidence but if the child was not injured and the event was not witnessed it may be hard to make much of a case of it. For that you need to be talking to a lawyer.

[Thunderwolf, MSN, RN]

Good input, everyone.