Hospitals operating as methadone clinics???

[rn undisclosed name]

I am a new nurse and I was curious about methadone. I have never given it and until recently didn't realize it was given in hospitals (except in psych hospitals for withdrawal) but I looked it up in my drug book and see that it does have a time and place in the hospital.

I worked on Sunday and we admitted a pt to the tele floor with a normal EKG and no cardiac problems. He was shaking and had normal VS. A couple hours after he was there he left AMA. He was tired of waiting for the md to come and see him. When he got there he refused to do the admission hx and wear the monitor. His admitting dx was asthma but lungs were clear. My preceptor asked him why he was there and he just said he wanted his methadone. Supposively he takes 250 mg 3x day.

I'm just wondering is it common practice to give a pt his methadone in the hospital. I thought they had to go to the clinic for this. Please share your stories. I would love to hear them.

Kelly

[NHavenRN]

Hi,

I work on a med/surg unit with an infectious disease emphasis in a large urban hospital (which somehow makes our unit the defacto stop for addicted and detoxing pts in this hospital), and I'm constantly giving methadone, as a continuation of a pt's outpt meds. When our patients on methadone need to be admitted, their regimens need to continue once they're in the hospital - in my opinion, just like any other home meds (e.g. BP meds, antidepressants, etc). I've also seen pts who are admitted while still with active IVDA, who make the decision to rehab while in the hospital and are started on methadone as an inpt - and then are often stuck without a spot secured in an outpt clinic to continue. From what I've seen, it can be very therapeutic to be able to start a pt on methadone and counseling while in the hospital, since whatever brought them in may be a good wakeup call/starting point for their wanting to recover from IVDA.

[TheCommuter, BSN, RN]

I work at a nursing home and one of my elderly patients receives a daily dosage of Methadone 40mg po.

Anyhow, most methadone clinics are not open on the weekends. Therefore, patients need to obtain their weekend doses one way or another. In addition, certain petients might not be "hooked up" with outpatient methadone clinics yet, so they'll need to go to the hospital for their methadone needs until clinic spots open up.

[begalli]

Some of our longer term patients will get a schedule of methadone to help with the unavoidable withdrawal if they have been on narcotics for a long period of time.

OP - I hope that guy eventually got his methadone and didn't end up on the street trying to find his fix.

I wish they would come up with a drug other than methadone for users who are trying to overcome their addiction.

Methadone is just as hard to kick - with as many withdrawal side effects - as their original drug of choice. Many have to use methadone for life.