Methadone clinics provide a vital medical service to those with an opioid addiction. However, many people in society have a distorted view of what a methadone clinic represents. Clinics almost always operate smoothly and quietly while blending into the background of the communities in which they are located.

A recent article highlights the irrational fear, and obvious bias, that some uninformed individuals hold toward those in methadone treatment. Habit OPCO Inc. sought to open a clinic in Dunmore, PA but received considerable opposition even though the proposed site for the clinic was located in a commercial zone.

In reference to the proposed clinic, the town of Dunmore instituted an ordinance requiring that a methadone clinic not be constructed within a half mile of a church, school, playground, day care, senior center, charitable institution, liquor store, or any hotel that serves alcohol. These prohibitions show a serious degree of paranoia which ...

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Interest in methadone as an opioid addiction treatment is continuing to grow. Many of the phone calls that clinics receive are based on direct word-of-mouth recommendations from current clients & former clients. I often perform telephone and walk-in triage for clients seeking methadone treatment at one of our local clinics. A majority of these individuals report prior efforts to address their addiction through traditional detox and/or intensive outpatient counseling. Some report multiple rounds of inpatient rehab.

I am often impressed with the readiness of callers to try something new. And it's clear that many feel they are running out of options and wondering if any treatment will ever work for them. In discussing methadone as an option, it is important to inform prospective clients that methadone is a powerful opioid replacement therapy, but that it may take several years before one can realistically attempt to taper off of methadone ...

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Those not familiar with opiate addiction may not readily grasp what it means to go through opiate withdrawal. For the addicted individual, he or she knows all too well how sick and uncomfortable it feels when withdrawal symptoms begin to surface.

Typical symptoms include diarrhea, muscle aches, cramps, fatigue, chills, runny nose, nausea & vomiting, sweating, shakes, sleeplessness, agitation, and depression. The duration of opiate withdrawal symptoms varies from person to person depending on the type of opiates used, amount, length of time, and method of use.

Some individuals may feel symptoms dissipate after just 1 or 2 days (obviously a preferable scenario). Others may feel withdrawal symptoms for weeks after last opioid use. Continued cravings for opiates may extend well beyond the disappearance of physical withdrawal sickness. This is due in part to structural changes which have occurred in the brain in which additional opiate receptors have been created along ...

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In reviewing the abundance of opioid treatment programs across the country, it was interesting to compare larger metropolitan cities with some of America's smaller, more rural towns. Typically, big cities have a higher concentration of methadone clinics and rural areas might have one or two programs.

One standout is the city of Baltimore, Maryland which currently provides 27 methadone clinics. By contrast, Brooklyn has 25. Brooklyn is the largest borough of New York City with a population of approximately 2.5 million people. Boston, obviously a densely populated metro city, has only five opioid treatment programs.

A positive development over the last decade was the emergence of more opioid treatment programs in rural America. Here is an example. Boone is a North Carolina college town of just over 14,000 people. Ten years ago they had no methadone programs. Today, they have two clinics, likely due in large part ...

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Suboxone® (a branded medication of Reckitt Benckiser Pharmaceuticals) is a relatively newer opioid replacement therapy consisting of a combination of buprenorphine and naloxone. Buprenorphine is the generic, active ingredient in Suboxone that provides extended relief from opioid withdrawal symptoms. Naloxone is an opioid antagonist that deters abuse of suboxone by injection.

Methadone and buprenorphine are the only two opioid medications which are FDA-approved for the treatment of opioid addiction. While they achieve the same end, they have significant differences. Buprenorphine can be administered in a physician's office, and is considered safer than methadone. However, buprenorphine is a "partial" opioid and provides little benefit beyond the maximum dose of 24 mg. This is sufficient for many opioid dependent persons and will provide substantial relief.

Methadone, by contrast, is more powerful and does not have the same ceiling effect of buprenorphine. Some clients find that they are more comfortable on methadone ...

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Methadone clinics all have a medication diversion control policy. Methadone is a strong medication, and must be maintained in a secure location at all times. This becomes particularly important when a client earns methadone take home privileges.

With take home medication comes the responsibility of insuring that no one else has access to a client's methadone take home dose(s). This requires that each client provide a locked container of some type in which he or she will store their take home medication.

Each day's methadone dose is packaged & labeled separately. Upon receipt of take home doses from the clinic nurse, a client will collect & place all doses in their respective lock box container. Losing or misplacing take home doses is usually a violation of a clinic's take home agreement and can result in suspension of take home privileges.

While this may seem like a stiff penalty ...

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A 2008 study, funded through SAMHSA, examined the characteristics of 1,056 Opioid Treatment Programs across the United States. At that time, there were 270,881 opioid treatment clients enrolled in an OTP clinic and receiving either methadone or buprenorphine for maintenance therapy.

Of the 270,881 OTP clients, 98.5% were receiving methadone with the remainder receiving buprenorphine. The study also looked at payment methods used for services in the various OTP clinics and found that self-payment, private insurance, and Medicaid were the three most prevalent forms of payment.

Approximately 33% to 53% of Opioid Treatment Clinics had contracts with LME's (Local Management Entities that use state funds to subsidize treatment). Clinics which offered mixed substance abuse & mental health services were more apt to receive LME state funding support for low income clients.

In closing, an updated 2009 SAMHSA study estimated there were 399,000 individuals in the ...

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As individuals enter methadone treatment, there are generally two important considerations. The first is dealing effectively with opiate withdrawal and establishing early relief from withdrawal sickness. The second consideration is embarking upon the more enduring process of holistic addiction recovery.

Methadone clinics function not only to relieve physical symptoms of opiate withdrawal, but to introduce their clients to a program of skill development, lifestyle change, and positive self-direction. Addiction recovery can encompass many things: becoming drug free, restoring health, gaining knowledge, achieving insight, applying new practices & behaviors, developing support, setting new goals, and discovering one's personal potential.

For the opioid addicted individual, methadone treatment offers a rare synergistic advantage built upon the combination of medication-assistance with recovery counseling. It is this combined approach that is so helpful to the methadone client in recovery.

Addiction is a true brain disease with underlying chemical & neurological changes which perpetuate the addicted state ...

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