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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14889
Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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Does the DEA have laws against increasing methadone to heroin

Customer Question

Does the DEA have laws against increasing methadone to heroin addicts :(ie 10mg to 30mg in a 24 hour period).
Submitted: 1 year ago.
Category: Health
Expert:  A. Schuyler, NP replied 1 year ago.

Hello,

Answers provided are for informational use only and do not confer patient-provider relationship. My name is XXXXX XXXXX I will help you.

 

Was your daughter already on methadone? How much and for what?

 

How was the 30 mg dosed over a 24-hour period?

 

How about the 10 mg?

 

Looking forward to hearing from you,

 

Schuyler

 

Customer: replied 1 year ago.

My daughter was not on methadone. She went to the hospital with severe pain in her upper abdomen. Instead of diagnosing the problem the physician just gave her methadone for the pain. In a 24 hr period he increased the dose from 10mg to 30mg. There was no follow-up the day after she was discharged, and Sat. March 29, 2008 was her 23rd birthday. I called her numerous times, as well as her friends, but was unable to reach anyone. I called the police and explained the situation and they went to her apt. and she had passed away. The ME said she had septic pneumonia and the methadone shut her down. I did pursue a wrongful death suit against the physician and we settled through mediation.


I have just discovered that certain individuals (like my self) who are tender hearted and a severe tragedy occurs it can lead to PTSD which has now developed into fibromyalgia, I am in constant pain, and symptoms continue to appear. The last being on Saturday. I went to the computer to order my daddy a birthday present and could not remember how to operate said computer. Sent me in a tailspin. I continue to suffer from severe depression from the fibro symptoms and the loss of my daughter. I see a psychologist, and pay out of pocket for acupuncture 2x a week. That's $320 a month and I am on a fixed income. Retired from disability from my job in VA, and moved to Deland, as my parents are in there 80's and I wanted to be here to help them. Also Walt Disney World had recruited my daughter in the in the ISE dept. with a starting salary of $56k!!!


 


The physician not only "murdered" my daughter, but has left me with a lifetime of unbearable pain at the age of 57.


 


I understand that there are state and federal (DEA) laws that would have prohibited the increase of methadone in such a short time frame if she hayed been a heroin addict and entered a state/gov't funded rehab center. If this is true, I am trying to get a law passed that prevents this from happening to any other families. I would like it to be called Meredith's Law.


 


I understand that the 2 year time frame has passed, but is there any other recourse for me to collect funds from the doctor? Last year I spent over $7,000.00 on prescriptions. New symptoms continue to occur. On Saturday, I was going to order my daddy a birthday present on the computer and could not even remember how to operate the computer. I have short term memory loss, and last week the newest symptom is the feeling that I am being shocked by electrical current over my entire nerves. Also it feels that a hammer is pounding on my joints when I go to bed. I have had 51 hours of sleep since April 11, 2013.


 


Is there anything I can do to collection from the Dr. to offset the massive amount of money that I am having to spend out of pocket?


Being on a fixed income is making it rough on my financial status.


 


Thank you for any idea you may have.


 


Sincerely,


 


Karen Winall

Customer: replied 1 year ago.

Would it be possible for you to call me? I have attempted to respond to my health issues 4 different times. I hit the backspace to correct misspelled words, and my comments disappear. There are so many health issues that have occured since my daughter passed away that the response to your question ha been about a page long. Noq the pain in my right wrist is hurting.3


Would it be possible for you to call me so that I can explain over the phone? I have a 9am appointment with my GI doctor at 9am and seeing the accupuncturist at 3pm. Should be home from 10 am to 3pm.


 


My phone # XXXXX XXXXX That would be easier for me and cause less pain from the carpal tunnel. If not, I will attempt to write all of my physical and mental health issues again.


 


Thank you for your help.


 


Sincerely,


 


Karen Winall


XXXXX

Deland, FL 32724

Expert:  A. Schuyler, NP replied 1 year ago.

Hi, Karen,

 

I'm so sorry, but Just Answer rules are that all interchange between experts and customers occurs only on this forum. We cannot telephone, email, fax, etc. In fact all personal contact information is blocked out for your security, since you don't want that information on the internet.

 

If you can respond here about your methadone concerns, I will get back to you. I am online off and on usually until about 9 p.m.

 

Best regards,

 

Schuyler

 

 

Customer: replied 1 year ago.

