Category Archives: Methadone Cost

Zubsolv For Treating Opioid Dependence

Posted on August 4, 2013 | Comments Off on Zubsolv For Treating Opioid Dependence

zubsolve-methadoneDr. Jana Burson made a recent post about the newly FDA-approved medication for treating opioid dependence called Zubsolv. Zubsolv is manufactured by a Swedish pharmaceutical company, Orexo.

Zubsolv is a new sublingual (tablet dissolved under the tongue) formulation of buprenorphine and naloxone that is taken once daily to eliminate opioid withdrawal symptoms. As an alternative to suboxone or methadone, Zubsolv was approved in July 2013 as a medication which may be prescribed by physicians for the maintenance treatment of dependency on opioids.

The medication is meant to be taken in conjunction with counseling so as to help the patient learn the necessary skills for avoiding opioid relapse. The sublingual tablet is designed to dissolve in about 5 minutes when held under the tongue.

New products such as Zubsolv bring additional choices to those suffering with opioid addiction. As new products enter the market, there is an improved chance that once costly opioid replacement medications may come down in price and become more readily available to individuals who could not afford them.

The primary ingredients in Zubsolv are buprenorphine and naloxone so it is similar to a Suboxone formulation although promoted by the manufacturer as having a better taste, being a smaller tablet, and dissolving more quickly. Note that suboxone is now offered in a thin film formulation that also dissolves more rapidly than the original suboxone tablets.

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Posted in Buprenorphine, Medication Assisted Treatment, Methadone, Methadone Blog, Methadone Cost, Methadone Treatment, Naloxone, Opiate Addiction, Opiate Treatment, Opiate Withdrawal, Recovery, Suboxone Physicians, Zubsolv

Time Limits on Methadone Programs

Posted on February 9, 2013 | Comments Off on Time Limits on Methadone Programs

methadone-servicesThere is growing interest from a number of entities in regard to America’s opioid addiction problem, methadone treatment, suboxone treatment, and the always important funding considerations that accompany these subjects.

This interest is coming from hospitals & the larger medical establishment across the country, your local community, the Federal government’s Medicaid services division, your State’s Division of Health and Human Services who allocate state dollars for opioid treatment, private insurance companies, employers, and the list goes on and on.

The nationwide costs and consequences of addiction are enormous. The cost of treating addiction is also very large. However, research has proven repeatedly that addiction treatment produces undeniable cost benefits. In other words, treating addiction saves money in the long run by helping addicted individuals arrest their disease and become functional again. For many of the entities listed above, it’s all about the dollars. And more specifically, saving dollars when it comes to treating addiction.

The U.S. economy has been hit hard and we have a growing number of people depending on entitlements and public assistance. This, of course, creates a scenario in which more and more people are relying on a “government pie” whose slices keep getting cut smaller and smaller. The recent reductions in funding for public addiction programs have caused some agencies to close their doors … while other agencies simply had to cut back on the services they are able to offer their addicted clients.

An important consideration, which may become a hot topic soon, is how much counseling a methadone or suboxone patient can receive. Or, how long he or she can remain on their opioid replacement medication before public assistance funding begins to stop. Medicaid and State dollars presently help to fund the treatment for many opioid addicted clients in programs. There are currently more people in need of opioid treatment than there are funds available to pay for that treatment. So inevitably, patients may find themselves needing to help pay for their treatment.

I would not like to see patients be pressured to taper off of methadone before they are ready. Experience has shown us that gradual tapering, initiated & paced by the client, is the most successful means of coming off of methadone or suboxone successfully. Government public assistance is becoming more like private “Managed Care Organizations” with every passing day. As this paradigm continues to evolve, we may possibly see time limits of some sort imposed on methadone & suboxone maintenance clients. Some may view this as reasonable and necessary since such limits and caps are already applied to recipients of other health care services.

If time limits are ever applied to one’s length of time on methadone or suboxone, we will likely see clients increasingly picking up the funding for their opioid treatment. This happens everyday around the country in private, self-pay methadone clinics. In the end, we know that opioid replacement therapy works. It’s been proven! The availability of Medicaid and State funding is a great benefit to many people across the country. How this might change in the years ahead will bear close observation.

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Posted in Addiction Recovery, Drug Rehab Programs, Drug Treatment, Methadone, Methadone Blog, Methadone Clinics, Methadone Cost, Methadone Maintenance, Methadone Programs, Methadone Taper, Methadone Treatment, Opiate Treatment, Recovery, Suboxone, Suboxone Clinics

The Cost of Running a Methadone Program

Posted on February 24, 2012 | Comments Off on The Cost of Running a Methadone Program

studyThe results of a NIDA-funded study prepared by RTI International in Research Triangle Park, NC were just released. The study sought to determine the approximate annual cost, per client, of providing a quality methadone treatment program.

