Monthly Archives: January 2011

Methadone Diversion Control and Safety

lockboxMethadone 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, it is good practice and helps to insure that all parties involved are taking necessary precautions. Methadone is safe when used properly, but can lead to serious medical emergencies if ingested by a child or non-tolerant user. Ultimately, each client must be responsible. And each clinic must take all available safeguards. The public depends on it, and regulatory authorities demand it.

Methadone Treatment Across America

methadoneclient4A 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 U.S. who were dependent on or abused heroin, and 1,900,000 persons who were dependent on or abused prescription pain medication. With over 2 million Americans "at risk" and suffering with an opioid problem, methadone treatment programs are providing a valuable intervention on both a personal and societal level.

Methadone Clinics and Their Role in Recovery

client6As 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. Addiction is also a behavior & thinking problem that, unless corrected, can leave a client vulnerable to relapse and future failure. Additionally, there are other important considerations that may feed into the recovery process such as housing, employment, and the management of mental health issues.

Methadone clinics, and methadone treatment staff, are equipped to assist clients with the above listed needs. Either through provision of their own in-house services, through collaboration with local partner agencies, or through referral to outside specialists. Methadone clinics are often a client's first experience with comprehensive care.