Brand new outpatient methadone clinic

Specialties Addictions

Published

I was recruited to help open a methadone clinic. It's been quite an undertaking, but very rewarding so far. We use the cherry liquid methadone and I have been dosing 4 days using a ivek pump and methodONE software. I am very concerned because each day I have dosed, my methadone is short (1st day 17ml, 2nd 2ml, today 11ml) I've heard it's typically always a little shot due to some that remains in the line, dripping, that sort of thing, but I'm very concerned about this. I have NEVER had a narc shortage my entire career. Does anyone know if this really is typical, and if so, are these typical amounts someone might be short? I use a 1000 ml bottle, and I've only dosed 500ml out of it! Please advise

Specializes in Psych ICU, addictions.

I'm not familiar with administering liquid methadone so I couldn't tell you if it's normal. However, I would be very concerned about this too, as methadone is Schedule II and you don't want to be caught short on any Schedule drug, let alone any Schedule II. The Feds really don't like that.

I will mention this as it's a valid possibility: are you ever leaving your equipment unattended at any time? If you are, it's possible that a patient/staff member is siphoning off small amounts.

It could be a machine fault. Perhaps the machine may need to be recallibrated so the drip rate is correct. Again, I'm not familiar with how the machines work, just throwing out an idea.

I'd talk to your DON/director to see what they say, and do it sooner than later before too much methadone is unaccounted for.

Specializes in Psychiatric Nursing.

Is there any pharmacy involvement- they tend to know how to document narcotic discrepancies. It could be a problem with the machine calibration as noted above.

We use 10000 ml Methadose liquid cherry at our treatment center as well and do not have a shortage daily. In fact we currently have an overage. It was explained to me that each bottle has extra mL to account for priming and tubing loss so over time, the extra accumulates. Do you calibrate daily? I understand your concern about this. I love working here and how rewarding it is helping my patients, but it is nerve wrecking that DEA can come in at any time for inspection. I hope this helps and you find out where the discrepancy is coming from.

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