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Discussion

question about nurses on methadone

I work in a facility where we have a lot of patients who are addicts, recovering addicts, etc.

Sometimes we have nurses, former nurses, etc. as patients.

The question came up the other day.....if a patient comes into your facility and their medication list shows that they are on methadone, and that patient is also currently a working registered nurse....is that something you are supposed to report, or would it be a HIPAA violation to do so?

My personal opinion is that you could not report them. However, I empathize with people who have issues with addiction a lot more than I've found that some of my fellow nurses do. I can see some of my co-workers having an issue with this and trying to report it. I believe it would be a HIPAA violation to report a nurse for being on a prescribed medication when the only reason their use was disclosed is because you had access to their record which is entirely different than reporting a co-worker who you suspect is impaired.

What do you think?

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I don't understand - what is there to report? A prescribed medication being used appropriately?

Apparently there's an assumption inherent in your question that methadone is only ever used for addiction purposes. That is incorrect.

So no, there is nothing to report.

The patient is prescribed methadone...nothing to report. And yes, I believe it would be a HIPAA violation to report it.

I seem to recall giving methadone to an elderly patient that had chronic pain issues and other pain meds weren't helping.

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I'm on the "don't report" train. Even if it is used for addiction (which would be impossible to tell from a pharmacy record), I still don't think it could be reported if the nurse is a patient.

No, you can't report it. However I'm with you in the sense that the nurse should be self reporting, and definitely not working while taking methadone. I wouldn't never even clear a patient to drive while taking methadone, much less work in an career like Nursing. If you want to work while taking methadone, be a greeter at wal-mart (and take the bus).

So your co-workers want to call a State agency and give out details of their patient's medical records? Maybe, and here I say maybe, if your co-workers knew of their patient's actual actions that were unsafe, maybe then they would have a justification but even then I would be super-cautious about violating their HIPAA privacy rights. Instead it seems your co-workers want to call and report details of patient's medical records when the patients are being compliant with a prescribed treatment.

Should the nurses be working on methadone? Nurses working while on opiates has been a hotly debated topic on this board. I don't believe the answer is clear-cut but I do believe these nurses have HIPAA privacy rights.

My hospital has strict policies against any of us even working with PO benadryl on board.

The patient is prescribed methadone...nothing to report. And yes, I believe it would be a HIPAA violation to report it.

I seem to recall giving methadone to an elderly patient that had chronic pain issues and other pain meds weren't helping.

When I worked for home hospice, our medical director used methadone as a drug of choice for chronic pain and when you asked him why, he would tell you. He had a very convincing argument.

Unfortunately I very much disagree with your thought on this. Obviously you don't know very much abou methadone and the way it works because if taken correctly with a prescription from a licensed clinic or physician it does not affect a persons driving ability nor their ability to work. In fact, I think if you were ask the majority of people find that being on methadone has allowed them to be successful at their job and fulfilling education goals and completely getting a productive life back. I encourage you to do further research on this topic because there are so many people who have a skewed few on the benefits of methadone maintainence treatment programs. Not only that but a person CAN be a great nurse while being on methadone!

My comment was in regards to Bluedevils post. I found what he said to be very offensive. Just wanted to clarify

If they should call in regards to these nurses taking Methadone, I hope the Board fines them with a HIPAA violation.

If I had proof that a nurse gave someone's employer info about prescribed meds that person was on, I would be very tempted to report the nurse for a HIPAA violation. That's just wrong.

So this got me thinking about something I read on here a few months ago that I was not aware of. I don't think it would fall under this scenario though so I think this would fall under a HIPAA violation.

But I read on here somewhere (and they provided the linkthat showed the law and specifics on it), but it stated that if a health care professional were to come into the ER for example, for a drug overdose, acute mental health episode and various other things; that if people in the ER knew the person was a health care professional they were obligated to report the person to the appropriate board. Even talked about a degenerative disease. That it trumped HIPAA. I was not aware of this.

So lesson learned, if you're gonna have a mental breakdown drive an hour if you need to so you aren't going where anyone knows you're a nurse or doctor. :|

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