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Prescription Opiods Case

Greetings, all!  I'm hoping for any insight or wisdom you might have to share in this situation.  Part of our program is 1:1 tutoring at libraries around the county.  In one group, the learner was having trouble focusing and when the tutor asked, "Why?" it led to a discussion of his pain meds.  He disclosed to his tutor last week that he is on a steady dose of morphine pills and explained the specific does to his tutor.  I checked with a doctor friend of mine, and he said that dose would be high even for a dying cancer patient.  Both for my learner's health and to improve his learning in tutoring, I'd like to have a conversation with the learner.  I'd appreciate any thoughts, ideas or resources.

In training I encourage tutors to ask the learners permission before sharing any sensitive information with staff.  Since the tutor didn't do that in this case, the first thing I'll do is ask the tutor to revisit the conversation with the learner and ask permission to seek support from staff. 


Morgan Winston's picture

We have a strict no drug policy for our program, as I'm sure everyone does.  However, it would be a great disservice in my opinion to turn someone away who is seeking education.  It is possible that the student could have mistakenly disclosed the wrong dosage, however, if drugs are being abused the problem should be addressed somehow before it becomes a danger to the student himself or to his tutor.

I've never had to have this conversation, but we generally tell our tutors that if a student has an issue unrelated to their tutoring (home life, finances, drug problems, etc) that we should refer them to someone who can help rather than getting involved.  Tutors and students develop personal relationships.  If they've been meeting a while, he or she may be able to approach the subject as a friend and refer him to a health center, pastor, or community organization that offers drug treatment.

Kathy_Tracey's picture
One hundred

Hi Josh, 

You are in a difficult situation. Trust is the foundation of a tutor (or teacher) / learner relationship and the student may feel like his confidence has been broken. And, you have a potential tutor who is working with a learner who is under the influence. This could potentially harm the tutoring program. Wow - such a complex issue. Yet the opied epidemic is touching every part of our world - and I am sure you have many learners and even tutors struggling with this issue. 

1. I would suggest having the tutor seek permission to disclose the information and open the door for you to have the conversation. 
2. Prepare the tutor for how to have the conversation, what to say, what not to say, how to establish boundaries, excetera.
3. Also, I encourage you to reach out to your local community health agency and see if they had any fliers or resources about opiod use and services available. Since this tutoring is happening at the library, the resources could also be placed in a location for easy access for the tutor / student. (The tutor can even have a copy of the flier with resources or references to share with the learner.)

After the tutor has the next meeting with the student, I would strongly encourage an immediate debrief of next steps and discuss concerns with the tutor. 

I'd love to hear your thoughts. 

Jessie Stadd's picture
One hundred

I came across this new federal guide that consolidates all available federal resources for rural communities dealing with substance abuse/opiod abuse:

Hope it is helpful!