A methadone clinic is a place where a person who is addicted to
opioid-based drugs, such as heroin or prescription painkillers, can
receive medication-based therapy. Patients receive methadone,
or the brand name version known as Dolophine, which is an opioid
analgesic. This treatment is often referred to as replacement therapy.
According to the Substance Abuse and Mental Health Services
Administration, methadone can be administered as a pill or in liquid and
wafer forms. It is used to block the effects of opiate pain
medications, including morphine, codeine, oxycodone, and other
semi-synthetic opioids. Although the treatment must be prescribed by a
doctor, it is not a cure for addiction issues. It is nonetheless
considered effective during the treatment and rehabilitation process as
part of a comprehensive treatment program.
The two main types of clinics are public and private. All methadone
clinics in the US are strictly regulated by state and federal laws. The
treatment provided at a clinic has several effects. People who have
visited one may see the following benefits.
What does PCP Stand For?
- A reduction or avoidance of opioid withdrawal symptoms
- A decrease in opioid cravings
- Blocking of the effects of illicit opioids
- Ceasing of a physical need for opioid substances, so a person can function normally
Who Is Most Likely to Visit a Methadone Clinic?
There are many methadone clinics throughout the United States. SAMHSA’s
2011 OTP Survey found nearly 245,000 people were admitted into opiate
treatment programs in 2010. More than half of those admitted required
maintenance and detoxification services. About 22 percent were
individuals seeking only maintenance treatment.
Methadone was the primary medication given to those in treatment; the
survey reported nearly 270,000 people receiving methadone in March
2011.
Anyone who is addicted to opiates may visit a methadone clinic under a
doctor’s supervision. More than half who do are male, although a
significant percentage of visits are by female clients as well. Nearly a
third of all people treated were in the same program for two or more
years. The SAMHSA survey also noted many veterans were in treatment
programs, often at facilities managed by the Department of Veterans
Affairs.
SAMHSA’s 2014 National Survey on Drug Use and Health estimated that
435,000 people used heroin, accounting for those aged 12 and up. People
in the 18-25 age range were most likely to abuse heroin, although the
study reflected an increase in use by adults 26 and older.
About 2.9 million adults 26 years and older were using pain relief
drugs for nonmedical use, according to the study. In the 2011 edition of
the study, just over 11 percent of people overall who
abused drugs or alcohol received the medical treatment they needed.
According to US law, methadone can only be given via a
SAMHSA-certified opioid treatment program. These facilities provide a
range of services. Clients can receive help with reducing or eliminating
drug use or preventing it in the first place. An OTP facility can also
address the spread of infectious disease and take preventive measures
against criminal activity in order to improve the wellbeing and quality
of life of people in treatment.
Most Likely Reasons to Visit a Methadone Clinic
Methadone has been legal in the country since 1947. It is known to
suppress drug withdrawal symptoms for a day. Sometimes, it works for up
to 36 hours after administration, according to the National Drug
Intelligence Center’s Methadone Fast Facts.
Alcohol Rehab
There are actually a variety of circumstances in which a person might
visit the clinic. The most obvious is to seek relief from daily
struggles with opiate abuse. People can go to their appointment to
fulfill the requirements of an ongoing drug treatment program. It’s also
possible for someone who falls back on a habit to seek methadone to
manage cravings or withdrawal symptoms.
The first time people visit a methadone clinic,
they usually don’t receive medication. They generally go through a
screening in which they talk about the nature of their problem to a
counselor or nurse.
Patients are asked about their history, potentially given blood
and/or urinalysis tests, and informed about the treatment program, its
goals, and its guidelines. Drug use history, co-occurring disorders, and
the impact of substance abuse on life are assessed via a clinical
evaluation, while a medical evaluation reviews health history, current
health, present medication requirements, and overall condition in regard
to being given methadone.
In addition, people might also visit a clinic to attend counseling
sessions. Counseling can focus on relapse prevention, how to repair and
rebuilt personal or professional relationships, or deal with stress.
Group, family, and one-on-one sessions may be offered. The format can
vary according to each client because some people attain stability more
quickly while others take more time.
Patients are also required to visit a methadone clinic to satisfy
guidelines for receiving doses. Local regulations may dictate whether
participants have to be present on a daily basis. Depending on the
individual and the circumstances, one might be permitted to manage doses
offsite and visit the clinic less frequently.
Family members, partners, and friends have the option of accompanying
a program participant to an appointment at any time. Professionals,
such as physicians, nurses, and counselors, may regularly or
periodically be present at a methadone clinic. Receptionists, treatment
advisors, and others involved in the individual’s case may be there as
well.
How Treatment Is Administered
Methadone
must be administered by a team of trained medical professionals.
