Methadone not reported on prescription monitoring

[Aether2000]

They are not complying in IN or in FL....

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[lobelsteve]

Cause 101N just makes $hit up

http://www.dailyreportonline.com/id...orial&bu=Daily Report&slreturn=20151128081934

 

[PikminOC]

http://www.chicagotribune.com/news/ct-tomah-va-hospital-nw-20150109-story.html
Veterans: VA hospital nicknamed 'Candy Land' because painkillers given out freely

 

[lobelsteve]

http://www.chicagotribune.com/news/ct-tomah-va-hospital-nw-20150109-story.html
Veterans: VA hospital nicknamed 'Candy Land' because painkillers given out freely

Responding to years of complaints about Houlihan, the VA's inspector general filed a report in March that found the psychiatrist had, on average, prescribed the equivalent of 25,000 milligrams of morphine to each of the 128 patients he saw in 2012. Investigators said that level was "at considerable variance compared with most opioid prescribers" and "raised potentially serious concerns" that should be brought to the attention of the federal agency's leadership.

One man is the problem here. Jail is too kind a place for this bozo Psychiatrist.

 

[Aether2000]

That is 68mg morphine a day.....or 3 tabs of 15mg roxicodone

 

[lobelsteve]

That is 68mg morphine a day.....or 3 tabs of 15mg roxicodone

Oh. I thought they were talking 25000 ms eq per day. This is a year. Oops. Still a drug dealer with years of complaints.

 

[hyperalgesia]

I just confirmed that my VA pharmacy monitors AND REPORTS to the PDMP.

 

[Ducttape]

That is 68mg morphine a day.....or 3 tabs of 15mg roxicodone

or 9 percocet 5/325 a day.

i think the greater issue is that, according to the article, every patient he saw got pretty much the same prescription....

 

[melancholy]

The information from methadone clinics is considered psychiatric treatment and is therefore protected under federal law CFR 42. with the advent of the prescription monitoring programs in conjunction with the massive opioid overdoses, the law needs to be changed however Congress has so far refused. It is no different than the Veterans Administration Hospital is refusing to input their data in the prescription monitoring programs.

Not true. When I prescribe a benzo it shows up on the prescription monitoring site. What you are referring to is a different thing.

The inability to monitor controlled medication prescriptions in VA system is annoying and it takes some work to verify if one of my patients is getting any meds from there although it doesnt come up too often.

I did not know the exact details about CFR 42, however since it pertains to chemical dependency issues (substance or prescription drug abuse, alcohol abuse, etc., see http://www.asam.org/magazine/read/a...-by-confidentiality-a-primer-on-42-cfr-part-2 ) - that would pertain to methadone maintenance prescriptions, but not to benzodiazepines which are psychiatric and would be disclosed in PDMP. Chemical dependency > psychiatric > general medical info in regards to confidentiality. Unfortunately, sometimes this gets in the way of good healthcare if a patient declines to sign release of information to discuss care with a chemical dependency specialist although from a HIPAA standpoint for two active treating providers when reasonable concern for patient or general public safety is involved, I think there may be a loophole for disclosing only what is necessary, esp if someone referred to said specialist.

if patient is serious about getting better, have him sign release of information so you can communicate with whomever sent him to methadone clinic or if there is an addiction specialist helping the patient. however would stay away from the stimulants to cover up the effects of the methadone. methadone clinic may need to adjust dose downwards although i don't know the ins and outs of these clinics and details on how maintenance works.

 

[Gina Maria]

New patient on liquid methadone from a clinic that dispenses it. This doesn't show up on the prescription monitoring site. Is this common? At least he told me he was on it.

He is asking for Adderall. Why on earth would he want to create another pill problem for himself? He is on methadone due to problems with opioids in the past (increased doses, tolerance, etc).

Ok I worked in a Methadone Clinic for 2 years as a dispensing nurse and the clinics do not legally have to report paitents methadone history but.. the clinic did check weekly at the paitents prescription history on multiple states and if any narcotic is prescribed and not reported to the clinic the paitent will get the boot and the dr prescribing narcotics will be notified. So it's the methadone clinics responsibility to monitor the paitent closely.

 

[Aether2000]

Ah, but at the tune of $16-25 per day per patient ($480-$750 per month) with 100 patients per day, there is a significant incentive for either selective evaluation or selective enforcement.

 

[PikminOC]

Ok I worked in a Methadone Clinic for 2 years as a dispensing nurse and the clinics do not legally have to report paitents methadone history but.. the clinic did check weekly at the paitents prescription history on multiple states and if any narcotic is prescribed and not reported to the clinic the paitent will get the boot and the dr prescribing narcotics will be notified. So it's the methadone clinics responsibility to monitor the paitent closely.

And meanwhile patient overdoses on opioids a doctor gave who had no idea the pt was on methadone

 

[melancholy]

Ok I worked in a Methadone Clinic for 2 years as a dispensing nurse and the clinics do not legally have to report paitents methadone history but.. the clinic did check weekly at the paitents prescription history on multiple states and if any narcotic is prescribed and not reported to the clinic the paitent will get the boot and the dr prescribing narcotics will be notified. So it's the methadone clinics responsibility to monitor the paitent closely.

If we are talking about confidentiality being the reason they don't have to report, are all these other pharmacies that dispense suboxone reporting bc they have to report everything else? I suppose this means methadone clinics that offer suboxone on a sliding scale don't have to report that either.


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