Rules and Regulations
Greencastle, Putnam County adheres to Indiana state regulations for methadone clinics and medication-assisted treatment programs. These regulations cover certification, operations, benefits, and insurance coverage.
Certification Procedures
- Clinics must submit certification applications detailing their plans for compliant operations, security, dispensing procedures, counseling services, and more
- Clinics must pass inspections of their facilities, staff credentials, and plans
Benefits of Medication-Assisted Treatment
Medication-assisted treatment provides supervised methadone doses to:
- Prevent opioid withdrawal symptoms
- Reduce opioid cravings
- Allow patients to focus on counseling and support programs
How Clinics Operate
Certified clinics provide daily supervised methadone doses and counseling to help patients in recovery from opioid addictions.
Insurance Coverage
- Medicaid covers methadone treatment
- Some private insurers provide limited coverage
- Uninsured patients may qualify for free or reduced-cost treatment through state and federal grant programs
Drug Use in Greencastle
The opioid crisis has been declared a nationwide public health emergency. In Indiana specifically:
- There were 1,832 drug overdose deaths in 2021, a 3.5% increase from 2020
- Opioids were involved in 93% of these deaths
- The drugs most commonly involved were fentanyl and methamphetamine
Addiction Treatment Overview
Inpatient Treatment
- Patients reside at the facility 24/7 for detox and behavioral therapies
- Typical stays range from 28-90 days
- Services include medical monitoring, counseling, group therapy
Outpatient Treatment
- Patients undergo therapy sessions 1-5 times per week
- Located in clinics, private practices, hospitals
- Services similar to inpatient but less intensive
Treatment Level Unreported
- An estimated 10% of facilities do not report treatment level
- The majority of these are presumed to be outpatient
Comparison of Treatment in Greencastle vs. Indianapolis
| City | Treatment Centers | Inpatient Beds | Cost per day |
| Greencastle | 2 | 18 | $250 |
| Indianapolis | 12 | 132 | $500 |
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 through the opioid treatment program (OTP) model. Patients take daily oral doses of methadone under medical supervision. Over time, optimal dosing stabilizes patients, supports other recovery efforts like counseling, and allows them to function without the negative effects of substance misuse.
Societal perspectives on methadone treatment vary. While it does replace one opioid with another, evidence shows MAT with methadone is associated with reduced drug use, disease transmission, and criminal behavior for those with opioid use disorder. Still, some view methadone as merely “switching addictions.” Explaining the medical evidence behind MAT can help reduce stigma.
Methadone Distribution
Strict federal and state regulations monitor methadone distribution to patients through approved OTPs. Policies include:
Urine Testing
Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment to detect any continued drug misuse.
Take-Home Requirements
During the first 14 days of treatment, take-home supplies of methadone are limited to a single daily dose. As patients progress, take-home doses can incrementally increase but remain contingent on responsible use and random testing.
Monitoring
In addition to urine testing, methadone treatment programs should have an interprofessional team including physicians, nurses, and behavioral health staff to coordinate care and closely monitor patient progress.
Prescription Drug Monitoring
Clinicians should also review their state’s prescription drug monitoring program (PDMP) data to carefully cross-reference any opioid dosage titrations. As methadone has a narrow therapeutic index, transparency between care teams is vital.
For example, in Greencastle, Putnam County, Indiana, methadone is a Schedule II controlled substance subject to federal and state tracking according to the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) PDMP system.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show it is an effective MAT medication that reduces opioid use, disease transmission, and crime for those with opioid use disorder. Compared to placebo, methadone demonstrates:
- 33% fewer opioid-positive drug tests
- 4.44 times more likely to stay in treatment
- Retention in treatment reduces overdose/disease transmission risk and increases employment
However, methadone does pose risks requiring careful management, including:
- Potential for misuse/diversion
- Severe withdrawal if stopped suddenly
- Possible QTc prolongation/cardiac issues
- Respiratory depression/overdose when combined with other substances
Research suggests methadone and buprenorphine are equally effective for reducing opioid use with no significant differences. Still, treatment plans must be individualized for patient needs and safety monitoring.
In conclusion, while methadone has demonstrated benefits as a medication-assisted treatment, it also carries substantive risks necessitating diligent oversight.
About Greencastle
Greencastle is located in Putnam County in west central Indiana. It is surrounded by the states of Illinois, Kentucky, Michigan, and Ohio.
Capital and Largest City
Indianapolis is the capital and largest city in the state of Indiana.
Land Area
Greencastle has a total area of 4.35 square miles.
Infrastructure
Greencastle has a public library, a community center, parks, and recreational facilities. The main road through Greencastle is U.S. Route 231.
Population Statistics
Total Population
The population of Greencastle was 10,326 at the 2010 census.
Gender
As of the 2010 census, there were 4,882 males (47.3%) and 5,444 females (52.7%).
Age Brackets
- 21.3% under 18
- 7.4% aged 18 to 24
- 24.5% aged 25 to 44
- 22.9% aged 45 to 64
- 23.8% 65 years and over
Occupations
The largest industries are education, healthcare, retail trade, and construction. The city is home to DePauw University so higher education plays a major role in the local economy.
