BIKLaw Medical Malpractice Lawyer > Opioid Rehab Center Guide

The Dark Side of Opioid Rehabilitation Centers

Introduction

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.

21% –
29%
of patients who are
prescribed opioids for
pain wind up misusing
or abusing them.

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.

CHAPTER 1:

Understanding Opioid Abuse

A large portion of opioid addicts begin their addiction with a legal
prescription given to them by their doctor. Although this medication
is provided for them for medical reasons, some patients may become
addicted to pain pills and begin to abuse them.

According to a study conducted by the Center for Disease Control and
Prevention (CDC), between 1999 and 2017, almost 218,000 people died
from overdoses of prescription-related opioids in the United States.

Today, over 130 people die from an opioid overdose on a daily basis.
The Consequences of Opioid Abuse

How an Overdose Can Be Fatal

An overdose of opioids can be fatal because
of the effect opioids have on the section of
the brain that regulates breathing. Opioids,
particularly in high doses, may result in
respiratory depression, which is characterized
by slow and inefficient breathing.

Other times, an overdose may result in
complete respiratory failure, causing the
person to fall into a coma and eventually
stop breathing.

The risk of an overdose fatality rises when
a person experiencing the overdose is alone,
and there is no one to seek medical attention
on their behalf.

Opioid death is preventable with the use of
a drug called naloxone and basic life support
if administered in a timely and appropriate
manner, and can often completely reverse the
effects of an overdose. However, when medical
attention is not provided on time, overdoses can
quickly become fatal.

Risk Factors of Opioid Overdose

Overdosing on opioids is not always fatal, and non-fatal overdoses are much more common than fatal overdoses. In fact, 45 percent of opioid users have experienced a non-fatal overdose during their lifetime, most of which do not result in death. Whether fatal or non-fatal, opioids are still responsible for a vast amount of drug overdoses worldwide.

You are more likely to have an opioid overdose if you:

  • 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.

A Doctor’s Liability for Opioid 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.

Guidelines for Prescribing Opioids to Patients

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:

CDC guidelines recommend:

  • Opioid therapy should only be considered if expected benefits for pain and function outweigh the risks the patient would face.
  • Opioids should not be the first line of treatment.
  • If the physician decides to prescribe opioids, it should be partnered with appropriate non pharmacologic therapy and nonopioid pharmacologic therapy as these are seen as the preferred treatment options.
  • Pain and function goals should be established and measured with the patient.
  • Patients should be aware of the benefits and risks of opioid therapy as well as the benefits, risks, and
    availability of nonopioid therapies. This should be established before starting opioid therapy and continued throughout the treatment.
  • When beginning therapy, patients are to be prescribed immediate-release opioids instead of extended-re lease/long-acting medications.
  • Physicians should always prescribe the lowest effective dosage.
  • When prescribing for acute pain, the lowest effective dosage is still required and should be prescribed no more than needed for the duration of severe pain which should be around three days.
  • Physicians should avoid prescribing opioids and benzodiazepines at the same time.
  • After prescribing opioids, physicians are required to follow up with patients and evaluate the risk of continuing treatment with these medications. If they find the risks outweigh the benefits, they should either reduce, discontinue, or taper the dosage.

Unfortunately, these guidelines are not always followed, and mistakes do happen.

CHAPTER 2:

Negligence in Opioid Rehabilitation Centers

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.

1 in 10
patients actually receive proper care and/or monitoring at such facilities

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.

CHAPTER 3:

California Laws and Rehabilitation Centers

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.

Rehab Centers Do Not Fall Under Medical Malpractice 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.

MICRA vs. Rehabilitation Centers

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.

Fortunately, for victims of rehab facility errors, most rehabilitation centers are NOT licensed under the particular provisions of MICRA. That means that unlike most medical facilities, the financial compensation for victims for pain and suffering or injury or wrongful death is
NOT capped at $250,000.

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.

CHAPTER 4:

What Can You Do About Opioid-Related Claims?

