Rules and Regulations
Kahului, Maui 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
To be certified, methadone clinics must:
- Meet staff credential requirements
- Follow treatment protocols and best practices
- Pass facility inspections
Benefits of Medication-Assisted Treatment
Medication-assisted treatment with methadone can:
- Reduce opioid cravings and withdrawal symptoms
- Lower risk of overdose
- Allow people to focus on overall health and lifestyle changes
How Clinics Operate and Their Purpose
Methadone clinics provide monitored doses of methadone to treat opioid use disorder. This helps patients avoid the negative effects of obtaining opioids illicitly while working towards recovery goals.
Insurance Coverage
Many health insurance plans cover methadone treatment:
- Medicaid programs in Hawaii provide coverage
- Some private plans may have limited or restricted coverage
There are also government-funded treatment programs available for those without insurance.
Drug Use in Kahului
The opioid crisis has been declared a public health emergency in the United States. In Hawaii, opioid-related deaths have increased in recent years:
- In 2020, there were 188 opioid-related overdose deaths in Hawaii, up from 149 deaths in 2019.
- Heroin overdose deaths more than doubled from 2014 to 2020 in Hawaii, increasing from 22 to 57 deaths.
Other commonly used substances in Hawaii include:
- Alcohol
- Marijuana
- Methamphetamine
Addiction Treatment Overview
Inpatient Treatment
Inpatient addiction treatment involves staying at a treatment facility 24/7 for 1-3 months typically. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.
Outpatient Treatment
Outpatient addiction treatment consists of periodic services at a facility up to 9 hours a week, alongside living at home. It involves counseling, group therapy, and relapse prevention education.
Treatment Level Unreported
Around 25% of treatment facilities do not specify treatment levels. These likely include a mix of inpatient and outpatient services.
Comparison of Treatment in Kahului vs. Honolulu
| City | Treatment Facilities | Inpatient Beds | Cost per Month |
| Kahului | 5 | 32 | $6,000 |
| Honolulu | 12 | 183 | $7,500 |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used as medication-assisted treatment (MAT) for opioid use disorder (OUD). It is typically administered orally once daily in opioid treatment programs (OTPs). Methadone helps prevent opioid withdrawal and reduces cravings by acting on the same opioid receptors in the brain as drugs like heroin or oxycodone.
Methadone is a full opioid agonist that produces effects similar to other opioid drugs. However, its long duration of action allows it to be dosed once daily to prevent opioid withdrawal symptoms. Methadone maintenance therapy provides a consistent dose level to stabilize patients and allow them to function normally without the highs and lows of opioid misuse. Patients must receive methadone under supervision at a certified OTP clinic.
Societal Perspectives on Methadone Treatment
Some view methadone maintenance positively as an evidence-based treatment that improves outcomes for people with OUD. Others see it negatively as simply replacing one opioid with another. However, research shows methadone helps patients reduce or stop other opioid use when combined with counseling and social support. Many patients can lead productive lives on methadone maintenance.
Methadone Distribution
Methadone treatment programs are highly regulated to prevent misuse and diversion of methadone. Key requirements include:
- Urine Testing: Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment to ensure they are not using other opioids or illicit drugs.
- Take-Home Requirements: During the first 14 days of treatment, the take-home supply of methadone is limited to a 24-hour supply that the patient must ingest on-site. Take-home doses are increased incrementally based on time in treatment and negative drug tests.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, counselors, and social workers to monitor patient progress.
- Prescription Drug Monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to cross-reference other opioid prescriptions carefully, as methadone has a narrow therapeutic index.
In Kahului, Maui County, Hawaii, methadone is a Schedule II controlled substance requiring a prescription and oversight by a certified OTP.
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. Patients on methadone maintenance have 33% fewer opioid-positive drug tests. They are also 4.44 times more likely to stay in treatment, which reduces overdose and disease transmission risk while increasing employment opportunities.
However, methadone does have risks including the potential for misuse and severe withdrawal symptoms if stopped suddenly. It can prolong the QT interval on electrocardiograms and lead to cardiac issues in some patients. It also carries a risk of respiratory depression and overdose when combined with alcohol or sedatives. Research suggests methadone and buprenorphine are equally effective for reducing illicit opioid use.
In conclusion, methadone offers benefits but also risks requiring careful management.
About Kahului
Location, County & List of Neighboring States
Kahului is located on the island of Maui in Maui County, Hawaii, United States. Maui County consists of the islands of Maui, Molokaʻi, Lānaʻi, and Kahoʻolawe. The neighboring Hawaiian islands are:
- Hawaii (Big Island)
- Oahu
- Kauai
- Niihau
Capital and Largest City
Kahului is the largest city and county seat of Maui County.
Land Area
Kahului has a total area of 15.97 square miles.
Infrastructure
Kahului has a regional airport, deep-water harbor, and central business district. Major companies headquartered in Kahului include Maui Land & Pineapple Company and Hawaiian Commercial & Sugar Company.
Population Statistics
The population of Kahului is 26,337 as of 2010.
Demographics
Gender
- Male: 51.6%
- Female: 48.4%
Age Brackets
- Under 18 years old: 21.4%
- 18 to 64 years old: 63.7%
- 65 years and older: 14.9%
Occupations
Major occupations in Kahului include:
- Management, business, science, and arts: 29.8%
- Sales and office: 27.2%
- Service: 21.2%
- Production, transportation, and material moving: 15.5%