She was on Vicodin for pain from having 9 surgeries on her knee. She was not on any other pain meds. Are there state and federal laws protection heroin addicts who enroll in state and federal rehab center that do not allow the physician to increase the methadone in such a large qty in such a short amount of time? There was no follow up call from the hospital that day.


 


My goal, if there are laws protecting heroin addicts in rehab that have state and gov't protection to have a law passed giving this protection to all individuals. He in fact "murdered" my daughter, and such a tragic event gave me PTSD which has led to fibromyalgia. I feel like I am being electrocuted in all of my nerve endings. The pain could easily drive one crazy. Thanks for your time. Karen

Expert:  A. Schuyler, NP replied 1 year ago.

Hello, Karen,

 

Generally methadone is used for treating opiate dependent individuals who want to abstain from opiates. Because it has an unpredictable half-life it isn't a first choice for pain management in anyone since there are so many other choices for managing pain.

 

For opioid dependence it can take huge doses of methadone (over 125 mg/day) to achieve its purpose. For that reason, there is no law saying that 30 mg of methadone is okay and 50 mg is against the law, just as there isn't with any other drug. Patients have to be very carefully monitored, especially when first starting treatment with it for any reason. No one can predict how any particular individual will metabolize it so that what is normal dosing for one person can build up to toxic amounts in the next person.

 

I can't fathom why a provider would choose methadone as a pain reliever, or why the diagnosis of pneumonia was missed. Septic means that the infection had spread through her blood system. This can cause an overwhelming inflammatory response in the body. The infectious agent can also produce toxins that lead to serious changes in the body. The blood pressure lowers to dangerous limits, heart rate and breathing rate increases. Sometimes the combination of responses is referred to as "shock." You may have heard of "septic shock."

 

Blood culture will usually grow in 24 hours and this gives the diagnosis of infection. People are usually admitted to the hospital until the culture comes back, even if they don't have fever.

 

I'm so sorry for the loss of the daughter and the medical problems you are having.

 

 

Best regards,

 

Schuyler

A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14889
Experience: Board Certified NP, MS, RN. Private practice & hospitalist
A. Schuyler, NP and 2 other Health Specialists are ready to help you
Customer: replied 1 year ago.

She started at 10 mg 3x/day and was increased to 30mg 3x day. In doing research, it seem I read that I she was in a state or federal funded rehab center there are laws forbidding increasing the dosage that quickly. If so, I'm working to have a law applicable to all individuals, so we can all be protected from physicians who are not familiar with methadone and the half life. I would like a law passed and have it named Meredith's bill.


You have provided excellent information. Thank you. Karen

Customer: replied 1 year ago.


She was increased from 10mg 3x/day to 30mg 3x/day in 36 hr. In state and federal rehab clinics are there laws preventing increasing that dosage in a period of 36 hour. He nor the hospital never called the day after release to see how she is doing.


 


I'm trying to pass a law protecting everyone from large dosages of methadone (if there are laws for people addicted to opiates that stay in state or federal funded rehab). I believe I read that the dosage could not be increased until a week had passed and the patient had to be under constant supervision by the doc. Thank you for all your info.


Karen

Expert:  A. Schuyler, NP replied 1 year ago.

Hi, Karen,

 

Handcuffing medical providers to a specified dosage of a drug doesn't serve any useful purpose. As I mentioned, it takes more than 125 mg/day for some patients to achieve pain control. As you may know, as a person's body becomes accustomed to other opiate pain killers or to methadone, it takes more and more to achieve the same medical effect. Limiting the amount that can be prescribed puts thousands of patients at daily risk for unbelievable pain just to make sure one physician knows his drugs and practice. There are laws in effect to control bad medical practice. A malpractice suit against the provider involved and the whole medical team would be the way to go.

 

I don't like to think that I have a cancer patient screaming with pain but I can't give them any more medication because Meredith's law says I can't. That would be a scenario duplicated all over the country if such a law existed. Punishing all medical providers (and their patients) because there is one rotten apple in the barrell isn't really going to help anyone. There are clear instructions on methadone that all providers are well aware of (or should be). Based on what you have written, the well-known warnings were ignored, and the provider needs to go before the medical board where his license will no doubt be stripped and taken to court in a malpractice suit.

 

I'm so sorry for the loss of Meredith, but preventing other physicians from practicing medicine to the best of their knowledge and ability isn't going to help future patients, and it won't help Meredith.

 

Sincere condolences,

 

Schuyler

 

 

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