Rules and Regulations
San Bernardino, San Bernardino County, California, United States adheres to strict regulations regarding methadone clinics outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA).
Certification Procedures
To operate legally, clinics must be certified by SAMHSA and licensed by the state. Certification requires adhering to regulations around medication dispensing, counseling requirements, and patient rights. Clinics must renew licenses annually by showing compliance.
Benefits of Medication-Assisted Treatment
Methadone and other medication-assisted treatments for opioid addiction can:
- Reduce illicit opioid use and relapses
- Decrease the risk of overdose
- Improve social functioning
How Clinics Operate and Their Purpose
Clinics provide methadone doses daily for patients along with counseling and other services to support recovery from opioid addiction. The structured environment helps stabilize patients’ lives allowing them to focus on health, family, and work while avoiding destructive behaviors.
Insurance Coverage
Many insurance plans cover methadone treatment:
- Medicaid programs in California cover services at certified clinics.
- Most private plans include coverage as part of mental health and substance abuse benefits.
Some clinics provide care on a sliding fee scale based on income for those without adequate insurance coverage. Grants and public funding also help support affordable treatment access. Public and private insurance play a vital role in responsibly funding addiction services.
Drug Use in San Bernardino
Opioid crisis declared public health emergency:
- In 2017, there were over 70,200 drug overdose deaths in the United States, including 47,600 opioid overdose deaths.
- The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000).
Statistics on drug overdoses and deaths:
- In San Bernardino County, there were 357 opioid overdose deaths in 2021.
- Deaths from synthetic opioids (mainly fentanyl) increased by 36% from 2020 to 2021 in the county.
Addiction Treatment Overview
Inpatient Treatment
- Involves living at a treatment facility for 30-90 days or longer.
- Includes medical detox, counseling, group therapy, and medication management.
Outpatient Treatment
- Does not require living at a treatment center.
- Usually meets 1-5 times per week for 1-2 hours per day.
Treatment Level Unreported
- Many who need treatment don’t report treatment levels.
- In 2020, only 10.1% of people in the U.S. who needed substance use treatment reported receiving any.
Comparison of Treatment in San Bernardino vs. Los Angeles
| Category | San Bernardino | Los Angeles |
| Treatment Facilities | 163 | 569 |
| Inpatient Beds | 1,557 | 5,047 |
| Cost of Treatment | $7,500 per month | $10,000 per month |
Methadone Treatment
What is Methadone
Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) programs, also known as opioid treatment programs (OTPs), to treat opioid use disorder. It binds to opioid receptors and reduces cravings and withdrawal symptoms. It allows patients to function normally without the negative effects of illicit opioid use.
Mechanism as Medication-Assisted Treatment
Methadone is taken orally once daily and binds to opioid receptors in the brain, blocking the euphoric effects of other opioids. This allows patients to stop illicit opioid use. It is part of a treatment program that includes counseling and support services to address the psychological aspects of addiction.
Societal Perspectives
Society has had mixed views on methadone treatment. Some see it as simply replacing one addiction with another. However, research shows methadone allows patients to improve their health, relationships, and employment and reduces crime and disease transmission associated with intravenous drug use when properly regulated.
Methadone Distribution
Strict regulations govern methadone distribution to prevent misuse and diversion. These include:
Monitoring and Regulations
- Urine testing: Patients must undergo at least 8 urine tests in the first year to ensure they are not using other substances.
- Take-home requirements: For the first 14 days, methadone doses must be consumed at the clinic daily to prevent diversion. Eventually, take-home doses are allowed for stable patients.
- Interprofessional team: Clinicians, counselors, and pharmacists provide comprehensive care and monitoring.
- Prescription drug monitoring (PDMP): Clinicians should carefully review PDMP data and opioid dosages due to methadone’s narrow therapeutic window.
In San Bernardino County, methadone is a Schedule II controlled prescription drug with strict regulations on prescribing and dispensing from licensed opioid treatment programs.
Methadone Treatment Effectiveness
Methadone has been used effectively since 1947 to treat opioid addiction. Studies show methadone MAT is effective for:
- Reducing opioid use supported by 33% fewer opioid-positive drug tests
- Retention in treatment, 4.44 times more likely than without medication assistance
- Reducing overdose death risk
- Lowering transmission rates of HIV and hepatitis
- Decreasing criminal behavior However, methadone also has risks requiring management like any medication. These include misuse potential and severe withdrawal if stopped suddenly. It can also prolong the QT interval causing cardiac issues. Respiratory depression and overdose occur when combining methadone with other substances like benzodiazepines. Research shows methadone and buprenorphine are equally effective for treating opioid addiction. However, methadone may have more misuse potential requiring OTP structure.
In conclusion, methadone is beneficial but only as part of carefully monitored addiction treatment programs.
About San Bernardino
Location, County & List of Neighboring States
San Bernardino is a city located in San Bernardino County in the U.S. state of California. It borders the states of Nevada and Arizona.
Capital and Largest City
San Bernardino is the county seat and largest city of San Bernardino County.
Land Area
San Bernardino covers a total land area of 59.6 square miles.
Population Statistics
Total Population
As of the 2020 census, the population of San Bernardino was 216,995.
Demographics:
Gender
- Male: 50.4%
- Female: 49.6%
Age Brackets
- Under 18 years: 30.6%
- 18 to 64 years: 56.5%
- 65 years and over: 12.9%
Occupations
The top occupations in San Bernardino are:
- Office and administrative support: 14.7%
- Sales and related: 11.4%
- Transportation and material moving: 10.8%
- Food preparation and serving: 9.2%
- Production: 7.9%
