Rules and Regulations
Santa Rosa adheres to strict regulations regarding methadone clinics, outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA). All clinics must be certified and meet standards around dispensing and dosing of methadone.
Certification Procedures
To be certified, methadone clinics must:
- Be accredited by an approved accreditation body
- Renew accreditation and certification regularly
- Allow regular inspections by state and federal agencies
- Employ qualified and licensed staff
- Follow controlled substance handling and dispensing rules
Benefits of Medication-Assisted Treatment
Methadone and other medication-assisted treatments for opioid addiction can:
- Reduce illicit opioid use and relapse risk
- Improve patient survival rates
- Lower risk of HIV and hepatitis infections
- Allow patients to improve their health and social functioning
How Clinics Operate and Their Purpose
Methadone clinics provide medication-assisted treatment to people addicted to opioids. Patients are given daily doses of methadone to prevent withdrawal symptoms and reduce opiate cravings without inducing a high. The clinics offer counseling and support services to help patients recover while avoiding relapse.
Insurance Coverage
Medicaid, Medicare, and private insurance plans in California often cover methadone treatment. Some clinics also offer treatment on a sliding scale based on a patient’s ability to pay.
Drug Use in Santa Rosa
Opioid Crisis Declared Public Health Emergency
- In 2017, the opioid epidemic was declared a nationwide public health emergency by the U.S. Department of Health and Human Services
- From 1999-2017, almost 218,000 people died in the United States from overdoses related to prescription opioids (CDC)
Statistics on Drug Overdoses and Deaths
- In 2020, there were over 93,000 drug overdose deaths nationwide, a 29.4% increase from the prior year (CDC)
- The age-adjusted rate of drug overdose deaths in California was 22.7 per 100,000 persons in 2020 (CDC)
Addiction Treatment Overview
Inpatient Treatment
- Typically 28 days or more of 24/7 supervised care with medical detoxification, counseling, group therapy, etc.
- Aims to treat addiction and underlying issues through immersive therapy
Outpatient Treatment
- Varies from 1-5 days per week for 1-6 hours per day
- Allows patients to continue living at home while receiving counseling, therapy, etc.
Treatment Level Unreported
- An estimated 9.5% of facilities did not report their treatment level in California per SAMHSA
- This may represent lower capacity facilities with less rigorous reporting
Comparison to San Francisco
| City | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| Santa Rosa | 15 | 250 | $15,000/month |
| San Francisco | 32 | 850 | $20,000/month |
Methadone Treatment
What is Methadone
Methadone is a medication used in medication-assisted treatment (MAT) for opioid use disorder. It activates opioid receptors in the brain, blocking cravings and withdrawal symptoms. Methadone is taken orally once daily in supervised opioid treatment programs (OTPs).
Societal perspectives on methadone treatment range from stigma to acceptance as an evidence-based practice. When taken as prescribed, methadone is safe and allows patients to function normally and regain control of their lives. However, methadone does carry risks if misused or combined with other substances. Careful patient monitoring is required.
Methadone Distribution
OTPs distributing methadone must follow strict federal and state regulations including:
- Urine testing: Methadone maintenance patients must undergo at least eight tests in the first year of treatment to detect illicit drug use.
- Take-home requirements: During the first 14 days of treatment, the take-home supply of methadone is limited to a 24-hour supply, taken onsite daily.
- Monitoring: Methadone treatment programs should have an interprofessional team including counselors and nurses monitoring patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference opioid dosage, as methadone has a narrow therapeutic index.
In California, methadone is a Schedule II controlled substance, available only at licensed OTPs.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947. Studies show methadone:
- Reduces opioid use (33% fewer opioid-positive drug tests)
- Reduces disease transmission from injection drug use
- Reduces drug-related crime
- Increases retention in treatment (4.44 times more likely to stay in treatment)
Retention in methadone treatment reduces overdose and disease transmission risk and increases employment opportunities.
However, methadone does carry risks:
- Potential for misuse/diversion
- Severe withdrawal if stopped suddenly
- Possible QTc prolongation/cardiac issues
- Respiratory depression/overdose when combined with other substances
Methadone is equally effective as buprenorphine for reducing opioid use. Benefits can outweigh risks with careful patient management.
About Santa Rosa
Location, County & List of Neighboring States
Santa Rosa is located in Sonoma County in the U.S. state of California. It is surrounded by the Sonoma Mountains and is located about 55 miles north of San Francisco. Neighboring states include Oregon to the north and Nevada to the east.
Capital and Largest City
Santa Rosa is the county seat and largest city in Sonoma County.
Land Area
Santa Rosa has a total area of 41.5 square miles.
Infrastructure
Santa Rosa has a council-manager style government with seven council members elected to four-year terms. The city provides police, fire, transit, parks and recreation, community development, and other public services.
Population Statistics
Total Population
As of 2019, the population of Santa Rosa was 176,753.
Demographics
Gender
- Male: 49%
- Female: 51%
Age Brackets
- Under 18 years: 19%
- 18 to 64 years: 62%
- 65 years and over: 19%
Occupations
- Management, business, science, arts: 38%
- Sales and office: 25%
- Service: 18%
- Production, transportation, and material moving: 11%
- Natural resources, construction, maintenance: 8%
