Rules and Regulations
Waialua, Honolulu County, Hawaii, United States adheres to strict federal and state regulations regarding methadone clinics. All clinics must be certified and meet standards for quality patient care and safe medication dispensing.
Certification Procedures
To be certified, methadone clinics must:
- Be accredited and licensed healthcare facilities
- Employ licensed and credentialed medical staff
- Follow federal and state opioid treatment standards
- Maintain rigorous security and record-keeping protocols
Benefits of Medication-Assisted Treatment
Methadone and other medication-assisted treatments for opioid addiction can:
- Reduce illicit opioid use and overdose deaths
- Lower transmission rates of infectious diseases like HIV and hepatitis
- Improve social functioning and quality of life
- Enable people to gain and maintain employment
How Clinics Operate and Their Purpose
Methadone clinics provide daily supervised methadone dosing and comprehensive support services to those recovering from opioid addiction. The highly-structured programs aim to stabilize patients, manage withdrawal and cravings, and allow people to regain control of their health and lives.
Insurance Coverage
Most private insurance plans and Medicaid cover methadone treatment to some extent. Some clinics also offer sliding-scale fees or arrangements based on individual circumstances. Grants and public funding may also be available to improve access and affordability.
Drug Use in Waialua
In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency. This impacts communities across the country, including Waialua.
Statistics on Drug Overdoses and Deaths
In 2020, there were 18 overdose deaths involving opioids in Honolulu County – a rate of 8.3 deaths per 100,000 persons compared to the national rate of 20.4 deaths per 100,000.
Data on Prevalence of Different Substances
Alcohol, marijuana, and methamphetamine are the most commonly used substances in Hawaii.
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.
Outpatient Treatment
Outpatient treatment allows the patient to live at home while attending 3-5 days a week for several hours at a time. Services include therapy, group counseling, and medication management.
Treatment Level Unreported
An estimated 10-20% of treatment in Waialua is unreported. Reasons may include privacy concerns or the use of alternative medicine.
Comparison of Treatment in Waialua vs. Honolulu
| Category | Waialua | Honolulu |
| Treatment Facilities | 5 | 25 |
| Inpatient Beds | 50 | 300 |
| Cost of Treatment | $10,000 | $15,000 |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used in medication-assisted treatment (MAT) for opioid use disorder. It is taken orally once daily and binds to opioid receptors in the brain, reducing cravings and withdrawal symptoms. Methadone is dispensed through opioid treatment programs (OTPs) that provide counseling and require frequent urine drug screening and EKGs.
Societal perspectives on methadone treatment are mixed. While it helps stabilize individuals and reduce illegal opioid use, some view it as merely replacing one opioid with another. However, research shows methadone helps patients function normally, obtain employment, and reduce transmission of diseases like HIV and hepatitis. It must be taken under medical supervision due to risks like cardiac issues. Explained simply, methadone relieves withdrawal symptoms and drug cravings by acting on the same brain receptors as opioids, allowing recovery.
Methadone Distribution
OTPs providing methadone must follow strict federal and state regulations:
- Urine testing: Patients undergo at least 8 random tests in the first year to ensure they are not using other opioids or illicit drugs.
- Take-home requirements: For the first 14 days, the supply is limited to 24 hours. More take-home doses are allowed over time for stable patients.
- Monitoring: A team including a doctor, nurses, and counselors monitor patient progress.
- Prescription drug monitoring: Providers check the state PDMP to ensure safe opioid dosage and prevent dangerous drug interactions.
According to the Hawaii PDMP, methadone is a Schedule II controlled substance in the state, available only through certified OTPs.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show it is an effective MAT option that reduces opioid use, HIV risk behaviors, and criminal activity when combined with counseling.
Evidence for Effectiveness
- 33% fewer opioid-positive drug tests versus no medication
- 4.44 times more likely to stay in treatment versus placebo
- Retention in treatment reduces overdose risk and increases employment
Major Drawbacks
Potential for misuse and diversion exists. Sudden discontinuation can cause severe withdrawal. It can prolong the QT interval and lead to cardiac issues in some patients. It also causes respiratory depression and overdose when combined with certain substances.
Comparison to Other Medications
Methadone and buprenorphine are equally effective for reducing illicit opioid use and retaining patients in treatment.
Methadone has demonstrated benefits but also risks requiring careful management under medical supervision.
About Waialua
Location, County & List of Neighboring States
Waialua is located in Honolulu County on the island of Oʻahu in the state of Hawaii. Honolulu County consists of the entire island of Oʻahu. Neighboring counties include Maui County to the east, Kalawao County to the southeast, and Kauai County to the northwest.
Capital and Largest City
Honolulu is the capital and largest city in Hawaii.
Land Area
Waialua has a total area of 57.2 square miles.
Infrastructure
- Roads: Farrington Highway, Kaukonahua Road
- Airports: Dillingham Airfield
Population Statistics
As of 2010, the population of Waialua was 3,860 people.
Gender
- Male: 51.5%
- Female: 48.5%
Age Brackets
- Under 18 years: 21.6%
- 18 to 64 years: 63.4%
- 65 years and over: 15%
Occupations
- Management, business, science, and arts occupations: 32.2%
- Service occupations: 20.6%
- Sales and office occupations: 27.1%
- Natural resources, construction, and maintenance occupations: 13.4%
- Production, transportation, and material moving occupations: 6.7%
