The Dark Side of Opioid Rehabilitation Centers

For many years now, the United States has been facing an opioid crisis stemming from the use of both legal and illegal substances. Opioids are substances that interact with opioid receptors found on nerve cells in the brain.

These can be derived from the opium poppy, or they can be synthetically made. While some opioids such as heroin are illegal, others such as morphine, oxycodone, codeine are available via a prescription obtained from a medical doctor. For medicinal purposes, opioids have been found to be effective painkillers.

Unfortunately, between 21 and 29 percent of patients who are prescribed opioids for pain wind up misusing or abusing them. Opioid abuse occurs when the drug is taken in a way other than how it was prescribed, such as taking a higher dose, using them for a longer time period than is recommended, or taking someone else’s prescription.

While opioids are good at relieving pain, they also produce a feeling of euphoria, which may lead to dependency, addiction, overdose, or death. Other side effects of opioids include constipation, drowsiness, confusion, and slowed breathing.

Doctors have specific guidelines they need to follow when deciding to give opioids to a patient. Even then, inappropriate prescriptions and errors may impact a patient’s risk of addiction. Many people who become addicted to opioids—both the legal and illegal kind—seek treatment, often from rehabilitation centers where negligence is becoming commonplace.

In California, lawyers that specialize in negligence are hard at work to hold these centers accountable for the treatment they deliver.

• Are dependent on opioids, including those who have undergone
  detoxification, incarceration, left a sober living house or ended
  their drug treatment. This is referred to as reduced tolerance.
• Inject opioids.
• Take prescription opioids, especially in higher dosages.
• Pair opioids with other sedating substances.
• Take opioids while having certain medical conditions such
  as HIV, liver or lung disease, and depression.
• Live in a house with someone taking opioids.
• Take opioids for an extended amount of time.
• Have a lower economic status but take opioids.
• Have a history of substance abuse.

• Doctors have a responsibility to properly care for their patients,
  especially when addictive medications are involved. A doctor can
  be liable for a patient’s opioid abuse when they fail to perform in a
  manner consistent with the applicable medical “standard of care”
  or by providing an inappropriate prescription of medications.

Doctors are expected to follow the prescribing guidelines set forth by the CDC. If they fail to do so, they may face serious legal sanctions for inappropriate prescribing of medications, including civil liability via a medical malpractice claim, medical board discipline, or even criminal charges.

Doctors may be held responsible for opioid abuse if they are the ones who have been inappropriately prescribing them. Around 25% of people prescribed opioids become addicted to them as the human body can develop a tolerance to them, making a higher dose necessary for the same effects. While some doctors may become negligent when prescribing opioids, others may be benefiting financially from it.

Although opioids were originally intended
to treat patients undergoing cancer treatment,
palliative care, or end of life care, they are now
also prescribed to relieve chronic pain.

Here is a list of CDC guidelines that
doctors are expected to follow:

There are three principal ways that prescribing opioids or managing patients with opioid-related problems may be considered negligent:

This refers to situations where a hospitalized patient is given an excess of opioids and isn’t closely monitored. It is also malpractice if a patient is given a drug incorrectly, whether it be the wrong dosage or wrong medication entirely.

This happens when a doctor prescribes opioids to a patient who is considered to be high-risk. This can include patients with a history of substance abuse or who has demonstrated drug-seeking behavior. This is also a problem if the doctor prescribes opioids when they are not needed or if they fail to use a safer alternative medication that was available.

Patients may be harmed if a doctor doesn’t carefully monitor them when they’re taking opioids, or once they have been taken off the medication.

Whether abuse begins with a drug prescribed by a doctor, or through other means, thousands of patients seek sobriety and treatment at a rehabilitation center. Unfortunately, many patients do not get the quality of care they need to get clean, and often relapse.

Rehabilitation centers also often create dangerous situations through negligent behavior that can put the patient at risk.

