New to methadone nursing

Published

Hello! I just got a job as a methadone nurse. This will be the first time that I have done this kind of nursing. I have been a school nurse and home health nurse for a child. What kinds of things will I need to take note of when I start? I am not even sure where to start. Super happy:) for the change in area of nursing but also on pins and needles:nailbiting: about it. Any heads up would be nice. Thanks

RNNMT

10 Posts

Hello

There isn't much to it! Just be sure to take your time when dispensing medication. Be observant of the patients behavior before and after medicating. It is quite easy to learn this field. It's been 5 months for me so far

DWillaman72

20 Posts

Specializes in Substance Abuse. Has 1 years experience.

Congratulations on your new position. Read up on methadone, read everything you can find, its a nasty one, how long does your clinic offer tapering? Do you also use suboxone? Would love to pick your brain on your new career!

Each1Teach1

30 Posts

Specializes in School Nursing (K-12). Has 4 years experience.

How is it going, Amber? I'm starting next week. School nurse switching to dispensing methadone at a clinic.

Nsg is an art

14 Posts

Methadone has a bad reputation as far as usage. I know that you will work in a clinic for substance abuse, but pain management uses it often for long term pain management ( instead of fentanyl patches) so don't assume.

substance abuse knows no socioeconomic, gender or age barriers. It's a disease and not everyone is a bad person.

Good luck.

Psychcns

3 Articles; 859 Posts

Specializes in Psychiatric Nursing. Has 30 years experience.

Best if patients are in counseling as well as receiving methadone maintenance. Also patients should be monitored for abusing other drugs. Goal of methadone maintence treAtment for substance abuse is harm reduction not abstinence. Methadone is a scheduled drug and there is a fair amount of record keeping to make sure none of the methadone is being diverted.

Jules A, MSN

8,863 Posts

Specializes in Family Nurse Practitioner.

I'm not a fan of it for substance abuse especially in young people, for oncology pain management absolutely, but the whole harm reduction model is one that I feel is flawed. To justify putting young people on a medication that they will likely never be able to come off in an effort to prevent them from using illicit drugs so they are not involved in criminal activity sounds way too much like we are throwing them away and I find that offensive. That we so readily accept that addicts aren't worth attempting recovery makes me sad. Then again our society wants everything easy and fast now so I guess not surprising.

Psychcns

3 Articles; 859 Posts

Specializes in Psychiatric Nursing. Has 30 years experience.

I worked in methadone maintenance as an RN a long time ago and there were always debates about the model. Clients found it stabilizes their addiction and their lives. Counseling was mandatory. Clients organized their lives around their dosing schedules with some driving many miles to be dosed between 6am and 9am when the clinic was open. A lot of axis 2 patients. Methadone seemed to have a psychological function as well as limitating craving for opiates. I learned a lot there.

Jules A, MSN

8,863 Posts

Specializes in Family Nurse Practitioner.
I worked in methadone maintenance as an RN a long time ago and there were always debates about the model. Clients found it stabilizes their addiction and their lives. Counseling was mandatory. Clients organized their lives around their dosing schedules with some driving many miles to be dosed between 6am and 9am when the clinic was open. A lot of axis 2 patients. Methadone seemed to have a psychological function as well as limitating craving for opiates. I learned a lot there.

I haven't seen too many on long term methadone maintenance who have what I would call a truly functional life. I also don't think there are many with a substance abuse diagnosis who don't also meet criteria for an Axis II diagnosis too. :(

Psychcns

3 Articles; 859 Posts

Specializes in Psychiatric Nursing. Has 30 years experience.

I worked in methadone in the 80's. Mental health and addictions were different than now. More services though this was when psychodynamic theory ruled. Client had mandatory individual and group therapy once week. Excellent supervision; a committed staff. Part of a teaching hospital with all the heavy intellect involved in training residents. Many clients on this program had jobs and had families despite their psychological impairments. Clients need for the methadone always seemed to me to be more than physical.

annabanana2

196 Posts

Has 2 years experience.
I'm not a fan of it for substance abuse especially in young people, for oncology pain management absolutely, but the whole harm reduction model is one that I feel is flawed. To justify putting young people on a medication that they will likely never be able to come off in an effort to prevent them from using illicit drugs so they are not involved in criminal activity sounds way too much like we are throwing them away and I find that offensive. That we so readily accept that addicts aren't worth attempting recovery makes me sad. Then again our society wants everything easy and fast now so I guess not surprising.

I work with approximately a zillion clients who are on methadone. I find it hard to believe you would rather a 30-year-old guy with a raging heroin addiction buy his drugs, six or seven times a day, from the street and as a result, live with homelessness, poverty, constant risk of overdose, violence and disease, than get his methadone once a day and be able to resolve those problems. To me it's such a no-brainer.

If he wants recovery then great! Let's do that! Let's do that all the way! More often than not, though, these young guys are not at all interested in recovery or detox and methadone is a great way to get them started in engaging with health care. It allows him the financial freedom to maybe find a place to live. It allows him to get connected with a physician that is caring for him where he is at. It allows him to (in many cases) get connected with counselling if he wants. Our guys see a pharmacist every day for their methadone, which means a health care professional is laying eyes on him every single day! That's amazing. And often, in a few years, maybe once he's in stable, supported housing and has good relationships with his health care providers and has a good handle on his life, maybe then he'll want recovery. But the sad fact of life is that dead people can't recover, and by refusing to prescribe methadone, we would be ensuring he would continue to use heroin, and be at very high risk for premature death one way or another.

Psychcns

3 Articles; 859 Posts

Specializes in Psychiatric Nursing. Has 30 years experience.

@annananana2. Why are your clients seeing a pharmacist every day and not a nurse??