A Brainerd doctor who has been disciplined for his prescribing practices could be added to a lawsuit involving a patient who triggered a fatal car crash in 2012 after injecting a take-home dose of methadone from his clinic.

Dr. John Stroemer's methadone clinic is already a target of the lawsuit, which argues that clinic staff should have known that the patient, Vanessa Brigan, was abusing the drug because of needle marks on her arm and prevented her from driving 100 miles back home to Cloquet.

But a recent disciplinary action and other new information regarding the doctor and his prescribing practices made it appropriate to also sue him, said Philip Sieff, an attorney representing the family of one of the crash victims. "Methadone clinics can be very effective and provide very effective treatment for addiction to opiates if they are operated correctly," Sieff said. "If they are not operated correctly, bad things happen."

The Minnesota Board of Medicine reprimanded Stroemer in January after concluding that he prescribed excessive quantities of controlled substances without assessing the risks to patients and prescribed an alternative opioid addiction drug, Suboxone, to three times as many patients as he was allowed at any one time under a federal permit.

The disciplinary action included a one-year ban from dispensing methadone or other controlled substances at his clinic, Pinnacle Recovery Services, which in the interim is being led clinically by Dr. Michael Reardon, a board-certified plastic surgeon.

Stroemer and his attorney did not return calls and e-mails seeking comment. A St. Louis County judge will rule in the coming weeks whether to add Stroemer to the lawsuit, which is set for trial starting Nov. 2.

The lawsuit underscores a broader unease that many Minnesota communities feel toward clinics specializing in opioid replacement therapy to treat patients addicted to heroin and prescription painkillers.

Both forms of addiction have grown worse in the state, leading to 291 overdose deaths and more than 5,000 related hospitalizations last year.

Because methadone itself is addictive and is sometimes used illicitly by opioid addicts, it must be dispensed at licensed clinics that are supposed to monitor patients closely. The Minnesota Department of Human Services (DHS) has paid about $3.9 million since 2012 to Pinnacle for addiction treatment of 593 state-funded patients.

But the clinics themselves can be controversial; law enforcement authorities in Brainerd have publicly complained about an increase in criminal cases involving methadone addiction since Pinnacle opened. A Duluth clinic is shutting down this fall — but stayed open under appeal for three years — after DHS sought to revoke its license in 2012 for inadequate supervision of methadone patients and lax screening before giving patients take-home doses of the drug.

Licensing problems have contributed to sporadic shortages of opioid replacement therapy in greater Minnesota, leaving the state with a rising bill to transport patients to distant clinics, or leaving patients to drive farther themselves.

Two died in crash

Brigan was sentenced to six years in prison after the crash. Court records say she received methadone at the Pinnacle clinic on Oct. 1, 2012, then injected an oral liquid take-home dose before driving home. Later that same morning, she swerved across Highway 210, striking a Carlton County maintenance vehicle in which Zachary Gamache was the driver and Mitchell Lingren was a passenger. Both died after their truck hurtled into a pickup that had been trailing Brigan's car.

Lingren's parents sued as trustees for their son's wife and two children.

The lawsuit argues that clinic employees should have noticed the needle marks that suggested Brigan was abusing drugs, and should have noted her drowsiness — she awoke at 4 a.m. to go to the clinic — and prevented her from driving home while medicated.

The suit also assigned blame to the pickup truck driver — claiming he shouldn't have been following an erratically driving Brigan so closely. But Sieff said that arm of the case has been settled.