Doctors are not the only ones that can be held responsible for injury or death resulting from opioid or opiate abuse. Rehabilitation centers, who have the duty to help the patient get clean, can sometimes have the opposite effect when they are negligent in the care of their patients, which can result in further injury or death.

Just like any other addiction, people often seek treatment at rehabilitation centers, and a patient’s time there is critical to their health and welfare. For that reason, all rehabilitation center clients or sober living home clients must be appropriately and intermittently be monitored by qualified staff. It is thought that only one in 10 patients actually receive proper care and/or monitoring at such facilities. If a rehabilitation center fails to provide this proper care, and it results in harm to the patient, then it may be classified as negligent behavior. If the patient dies in such a facility, there may be a claim for wrongful death as well.

Negligence can occur in an inpatient or outpatient program; however, the majority of lawsuits that claim negligence occur in an inpatient program while a patient is undergoing detox. This is the period when a patient is most vulnerable, and their body is being cleared of the addictive substance they were abusing. This is when most of the withdrawal symptoms are at their worst, especially in cases of opioid abuse.

Common Causes of Negligence in Rehabilitation Centers

Unfortunately, rehabilitation centers are not always optimized to give the best patient care. One reason is that many of them are for-profit institutions and may not have the patient’s best interest at heart. They often focus on marketing their business to make money, which may contribute to substandard care.

Some facilities have even gone so far as to fly patients in from different states in order to bill their private insurance companies for their treatment.

Rehabilitation centers are also often understaffed, and the staff they do have is often underqualified. Staff at these centers are usually not equipped with the knowledge and background to allow them to provide care in an appropriate way, and therefore, the patient is put at risk. In fact, many owners, operators, and staff members at rehabilitation facilities are recovered drug abusers themselves, which can be a recipe for disaster.

Perhaps the biggest issue regarding
rehabilitation facilities is that they
are poorly regulated in comparison
to hospitals and other medical centers.

This lack of regulations can lead to
fatal mistakes.

While you would think that rehabilitation
facilities would have the same regulations
as hospitals or other medical facilities, they
do not. By definition, rehabilitation facilities
are not the same as medical facilities, and so
they do not fall under the same regulations
and laws.

When someone is injured or dies at a drug treatment center, it could be considered negligence by the facility. This refers to the errors by staff at the rehab center, and these errors are not considered to be medical malpractice, but a different type of lawsuit.

Be sure to contact The Trial Law Offices of Bradley I. Kramer, M.D., Esq if you are unsure if you have a case of negligence or medical malpractice.

When an incident happens, and an individual is harmed by the conduct of a doctor, a medical professional, or a medical facility such as a hospital or pharmacy, there is a cap on damages (or compensation) that can be recovered as a result of those injuries. These claims are defined as “medical malpractice” claims because the care being provided is by a medical professional or a licensed medical facility. Rehabilitation centers, however, are not licensed medical facilities, so they are not bound by these same rules.

In California, medical malpractice cases are governed by the MICRA (Medical Injury Compensation Reform Act) law, which is the legal framework by which victims in California can receive compensation for medical injury by a medical professional or a medical facility. MICRA places a cap on noneconomic damages, such as the pain and suffering a patient may have endured while under the care of a medical professional. This figure does not include expenses that are paid out of pocket, the cost of future medical care to deal with the error committed, or lost earnings.

The reason why rehabilitation centers are not held to the same responsibilities under MICRA is because of how the law defines health care providers and health care facilities.

Under MICRA, a health care provider is defined as “…any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or licensed pursuant to the Osteopathic Initiative Act, or the Chiropractic Initiative Act, or licensed pursuant to Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code; and any clinic, health dispensary, or health facility, licensed pursuant to Division 2 (commencing with Section 1200) of the Health and Safety Code.”

Rehabilitation facilities, which may be residential or non-residential detoxification facilities, residential care facilities, or opiate rehabilitation centers, are not deemed to be licensed under Division 2 of the Health and Safety Code. This means they are not seen as health care providers because they are not a clinic, health dispensary, or health facility.