I'm confused about the use and laws on methadone?

I've been in treatment for chronic pain since 2005 after a 3 level Cervical fusion. I was on morphine extended release and hydromorphone. Of course part of the pain contract is no excuses no replacement of lost or stolen prescriptions. After a family function at the house I discovered someone had jimmied the privacy lock to my room and got my meds out of the night stand. some family huh? Knowing I can't get another prescription I go to the local E.R and ask the doc what can I do? he says the methadone clinic will keep you out of withdrawal. And they sure did. for a hundred bucks a week and you have to go every day. The next month comes around and I go to my doctors get my meds everything is fine. But I notice the methadone is more effective than the extended release morphine plus takes the "High" out of everything the only trouble when it showed in my urine my doc booted me. Now I'm in a pain mang. dept. of a major University hospital and that came up and seems to be a big problem with them. How do I get around that.

Hi Gary and welcome to HW.

Im a bit confused, did you not call the Dr who originally prescribed the morphine,the one with the contract? Generally speaking and by the way have been on methadone for PM for 13 years, if you have a theft and report it even under contract most Drs cannot replace your original script but will cover you with something else. They will do this like once if your a longtime patient and you don't have a habit of asking for early refills, losing meds, etc.

The ER should never have referred you to the clinic, they were almost being smart*** about doing so as the laws are very clear concerning addiction issues and pain management Drs.

The methadone clinic also work under clear regulations concerning folks who are PM and not drug addicts. If you didnt sign paperwork stating you had a drug problem for far more then a month they shouldn't have accepted you.

They both Er and addiction clinic did you a great disservice!

The DEA says any DR may use methadone in the treatment of PM but not every Dr can prescribed methadone in the treatment of drug addiction, they actually have to apply for certification to do so.

They are also clear on how a PM Dr proceeds in treating someone for pain whose known to have addiction issues.

Those are Federal laws, each state also can and does have rules inside those rules.

Some states have laws on their books that say Drs cannot treat patients with methadone who have a history of addiction without obtaing certification since your basically treating addiction.

Many Drs will not treat addicts for PM period, it opens the door for scrutiny from the ever watchful eyes of the governing body's that make these "rule's "

However not to say addicts cant be treated for CP they can and there are actually Drs trained to do just that. Addictologists are Drs who are knowledgeable in the areas of PM and the issues of addiction.

Methadone is a great pain reliever and its long half life allows me the freedom to not be tied to a pill bottle all the time.

Its not given in as high doses for PM as it is for addiction. I dose once a day like clinic patients and that works for me. Others dont.

Everyone knew from the ER to the clinic you would carry this with you and have issues. It will always show up in a prescription monitoring state and many are required to notify hospitals if your a methadone clinic client. All states that have a monitoring system require ERs to automatically run you through the monitoring system before treating you and it shows you were at the clinic.

Many Drs who are new Drs will run new patients to see when and who was filling for them. Its hard to hide from it.

Hope this helps.

Im so sorry Gary. This actually happens often and so many practitioners, staff and counselors look at us as addicts anyway that they encourage this to happen.

Be completely honest with them. Tell them the pain was overwhelmingly ruining your life and you did and sought treatment for pain relief where and when you could. That no one was helping you and you had no idea what you were getting into. The clinic was someone's suggestion and you took it.

Unfortunately VA is a state that joined Ky, GA, TN, and Fl as top ranking in drug abuse numbers leaving Drs in those states leery and afraid to prescribe.

Dont give up, there are Drs out there who will help you. Keep looking and if methadone is what works then that's what I would try to stick with although your aware I hope of how difficult it is to back down off of.

If all else fails and you absolutely can not find a Dr to treat you then personally I would find another clinic. Being treated by them is better then the alternative you mentioned serious or not.

Good luck and please let us know how it turns out.