Rules and Regulations
Rialto, 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 be certified, clinics must submit an application and fee, undergo onsite surveys, develop policy and procedure manuals, and fulfill other requirements. Staff must complete training programs. Security and diversion control measures must be in place. Record keeping and reporting requirements must be followed.
Benefits of Medication-Assisted Treatment
Medication-assisted treatment benefits individuals and communities by:
- Reducing illicit opioid use and overdose deaths
- Lowering transmission rates of HIV and hepatitis
- Decreasing criminal activity
How Clinics Operate and Their Purpose
Methadone clinics provide medication-assisted treatment to those with opioid use disorder. Patients receive methadone doses under medical supervision to prevent withdrawal symptoms and reduce opioid cravings without inducing a high.
Insurance Coverage
Public and private insurance, including Medi-Cal and Medicare, typically cover methadone treatment. Some clinics offer treatment on a sliding fee scale based on income for those without insurance. Grants and public funding also help fund low-cost and free treatment programs.
Drug Use in Rialto
The opioid crisis has been declared a nationwide public health emergency. In San Bernardino County, prescription opioid overdose deaths quadrupled from 2000 to 2015. Heroin overdose deaths rose by 75% from 2014 to 2015 alone.
- In 2017, approximately 2.1 million Californians reported misusing prescription opioids in the past year
- An estimated 2,196 Californians died from opioid-involved overdoses in 2018
The most commonly misused substances in San Bernardino County and across California are:
- Prescription opioids
- Heroin
- Methamphetamine
- Cocaine and crack cocaine
- Marijuana
Addiction Treatment Overview
Inpatient Treatment
- Typically 28 days, with potential extensions
- 24/7 medical supervision and counseling
- Detoxification, behavioral therapies, medication
Outpatient Treatment
- 1-5 visits per week for counseling and therapy
- Provided at clinics, private practices, etc.
Treatment Level Unreported
Around 21% of addiction treatment is provided at unreported treatment levels, likely including detox centers and sober living homes.
Comparison of Treatment in Rialto vs. Riverside
| Category | Rialto | Riverside |
| Treatment Centers | 15 | 25 |
| Inpatient Beds | 250 | 500 |
| Cost of Treatment | $15,000/mo | $25,000/mo |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder (OUD). As medication-assisted treatment (MAT) in opioid treatment programs (OTPs), methadone helps prevent withdrawal symptoms and drug cravings by acting on opioid receptors in the brain. It is taken orally once daily and allows patients to function normally without euphoria or sedation when an adequate dose is reached.
Societal perspectives on methadone treatment are mixed. While it does help many addicted to opioids avoid painful withdrawal and achieve sobriety, some view it as merely replacing one opioid for another. However, research shows MAT with methadone or buprenorphine is more effective for treating OUD than abstinence-only programs. Most experts agree MAT is an evidence-based component of recovery along with counseling and social support.
Methadone Distribution
Monitoring and regulations around methadone aim to ensure patient safety while providing access to those in need. Guidelines include:
Urine Testing
Methadone maintenance patients must undergo at least eight random urine drug tests in the first year of treatment to detect any unauthorized drug use.
Take-Home Requirements
During the first 14 days of methadone treatment, take-home doses are limited to a one-day supply dispensed daily at the OTP under observation. After 2 years of compliance, patients may earn up to 30 days of take-home doses.
Monitoring
Methadone treatment programs should have an expert interdisciplinary team including physicians, nurses, counselors, social workers, and pharmacists to coordinate care.
Prescription Drug Monitoring
Clinicians should review their state’s prescription drug monitoring program (PDMP) database to carefully cross-reference other opioid medications a patient may be prescribed. As methadone has a narrow therapeutic window, overlapping opioids can increase overdose risk.
According to the state of California, methadone is a Schedule II controlled prescription drug, with strict regulations around prescribing and dispensing to prevent misuse while ensuring access to medical treatment.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show it is an effective MAT medication for OUD. Evidence includes:
- 33% fewer opioid-positive drug tests for methadone patients
- 4.44 times more likely to stay in treatment long-term compared to non-medication programs
- Retention in methadone treatment reduces overdose death risk and infectious disease transmission while improving employment opportunities
However, methadone does come with risks requiring careful oversight:
- Potential for misuse/diversion of medication
- Severe withdrawal if stopped suddenly after long-term use
- Possible QTc interval prolongation or cardiac arrhythmias
- Respiratory depression and overdose when combined with benzodiazepines or other sedatives
Research trials demonstrate methadone and buprenorphine have equal effectiveness for treating opioid addiction and reducing self-reported opioid use. Both play an important role as MAT options.
In conclusion, methadone MAT provides significant benefits but also risks requiring careful management under medical supervision.
About Rialto
Location, County & List of Neighboring States
Rialto is located in San Bernardino County in the state of California, United States. It borders the following neighboring states:
Capital and Largest City
The capital and largest city in California is Sacramento.
Land Area
The land area of Rialto is 22.42 sq mi.
Population Statistics
The total population of Rialto is 103,314 (2020 census).
Demographics
Gender
- Male: 51%
- Female: 49%
Age Brackets
- Under 18 years: 28.8%
- 18 to 64 years: 57.5%
- 65 years and over: 13.7%
Occupations
The top occupations in Rialto are:
- Office and administrative support
- Transportation and material moving
- Production
- Sales
- Management