If you or a loved one have been injured as a result of a medical professional, or staff at a rehabilitation center, you may have a negligence or wrongful death claim. You should contact a lawyer immediately.

How to Prove Liability in an Opioid Case

There are several parties that may be liable in an opioid case, including the healthcare provider, which refers to the healthcare workers, the hospital or clinics, and/or the pharmaceutical companies.

As mentioned earlier, rehabilitation centers are not generally governed by the MICRA statute, so plaintiffs are generally NOT limited to compensation under the MICRA law because the facilities and their employees are generally not classified as health care providers. Instead, the staff and facility have a more standard legal obligation to their patients to provide appropriate care, and any death or injury that results from a lack of such care may constitute negligence.

Common Claims Against Rehab Centers

Thousands of people every year seek help at rehabilitation centers, never expecting harm to come to them while they are there. Generally, the person who is seeking treatment has gone through long periods where they have abused drugs, causing them to be in a more fragile state, mentally and physically.

Unfortunately, hundreds of people are either injured or die in rehab centers every year, and while these centers are not hospitals, they do have a level of expected care that you would receive from a hospital.

How to Prove Liability in an Opioid Case

Some of the more frequent claims against rehabilitation facilities include the following:

Increased Infections from Disease

People who have a history of opioid or other drug use are more likely to contract certain diseases, such as Hepatitis B and C, tuberculosis, and HIV/AIDS. If a patient is not properly tested and treated, and then passes the disease to another patient, it could be grounds for a lawsuit.

Assault by Other Patients

Due to drug use and past experience, some patients may become short-tempered, and this could small disputes to lead to patient assault. Often, the staff is not trained to handle and de-escalate these situations properly and this could lead to patient injury.

Assault by Staff

As stated, the staff is often not properly trained to handle specific situations, and this could cause a staff member to overreact while attempting to subdue or control a patient, injuring them in the process.

Sexual Assault

When someone enters a rehabilitation facility, they are generally more vulnerable emotionally and physically than the average person. This leaves them vulnerable to unsavory staff who could take advantage of them.

Self-Destruction

When someone attempts to get clean after a history of drug abuse, it is not uncommon for them to try and harm themselves as they work towards sobriety. Rehabilitation facilities should have the staff that is equipped to handle this, such as doctors, counselors, and psychologists. When a center fails to have these professionals employed, or they fail to recognize self-destructive behavior, it could end in injury or death.

Being Discharged too Early

Discharging a patient before they are ready is not uncommon, even if the stay is court-ordered. This can be dangerous and increase the chances of relapse in the patient.

Symptoms from Withdrawal

Withdrawal symptoms can be dangerous, and some can even lead to death if not properly handled. It is the responsibility of the trained medical staff at rehabilitation facilities to manage patients properly as they detox and go through withdrawal.

Violating Duty of Care

Although treatment centers are not hospitals, they still have an expected level of care to protect and treat their patients, who are often in a fragile state. When a center does not meet this duty of care and are
negligent, it could lead to injury or death.

If you feel like you or a loved one has been a victim to one of the above scenarios, contact a lawyer right away to see if you might have a case.

When You Should Speak to a Lawyer

If you or a loved one were injured in a rehabilitation center while seeking treatment for opioid abuse, you should speak to a lawyer who specializes in rehabilitation center negligence right away to determine whether or not you have a case.

When you speak to a lawyer, you will need to be able to tell them the facility involved, the incident in question, the circumstances of the patient’s time at the facility, and the background information of the patient, including family relationships, lifestyle, and history of drug abuse and treatment.

Hire a Knowledgeable Lawyer for Your Opioid Case

Opioid abuse is becoming more common, and the effects can be deadly. If you or a loved one have suffered from opioid addiction as a result of an inappropriate prescription, or have sought treatment at a rehabilitation center that resulted in injury or death, you may have a case of rehabilitation center negligence.

Contact The Trial Law Offices of Bradley I. Kramer, M.D., Esq to speak to an experienced negligence lawyer in Los Angeles.

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