The opioid epidemic remains a crisis in the U.S and around the world. The number of deaths and hospitalizations associated with opioids, including prescription painkillers, illicit drugs, and analogs, has reached epidemic levels. And as a result, drug overdose is currently the leading cause of accidental deaths in the U.S.
The number of deaths related to accidental opioid overdose largely overshadows every other drug combined. According to the Centers for Disease Control and Prevention (CDC), over 68 percent of drug overdose deaths in 2017 involved an opioid.
Governments and health institutes around the world have initiated various measures to tackle this growing crisis, including campaigns to educate people about the dangers of opioids, encouraging public health departments to provide drug screening and refer people to appropriate treatment, the deployment of medications to combat overdoses, and medication-assisted treatments (MATs) to treat opioid use disorders (OUDs).
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT utilizes medications, counseling, and behavioral therapies to provide a “whole-patient” approach to substance use disorder treatment. The use of medications in treatment is proven to help minimize the risk and severity of withdrawals so that patients can focus more on recovery.
One of the most widely used medications approved by the U.S Food and Drug Administration (FDA) to treat opioid use disorders is methadone.
What Is Methadone?
Methadone, sold under the brand names Dolophine and Methadose, is an opioid analgesic used to relieve chronic pain. It’s also used to treat OUDs as part of a comprehensive opioid addiction treatment program. Methadone functions by acting on the same opioid receptors as heroin and morphine to reduce opioid withdrawal symptoms and block the effects of other opioids. Therefore, methadone helps people in recovery avoid relapses and maintain long-term abstinence.
Methadone is a federally designated schedule II medication that has a high risk for misuse and dependence. Although it doesn’t cause euphoric highs when prescribed as part of an opioid addiction treatment program, it does have certain sedative effects that can turn euphoric when misused. Although such euphoric effects are limited, they are still strong enough to cause certain side effects. And as such, methadone is only dispensed through methadone clinics to limit the risk of misuse and adverse side effects.
What Is a Methadone Clinic?
A methadone clinic is a facility that provides medication-assisted treatment for patients with opioid dependence. They are most accurately called “substance use disorder services” as they also dispense other medications such as Suboxone and naltrexone to help overcome opioid dependence. However, since methadone is the primary medication dispensed, the term has become synonymous with such facilities.
Methadone clinics prescribe patients with medications over a certain time frame to help prevent withdrawal symptoms and reduce opioid cravings. They also provide patients with family, group, and one-on-one counseling sessions to ensure comprehensive treatment and recovery. Counseling helps patients avoid relapses, deal with stress, repair estranged personal relationships and learn healthy coping skills.
There are two main types of methadone clinics available: private and public. Public clinics are generally less expensive but involve a long waiting list due to limited government funding. In contrast, private clinics are quite expensive but provide patients the opportunity to receive treatment within short notice. All methadone clinics must be certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) and registered with the Drug Enforcement Agency (DEA) to provide treatment. And as of 2018, there were around 1,500 methadone clinics across the U.S.
How Do Methadone Clinics Work?
Most methadone clinics don’t require prior authorization. Patients can simply walk into a methadone clinic and request to be treated. The clinic will then perform a series of in-depth assessments and tests to determine the patient’s eligibility for methadone treatment. Once all requirements are met, the clinic will develop an individualized treatment plan based on the patient’s severity of addiction and specific treatment needs. The treatment plan will include the use of methadone and counseling and therapy sessions to ensure successful long-term recovery.
Methadone is mostly administered on-site. Patients are required to visit the clinic every day to receive their daily dosage of the medication. However, some programs may also allow patients to take home a few doses for self-administration once it’s clear that they are responsible enough to take the medication unsupervised. Methadone is dispensed by a practitioner licensed by the state or federal government. Registered nurses, nurse practitioners, and pharmacists may also dispense the medication or other opioid treatment medications under the supervision of a licensed practitioner.
Methadone maintenance treatment is often a long-term commitment. Patients should take their daily dose of the medication religiously and engage in counseling and therapy sessions as scheduled to reap the program’s benefits.
What Requirements Should Methadone Clinics Meet?
To gain the certifications required to dispense medication-assisted treatments, methadone clinics must meet a few federal guidelines and protocols, such as:
- Perform a complete physical examination on all patients under the supervision of a licensed practitioner prior to treatment. They must also provide full documentation of the examination.
- Have adequate policies and procedures in place to cater to the unique needs of pregnant patients. They should be able to provide prenatal care or refer such patients to appropriate services.
- Perform an initial assessment and subsequent periodic assessments on patients to develop and modify treatment plans as needed.
- Provide adequate substance abuse counseling through qualified professionals.
- Staff must conduct a minimum of eight drug tests per patient per year. Short-term detox programs require an initial drug test, while long-term detox programs require an initial drug test and randomized drug tests each month.
The above are some of the basic services provided by all methadone clinics. The best clinics will go above and beyond such requirements to provide their patients with the highest level of care.
Benefits of Methadone Clinics
Some of the main benefits of methadone clinics are their cost, time-effectiveness, and convenience. Unlike residential treatment, methadone clinics require patients to only pay for the medications and services provided and not for accommodations. They also provide patients the flexibility to receive treatment while continuing their routine life with minimal interruptions. As long as patients commit to visiting the clinic every day to receive treatment and counseling, they can successfully participate in methadone maintenance treatment.
Methadone maintenance treatment helps patients apply the skills learned during therapy and counseling sessions in their daily lives rather than at the end of their rehabilitation program. This helps people in recovery and counselors navigate through issues as and when they arise.
Methadone maintenance programs are regarded as the gold standard for opioid addiction treatment. Methadone maintenance treatment has a success rate of 90 percent. Those who employ methadone services do have a better long-term prognosis than those who don’t. Its efficacy over 40 years has led to it being regarded as the most standard of opioid addiction treatment strategies.