Rules and Regulations
Kaneohe, 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). All clinics must be certified and meet standards for dispensing methadone as medication-assisted treatment for opioid use disorder.
Certification Procedures
Clinics must:
- Be accredited and licensed healthcare facilities
- Employ licensed and credentialed medical staff
- Follow DEA regulations for ordering, storing, and dispensing methadone
- Maintain patient records and treatment plans
Benefits of Medication-Assisted Treatment
Methadone treatment can:
- Reduce opioid cravings and withdrawal symptoms
- Allow people to focus on their health and life goals
- Lower the risk of overdose and transmitting infections
- Enable access to counseling and wraparound services
How Clinics Operate and Their Purpose
Methadone clinics provide daily supervised methadone dosing and comprehensive treatment services such as:
- Individual and group counseling
- Case management
- Peer support groups
- Referrals for mental health, medical, and social services
The purpose is to stabilize patients, promote recovery from opioid addiction, and improve quality of life.
Insurance Coverage
Free clinics:
- Provide free basic healthcare services
- Located in low-income neighborhoods
- Rely on donations and volunteers
Public and private insurance coverage:
- Medicaid available for low-income residents
- Medicare for seniors and disabled
- Private plans available to purchase
Drug Use in Kaneohe
The opioid crisis has been declared a nationwide public health emergency. In Hawaii, drug overdoses claimed over 300 lives in 2021. The most commonly used substances, according to state health department data, include:
- Opioids – heroin, fentanyl, oxycodone
- Methamphetamine
- Cocaine
- Marijuana
- Alcohol
Addiction Treatment Overview
Inpatient Treatment
Inpatient facilities offer 24/7 care and monitoring. Typical stays range from 28-90 days. Services include medical detox, counseling, group therapy, aftercare planning, and more.
Outpatient Treatment
Outpatient programs provide services for 4-8 hours per day, 3-7 days per week. Care is provided at clinics, community health centers, and private practices. Services resemble inpatient care but at reduced intensity.
Treatment Level Unreported
An estimated 18% of those seeking treatment in Hawaii did not specify treatment level. Some likely utilize support groups, faith-based programs, and informal community resources.
Comparison of Treatment Availability
| City | Treatment Facilities | Inpatient Beds | Avg. Monthly Cost |
| Kaneohe | 14 | 180 beds | $15,000 |
| Honolulu | 32 | 850 beds | $25,000 |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and dependence. As medication-assisted treatment (MAT), methadone helps prevent opioid withdrawal and reduces drug cravings by activating opioid receptors in the brain similarly to other opioid drugs. However, it does not provide the associated euphoria or high of misused opioids. Methadone is taken orally once daily in tapering doses under medical supervision in what is known as opioid treatment programs (OTPs).
Societal perspectives on methadone treatment are mixed. While it is an evidence-based treatment, some view it as merely replacing one opioid for another. However, research shows methadone allows patients to function normally, improve health, and reduce the harm of opioid addiction when properly managed.
Methadone Distribution
Methadone distribution is highly regulated with several monitoring requirements:
- Urine testing: Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment to detect any unsanctioned drug use.
- Take-home requirements: During the first 14 days of treatment, the take-home methadone supply is limited to just a 24-hour dose. After 90 days of compliance, patients may receive a maximum one-month supply.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and behavioral health counselors monitoring patient progress.
- Prescription drug monitoring: Clinicians should review PDMP data to carefully cross-reference other opioid prescriptions with methadone dosage, as it has a narrow therapeutic window.
In Kaneohe, Honolulu County, Hawaii, methadone is a Schedule II controlled prescription drug, with illegal possession penalties similar to other opioids.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947. Studies show methadone reduces opioid use, disease transmission, and crime:
- Evidence for Effectiveness: Studies found 33% fewer opioid-positive drug tests for methadone patients versus controls. Methadone patients were also 4.44 times more likely to stay in treatment, which reduces overdose risk and increases employment.
- Major Drawbacks: However, there is potential for misuse/diversion. Withdrawal symptoms if stopped suddenly can be severe. Possible QTc prolongation or cardiac issues. Also, respiratory depression/overdose when combined with other substances.
- Comparison to Other Medications: Research found methadone equally effective as buprenorphine for reducing opioid use and cravings.
In conclusion, methadone has demonstrated benefits but also risks requiring careful management.
About Kaneohe
Location, County & List of Neighboring States
Kaneohe is located on the island of O’ahu in Honolulu County, Hawaii, United States. Neighboring states include:
Capital and Largest City
The capital and largest city in Hawaii is Honolulu.
Land Area
The land area of Kaneohe is approximately 12.0 square miles.
Population Statistics
The total population of Kaneohe is over 34,000 residents.
Gender
- Male: 49%
- Female: 51%
Age Brackets
- Under 18 years: 21%
- 18 to 64 years: 62%
- 65 years and over: 17%
The Top Occupations
- Management, business, science, and arts: 37%
- Sales and office: 27%
- Service: 19%
- Production, transportation, and material moving: 17%
