I'm going to try to answer your questions to the best of my ability. My responses are in italics.
*How do you get a hospital "medwash"? I've heard this a few times now.
I would think you would need the psychiatrist you're working with to recommend the medication wash and then recommend that your son be inpatient to do the medication wash. Some kids do not need to be inpatient to have a medication wash if it's done carefully and systematically and under the guidance of a competent child psychiatrist. Some kids need to be inpatient because the medication wash must be done quickly because of adverse reactions, and the medication wash will destabilize them further.
*Does/will medicaid pay for it?
You will need to call Medicaid. Does your son have a caseworker?
*Since medicaid wouldn't even pay for the inpatient evaluations, how could I get them to pay for an inpatient medwash?
Again, that's a question for Medicaid.
*Since the psychiatric hospital told me difficult child can't "keep" going there (over the state line), could I get it done at hospitals in my community that don't have pediatric psychiatric units?
It is safer to have a psychiatric medication wash done in a pediatric psychiatric unit. I'm not sure there is another unit that is safe for your difficult child to undergo a medication wash.
*Would I need approval/referral from the psychiatrist? If so and if I can't get it from the psychiatrist, who could I go to?
Can you start working with a new psychiatrist if you don't like the current psychiatrist?
*How long would difficult child need to stay in the hospital to get all the drugs out of his system safely?
It depends on the medications, the doses and his reactions once he's off the medications.
*How safe is it? What kind of reactions/effects would I need to expect?
Again, it depends on the medications, doses and the child, but here are some common reactions:
Clonidine - spike in high blood pressure if not weaned slowly
Prozac - increased aggression, anxiety, mood instability, mania, depression could occur but then could resolve over time OR he could need other medications because symptoms persist
Abilify - same as above
*How does the medwash compare to weaning off the medications at home in terms of safety?
We've always done it slowly at home under the guidance of a child psychiatrist. I know medication washes inpatient are done more quickly.
****difficult child is still on: abilify, prozac and clonidine****