The study was completed in close association with Alcohol and Drug Services who operated three methadone clinics in Greensboro, High Point, and Burlington, North Carolina. Estimating the costs to operate an opioid treatment program is a difficult undertaking with many variables which must be accurately factored into a comprehensive analysis.

Some of the variables include: numerous monthly facility-related fees (lease, utilities, cleaning & maintenance), staff salaries, medication, medical equipment, urinalysis testing & lab fees, office equipment (phones, computers, copiers), educational materials and media devices, marketing & promotion, administrative & accounting costs, accreditation fees, medical records, and many other miscellaneous costs. The client census for any opioid treatment program also factors heavily into the clinic’s financial viability as well as does the clinic’s policy on charging for take home medication and other ancillary services.

The RTI study results were based on a clinic census of 170 clients. The largest single cost was labor since all methadone programs require a number of professionals working together as a team in order to deliver quality services. Labor constituted 86.5% of the costs to operate a methadone clinic.

Based on an average daily census of 170 clients, the study defined the annual per client cost to be $7,458. Divided by 365 days per year, this equates to $20.43 per day, per client, to run a quality methadone treatment program. “Quality” mean that clients are receiving regular individual and group counseling services in addition to case management and referral, and some supplemental medical monitoring, referral, and oversight.

Many methadone programs charge their clients far less than $20.43 per day thus promoting the question as to how a clinic can survive financially on an average $13.00 per day client fee. Delivering services at break even or for-a-profit will require that the clinic either cut costs by operating with minimal underpaid staff, offering minimal counseling services, receiving some supplemental State or Federal funding to offset their costs, collecting additional client fees from those whose treatment is partially funded through State/Federal monies, raising their client census to make up losses by serving a larger volume of methadone clients, or acquiring additional funding through grants, donations, or special community funding such as United Way contributions.

Some of these approaches are more problematic than others. “Quality treatment” is always a direct function of having knowledgeable, well-trained staff who are motivated to work with clients and to advocate for their needs and personal growth.

Ultimately, methadone clinics provide life saving treatment and a valuable opportunity for people to reclaim and restart their lives. However, establishing & running a quality methadone program is not cheap. For the addicted individual, opioid treatment is a much more affordable option than buying illicit drugs off the street and living an exhausting, high risk, unhappy existence.

Fortunately, many methadone programs are partially paid for through Medicaid, private insurance, or State dollars earmarked for substance abuse treatment. Even these publicly funded programs struggle … especially when Federal and State budgets are cut year over year.

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Posted in Drug Rehab Programs, Methadone, Methadone Clinic Jobs, Methadone Cost, Methadone Maintenance, Methadone Programs, Methadone Taper

Methadone and the Importance of Safety

Posted on September 14, 2011 | Comments Off on Methadone and the Importance of Safety

safety1Methadone is so very beneficial when used properly and judiciously (as prescribed). However, in the wrong hands, methadone can lead to tragic consequences. Here is a cautionary tale.

Making the news in Gaston County, North Carolina was the recent death of a young man who was a member of his school’s football team. His name was Harry Cohen, and he was 17 years old.

Harry had played in an extraordinary football game on August 26, just days before his death. He is reported to have rushed for 241 yards and passed for 107 yards. A very impressive performance. He is also reported to have taken some hard hits in the game. His family indicated that he was sore from the highly physical contact.

While visiting with his grandmother later (who had a legitimate methadone prescription for pain management), Harry decided to take some of the medication to ease his physical pain. His mother found him the next morning in bed. He had died from a methadone overdose as a result of not having developed a tolerance to the medication.

This story reinforces how important it is that methadone (and all potentially high risk medications) be carefully safeguarded. The Gaston County article had a number of comments and opinions posted by local community members expressing their sorrow over Harry’s death. Fortunately, no one blamed “methadone”.  Most commenters emphasized the importance of treating prescription meds with caution. This is exactly the right sentiment, and a message that bears repeating over and over.

Often, children & teens assume that a medication must be “safe” if it is prescribed by a doctor and sitting out in plain view. Of course, this is not the case in many instances. It is imperative that adults think twice about securing medications, and also educate themselves on the associated safety concerns that come with various medications.

It saddens all people when something tragic like this hits a family and a community. Hopefully, we can draw from this loss an important lesson … that will help to prevent future losses.

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Posted in Methadone, Methadone Benefits, Methadone Cost, Methadone News, Methadone Safety, Methadone Success, Methadone Treatment, Prescription Monitoring