Need Your Input and Advise

Question

I am a current in home health care provider for a 60 year old male with advanced stage 4 small cell cancer with a limited amount of time with us.
My clients wife age 57 has been using his morphine as well as street purchased morphine for sometime, well over 1 year, once I figured out where it's all been going I was amazed to find out that she is snorting them for full effect instead of time release and is up 200mg+ per day.
Please do not think ill of her, the pressure she is under is overwhelming and even though there are no excuses, she has come forward and admitts the problem and is reaching out to me for assistance in breaking the addiction.
They have no medical insurance, no funds or money or assists to speak of, the cost of chemo has left them almost homeless and broke for the most part.
I am asking for your advise and value adding direction to help me, help her.
I have called drug addiction agencys and ever single one of them wants a small fortune and the first and second born child.
What is the best and of course a safe method of breaking this addiction, please keep in mind her age and the stress level of watching her husband of 30+ years is dying before her eyes.
Thanx friends.

careprovider12 · Answer

Thank you for your input on this, I was left with little choice and had to pass this problem to the case manager and yes it openned a bunch of problems but at the same time openned the doors to assistance for her, the unfortunate part is she been addicted to pain meds for well over 27+ years and the stress on her husband is really hard at this time.
Yikes talk about stuck in a hard spot and feel like Im in a meat grinder.
But I have big shoulders and will all get over it.....
Right.

tomskat · Answer

Hi there...I too am in the medical field and see diversion often. Diversion amongst caregivers that are family members are unfortunately very common. I too agree with the others-you must protect yourself. If,God forbid,she did in fact OD and you knew of her abuse you could be in serious trouble. Do not ruin your career over this. Please notify the appropriate people. There is help out there for those who are in financial distress.Being a caregiver takes an incredible toll on people physically and emotionally. This woman needs help during this difficult time. When her husband passes she will continue to use,getting it from the street. You will be doing a great service by attempting to help her. Please do the right thing both for yourself and this couple. Here if you need us. take care and keep us posted.

Bkitty · Answer

Just a side note,,,I am amazed at the amount of family members that divert medications these days. I had a patient on MS contin and her grandson diverted her pills and OD'd on them and died. You never really think about what that person is doing with the medications. All you think about is they are missing. If something happened to her you could be help liable. Protect yourself too.

Bkitty · Answer

I agree with the above post,,diversion of controlled substances is a felony even if its by a family member,,you need to protect yourself and your liscense. Id start with notifying the attending of the issues in the home. Is she diverting his medications? That is not good as she is only going to cause him more pain and suffering cuz if he runs out of his meds the pharmacy may not refill them too soon and he will have to wait x amount of days-go without. Is it possible to place a lock box in the home? In regards to his spouse,,can you get social services involved from your company? Its going to protect you the more team members involved. I would hate that you get accused of diverting the pills. Can she call her primary and explain her problem,,there are meds to help ease withdrawal symptoms but continuing to have narcotics available in the home is only going to tempt her more and she is gonna have a hard time staying clean. She could easily relapse with the pills around. I am dealing with a similiar issue as well,,my patients spouse is diverting his meds,,we had to get state involved and file a police report. It *****. I wish you and her the best. Hope that this gets resolved and she can get clean.~Bkitty

justsaynotodrugs · Answer

I also have a degree in social services and would advise you to report this to your supervisor this could get you in trouble with the agency. They can help you with this decision. This matter should be confidential right now.

caregiver222 · Answer

Well - upon his passing she is going to have to go cold turkey, so the sooner she gets into a professional program the better. I can't recommend any one program, but in view of the high dose of opiates I recommend one affiliated with a teaching hospital. As a home health care provider you are in  a difficult legal position if she overdoses, or tells someone you knew about her taking narcotics from your client and did nothing about it. The answer is to get her into a program, as soon as possible. There are many good programs around for those without funds.