Treatment is provided based on the principal addiction. Since each
person reacts to the specific type of drug and treatment differently,
each individual’s care is tailored to their unique problems. This is not
limited to drug use. The program must also focus on the appropriate treatment setting, family and work life, how the person functions in society, and what is needed to be functional and productive.
Other aspects of the treatment protocol include its length of time
and other needs. Methadone clinic treatment does not only focus on drug
abuse. There can be social, medical, job-related, and legal matters that
need to be addressed. People with co-occurring disorders, such as
psychological issues, need to have their addiction and co-occurring
disorders controlled so they can have a healthier, more productive
future.
Following a complete evaluation of the person’s history and health,
treatment can begin. The National Institute on Drug Abuse (NIDA)
outlines the Principles of Drug Addiction Treatment, which provides a
basic idea of how addiction is treated in general. Methadone is the
preferred course of treatment at a clinic, and often part of other
protocols.
Krokodil – Uses, Health Risks, Side Effects, and Legality
Recommended basic treatment options include:
Medication-assisted treatment: Prescription
medications can block how opioids affect the brain and even manage
aspects of brain chemistry that control drug cravings and dependencies.
In addition to methadone, used since the 1960s, other more recently
introduced medications include buprenorphine, which is used to relieve
drug cravings with fewer side effects; naltrexone, a nonaddictive
substance, that blocks the effects of opioids and does not cause
physical dependence; and an injectable form of naltrexone, known as
Vivitrol, that is administered monthly rather than daily like most other
opioid treatment drugs.Flakka – Uses, Health Risks, Side Effects, and Legality
Cognitive Behavioral Therapy (CBT): Drug abuse
often comes with a set of behaviors and expectations on the part of the
user. Counselors can work with clients to change these in the hopes of
getting people on a healthier track. Clients can also work on developing
various coping skills. CBT is common for those with heroin addiction
and in methadone treatment, as the therapy focuses on dealing with substance cravings and general stress factors that lead to drug abuse as a coping mechanism.
Medical detox: Withdrawal is associated with
many acute physical reactions. Some can be severe but treated with
medications to prepare the individual for long-term recovery. With
medical detox, clients are monitored until withdrawal is over, so their
safety and comfort can be prioritized. Opiate withdrawal symptoms generally abate in a week, but may last up to a month.
Emotional symptoms, such anxiety, insomnia, and low energy can last for
a few months, especially for those used to high opiate doses.
Common physical symptoms include runny nose, teary eyes, and hot and
cold sweats. A person withdrawing from opiates may yawn a lot. Other
symptoms include muscle aches and pains, nausea, vomiting, diarrhea, and
abdominal cramps.
Risks of Treatment
Methadone treatment has its risks. While the medication is used to
treat addiction, it can be addictive if not administered properly. Doses
must be adapted for each individual, and periodic adjustments are
typically required. This process is known as induction and must be
closely managed by medical staff. Healthcare providers must always have a
complete health history on hand to ensure the client’s safety.
Common side effects of taking methadone include:
- Feeling lightheaded
- Labored or shallow breathing
- Chest pain
- Rapid heartbeat
- Confusion
- Hallucinations
- Muscle tremors
- Nausea/vomiting
- Diarrhea
- Abdominal cramps
When taking methadone, there can be potential interactions with other
medications. In some cases, these can affect the heart, while the
active ingredients in other medications can remain in the body for
longer than usual, triggering an overdose. Methadone should always be
taken in the prescribed dose, at the right time. People should never
stop taking it, double up after a missed dose, or change their dosing
schedule without a doctor’s permission.
When on methadone, it’s also important to:
Avoid alcohol consumption.
Be careful when driving or operating machinery.
Store the medication at room temperature.
Keep methadone away from light sources.
Contact emergency services in case of an overdose.
Methadone overdoses are becoming more commonplace because it is more
widely available than it used to be. Since it does not yield the same
euphoric effects as other drugs, individuals who become addicted may
consume lethal doses to compensate. Signs of an overdose, per the U.S.
National Library of Medicine’s MedLine Plus, include constipation,
nausea, vomiting, and stomach/intestinal spasms. Low blood pressure,
weak pulse, breathing disturbances, dizziness, fatigue, disorientation,
weakness, blue fingernails and lips, cold and clammy skin, and coma may
result as well. The consequences are potentially fatal.
According to a CDC report, methadone overdose deaths increased by 5.5
times between 1999 and 2009. In 2014 alone, 14,000 people died from
prescription opioid overdoses from medications such as methadone.
Pros of methadone treatment, according to the National Alliance of
Advocates for Buprenorphine Treatment, include decades of experience
using it to treat opioid addictions and a cost that is typically less
than other treatments. Pricing may be calculated based on the patient’s
income. If a person gains tolerance to the medication, dosages can be
increased under medical supervision to relieve withdrawal symptoms.
