A methadone clinic is a clinic which has been established for the dispensing of
methadone, a schedule II opioid analgesic, to those who abuse heroin and
other opioids. The focus of these clinics is the elimination or reduction
of opioid usage by putting the patient on methadone. Some clinics also offer
short- or long-term detoxification services to their patients using
methadone. A common term for the type of treatment at a methadone clinic is
"replacement therapy". While generally considered successful as a treatment
method, the use of this maintenance treatment is often viewed as
controversial. Regulation and policy
In the United States, there are generally two types of methadone
clinics, public and private. The public clinics are generally cheaper to attend.
However, there is usually a waiting list due to limited funding. The private
clinics are more expensive to attend but usually have either a short or no
waiting list. In many parts of the United States, methadone clinics are few
and far between, which presents problems for addicts seeking methadone treatment
who live far from a clinic. The greatest concentrations of clinics are in
California, Maryland, New York, and New Jersey.
Methadone clinics in the United States operate under close federal observation
and regulation. The medication is monitored by nursing staff and is
prescribed by a physician. Regulations require that to enter this form of
treatment, the person must show current addiction to an opioid. This is
generally established by a simple urine sample. A medical examination is given
prior to administration of the methadone, and new patients are often
tested for certain conditions which are known to be prevalent in addict
populations, such as HIV, hepatitis, and tuberculosis.
Getting admitted into a methadone clinic in New York State has several
requirements. One must be an opiate user for a minimum of one year. One must not
have methadone or suboxone in his/her blood or urine analysis. They also base
the amount of methadone given to a patient by the amount of opiates in the
person's system. If there are extremely low amounts of opiates in the person's
system that individual will be rejected methadone treatment due to the high
amount of methadone abuse as well as assuming the person will try to sell
their methadone on the streets. This amount is equivalent to using 6 bags of
50% pure heroin, or 360 mg of Oxicodone and 240 mg of oxymorphone.
Use of methadone clinics Although not required by regulation at
this time in the United States, people are usually encouraged to attempt other
types of treatment methods prior to entering methadone treatment programs.
While not restricted to adults, this treatment method is generally not
considered for people under the age of 18. As of 2013 due to the strict changes
in receiving prescription pain medication as well as decreases in
prescription abuse the requirements to be accepted into methadone clinics have
changed in areas such as New York State. Requirements for individuals to be
accepted into a methadone clinic include abusing opiates for a minimum of one
year and using 135 mg of Oxycodone, 90 mg of oxymorphone, 6 bags of 25% pure
heroin and 200 mg of hydrocodone. An important part of treatment for
addiction is counseling. Methadone clinics are only for recovering addicts
from opioids. Clinics require attendance at counseling groups as well as
individual counseling contacts. It is generally accepted that the more
intensive the counseling contacts the individual is willing to submit to, the
higher the success rate of the program. Methadone clinics operate as any other
addiction medical facility. The staff usually consist of a physician to
monitor the medications and treatments and nurses to administer the medication
and ensure effective delivery. Additionally, drug counselors will be
available for individual and group counseling, and there will be
administrative staff to run the administrative functions. The clinical
operations of the clinic are often housed in a hospital setting, although
this is not required by U.S. law. Effectiveness
While methadone clinics are generally considered to be effective treatment
options for patients addicted to opioids, especially when other
interventions have failed, there is controversy surrounding the placement of
methadone clinics. There is a perception that the presence of the clinics
attracts crime to surrounding areas. However, one study by the University of
Maryland School of Medicine found that is not the case, crime rates do not
increase when a methadone clinic is opened.
Relapse rates are high in patients treated at methadone clinics, between
80-90% The high relapse rate may be partially due to the severity of cases
seen at methadone clinics, as well as the long-term effects of opioid use.
Some patients will be on methadone for the rest of their lives, which generates
criticism regarding the effectiveness of the clinics. Supporters argue that the
clinics aim not just to eliminate narcotic addictions, but also to help
people function in their lives. Methadone clinics may decrease the use
of emergency rooms by patients addicted to opioids According to a 2009 Cochrane
review, methadone maintenance treatments decreased the likelihood that heroin
dependent patients would use heroin, but did not change crime or mortality rates.
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