Methadone Clinics in Honolulu

Rules and Regulations

Honolulu, Honolulu County, Hawaii, 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

Methadone clinics must be certified by SAMHSA and licensed by the state. Staff must complete special training and clinics must meet security and record-keeping standards. Patients must meet eligibility criteria and comply with treatment plans.

Benefits of Medication-Assisted Treatment

Methadone maintenance treatment provides:

• Relief from withdrawal and cravings
• Stable dose levels compared to illicit opiates
• Ability to focus on recovery goals and responsibilities

How Clinics Operate and Their Purpose

Methadone clinics provide daily supervised methadone doses and counseling to those with an opioid use disorder. The goals are to reduce illicit opiate use and associated risks like disease and overdose.

Insurance Coverage

Many clinics accept Medicaid and private insurance. Some offer sliding scale fees based on income for uninsured patients.

Free clinics

Free or low-cost methadone treatment may be available from certain nonprofit clinics or through public assistance programs. Uninsured patients can also apply for state and local grants or vouchers to cover treatment costs.

Drug Use in Honolulu

The opioid crisis has been declared a nationwide public health emergency. In Honolulu, the rates of drug overdoses and deaths related to substance use disorders have been rising over the past decade.

Statistics on Drug Use and Related Harms

• In 2020, there were 123 drug overdose deaths in Honolulu County, up from 107 in 2019. Opioids were involved in most deaths.
• Alcohol remains the most commonly used addictive substance, with binge drinking rates over 15% among adults.
• An estimated 2.3% of people need but do not receive treatment for illicit drug use.

Addiction Treatment Overview

Inpatient Treatment

Inpatient facilities provide 24/7 supervision, counseling, and access to medications. Typical stays last from a few days to 6 weeks depending on patient needs.

Outpatient Treatment

Outpatient programs offer services for 4-8 hours per week in various office locations. Services include therapy, support groups, and medications.

Treatment Level Unreported

An estimated 18% of people receive some level of treatment without specifics being reported. Reasons may relate to privacy concerns or involvement in non-traditional recovery support services.

Comparison of Treatment Availability

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, allowing patients to focus on recovery.

Societal perspectives on methadone treatment vary. Some view it as lifesaving addiction treatment, while others see it as merely replacing one opioid with another. However, research shows methadone maintenance therapy helps patients reduce or stop misuse of other opioids. Careful patient monitoring and dosage adjustments are necessary to ensure safety.

Methadone Distribution

Methadone distribution is highly regulated to prevent misuse and diversion. Patients in an OTP must follow strict urine testing and take-home dosage rules:

• Urine Testing: Patients undergo at least eight urine tests in the first year to ensure appropriate use and compliance.
• Take-Home Requirements: For the first 14 days, take-home doses are limited to a 24-hour methadone supply. After showing progress, take-homes may be increased up to a 30-day supply for stable patients.
• Monitoring: A team including physicians, nurses, and behavioral health specialists monitor patient progress. Dosage is adjusted individually based on effectiveness and side effects.
• Prescription Drug Monitoring: Clinicians should review state prescription drug monitoring program (PDMP) data to coordinate care and avoid dangerous drug interactions.

As an example, in Honolulu, methadone is a Schedule II controlled substance, with extra prescribing and dispensing regulations.

Methadone Treatment Effectiveness Research

Studies since 1947 support methadone maintenance therapy for opioid use disorder. It is on the World Health Organization’s List of Essential Medicines.

Evidence shows methadone MAT leads to:

• 33% fewer opioid-positive drug tests
• 4.44 times higher treatment retention
• Lower overdose death and disease transmission risk
• Increased employment opportunities

However, risks include the potential for misuse/diversion, severe withdrawal if stopped suddenly, QTc prolongation, respiratory depression if combined with other substances, and overdose.

Methadone is equally effective as buprenorphine, another MAT medication. Careful patient selection and monitoring help maximize benefits and reduce harm.

About Honolulu

Location, County & List of Neighboring States

Honolulu is located in Honolulu County on the island of Oʻahu in the U.S. state of Hawaii. As an island state, Hawaii does not border any other states.

Capital and Largest City

Honolulu serves as both the capital and largest city in Hawaii.

Land Area

Honolulu has a total land area of approximately 68 square miles.

Population Statistics

Total Population

Honolulu has an estimated population of 337,256 as of 2019.

Demographics:

Gender

• Male: 50.1%
• Female: 49.9%

Age Brackets

• Under 18 years: 20.2%
• 18 to 65 years: 63.3%
• Over 65 years: 16.5%

Occupations

• Management, business, science, arts: 34.8%
• Sales and office: 26.7%
• Service: 18.5%
• Natural resources, construction, and maintenance: 12.5%
• Production, transportation, and material moving: 7.5%