Methadone clinics are not legally restricted in terms of patient volume,
so they generally don’t turn people away if they are in need of help.
There are also cons to methadone treatment, which tends to be
administered based on strict protocols. This can make those being
treated feel like they have no control. A person who abuses opioids can
still possibly use these drugs, despite being in a treatment program.
Other cons include having to travel far, sometimes a requirement for
daily visits, and dealing with self-esteem and other emotional and
psychological issues associated with visiting a clinic. Also, if an
employer were to do urine testing, methadone can show up in the results.
Despite the positives and negatives, methadone remains a common form of treatment for opioid addiction and withdrawal.
People should avoid methadone if they have been addicted to the drug
before. Methadone should also be avoided if alcohol or other
opioid-based substances have been consumed.
The combination of these substances can depress
the central nervous system even further, while the interaction between
methadone and alcohol or Valium can be deadly, says the Centre for
Addiction and Mental Health.
If someone has a similar drug addiction or symptoms and is given
methadone, it does not mean the same
Watson 349 Pill – Uses, Side Effects, Overdose and Precaution medication or dosage is right for
someone else, regardless of how similar the two people seem. Methadone
should be avoided unless taken under the supervision of a medical
professional familiar with the individual’s case. Taking it otherwise
can have unintended consequences.
Methadone should also be avoided by those who:
- Take pain, antidepressant, anti-anxiety medications, sleeping pills, tranquilizers, or antihistamines
- Take medications for heart arrhythmias
- Plan to become or are pregnant
- Have a seizure disorder, such as epilepsy
- Have low blood pressure
- Have asthma, sleep apnea, chronic obstructive pulmonary, disease, or other breathing disorders
- Have a history of head injuries
- Have liver, kidney, thyroid, gallbladder, prostate, or adrenal gland problems
Controversy
The American Journal of Psychology says the DSM-5 manual, which
doctors use to diagnose mental health disorders, describes methadone as a
safe substance for treating substance use disorders, but years of
experience have proven people need to be careful with it. Various myths
have plagued public perception as well. The drug being a substitute for
heroin, for one, is incorrect, as it is a much longer-acting formulation
intended to treat opioid addiction. The risk potential is therefore
lower since there is less reward. Also, people taking methadone as part
of a medical protocol are physically dependent, rather than addicted,
but this can be managed by reducing or maintaining doses under medical
supervision.
Controversies between methadone clinics and law enforcement have
arisen as well. The Beyond Methadone study in New York City monitored 29
locations where patients had been stopped by police, all near treatment
clinics. For a period in 2010, 40 percent of people surveyed had
reported being checked by law enforcement while 70 percent of others
said they witnessed such activity.
In 2014, the Institute for Research, Education, & Training in
Addictions conducted a study and found that there was no increase in
crime due to the presence of methadone clinics in Baltimore. The report
highlights the benefits of methadone maintenance therapy stated by the
CDC. It also assessed the frequency of crimes within certain distances
of clinics, which did not yield evidence of increased crime reports.
There are a number of online resources for finding local methadone
clinics. One can search by state or city, read customer reviews, or get
referrals. Some sites provide resources based on specific treatment
services or even insurance companies. In 2011, methadone contributed to
26 percent of opioid-analgesic overdose deaths, the National Center for
Health Statistics reported, so it is important to find an experienced
and reputable medical facility.
Many state and federal guidelines cover methadone clinic safety. One
must feel comfortable in the facility and amongst its staff members.
Those that don’t adhere to local and national regulations are best
avoided, and a clean, supportive environment should always be present.
Next, people should look for a clinic they can afford. While free
methadone clinics do exist, many also offer payment plans and other
payment options.
Some clinics are crowded, and that can invoke fear and anxiety.
Others may cater to specific demographics; certain clinics cater to a
specific gender or religion, for example, to maximize the comfort of
their clients.
Lastly, it’s essential to find a clinic that can handle one’s
specific issues. Medical detox, withdrawal, counseling, and treatment
for co-occurring disorders are considerations many drug treatment
clinics can handle. In many instances, a comprehensive, private
addiction treatment program may be preferable to a methadone clinic. The
services, staff, and reputation of the facility need to be taken into
account before enrolling in care.
In Summary
Proper use of methadone is sometimes appropriate for certain
individuals in recovery. SAMHSA’s guidelines, Follow Directions: How to
Use Methadone Safely, outlines the risks, considerations, and
precautions of taking the medication. Methadone clinics are functional
medical facilities where staff members work to assist patients with
rehabilitation and first steps on the road to recovery. In some cases,
these clinics may be the appropriate choice for those in early recovery.
In other instances, different types of addiction recovery programs may
better serve the individual. Regardless of the type of treatment chosen,
comprehensive care is always needed.
