Rules and Regulations:
- Tyner, Jackson County, Kentucky, 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 accredited by an independent accrediting body. Staff must complete required training and clinics must meet standards for quality patient care.
Benefits of Medication-Assisted Treatment
MAT with methadone helps individuals with opioid addiction by:
- Preventing painful withdrawal symptoms
- Reducing opioid cravings
- Allowing patients to focus on counseling and behavioral therapies
- Lowering the risk of overdose
- Improving overall health and social functioning
How clinics operate and their purpose:
- Methadone clinics provide medication-assisted treatment to help individuals recover from opioid addiction. Patients receive methadone doses daily under medical supervision.
- Clinics offer counseling and behavioral therapies to address the psychological aspects of addiction. The ultimate purpose is to help patients achieve sobriety and improved health.
Insurance Coverage
- Medicaid, Medicare, and many private insurance plans cover methadone treatment. Some clinics offer sliding-scale fees based on income for uninsured patients.
- Some non-profit and government-funded clinics provide methadone treatment free of charge to qualifying uninsured, low-income patients.
Drug Use in Tyner
The opioid crisis has been declared a public health emergency in the United States. In Kentucky, drug overdose deaths have increased steadily over the past decade. The most commonly abused substances in Kentucky are prescription opioids, heroin, and fentanyl.
Statistics on Drug Use and Overdoses:
- In 2020, there were 2,250 overdose deaths involving opioids in Kentucky – a 49% increase from 2019.
- The overdose death rate in Kentucky is 37.2 per 100,000 persons, compared to the national rate of 20.6 per 100,000.
- Heroin and fentanyl are involved in over 60% of overdose deaths in Kentucky.
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 provides services for 4-8 hours a day, 3-5 days a week. It includes counseling, therapy, medication management, and recovery support groups.
Treatment Level Unreported
An estimated 10-20% of those with substance abuse disorders in Kentucky receive some form of treatment, according to SAMHSA. Barriers include cost, availability, and social stigma.
Comparison of Treatment in Tyner vs. Lexington
| City | Tyner | Lexington |
| Treatment Centers | 2 | 12 |
| Inpatient Beds | 20 | 300 |
| Cost of Treatment | $10,000/month | $15,000/month |
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 produce the same level of euphoria or high as other opioids when taken as prescribed. Methadone is typically administered orally as a liquid concentrate at opioid treatment programs (OTPs).
- Societal perspectives on methadone treatment are mixed. While it helps stabilize individuals struggling with addiction, some view it as merely replacing one opioid with another. However, research shows methadone significantly improves outcomes when combined with counseling and social support.
- Explanation in layman’s terms: Methadone tricks the brain into thinking it is still getting the problem opioid, preventing withdrawal symptoms. This allows individuals to function normally and focus on recovery.
Methadone Distribution
OTPs providing methadone must follow strict federal and state regulations including:
- Urine testing: Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment to ensure appropriate use and identify additional substance issues.
- Take-home requirements: During the first 90 days of treatment, methadone take-home supplies are limited to a 1-week maximum supply to prevent misuse and diversion. After 2 years of compliance, patients may receive a 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 prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid medications and dosages prescribed, as methadone has a narrow therapeutic window and overdose risk.
For example, Jackson County, Kentucky has a 21.5 per 100,000 population rate of overdose deaths involving methadone based on PDMP and Office of National Drug Control Policy (ONDCP) data.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder that has been used since 1947.
- Studies show methadone reduces opioid use, disease transmission, and crime when combined with counseling and social support.
- Evidence includes 33% fewer opioid-positive drug tests and 4.44 times higher treatment retention rates versus non-medication approaches.
- Retention in treatment reduces overdose and disease transmission risks and increases employment opportunities.
However, methadone does carry risks including the potential for misuse and diversion, severe withdrawal if stopped suddenly, QTc prolongation and cardiac issues, respiratory depression, and overdose when combined with benzodiazepines and alcohol.
It is equally as effective as buprenorphine for reducing illicit opioid use and criminal behavior.
Careful patient selection and monitoring is vital to maximize benefits and minimize harm.
About Tyner
- Tyner is located in Jackson County in the U.S. state of Kentucky.
- Jackson County borders the states of Virginia and Tennessee.
- The capital and largest cities in Kentucky are Frankfort and Louisville, respectively. The land area of Tyner is roughly 0.2 square miles.
Population Statistics
The total population of Tyner is around 115 people.
Gender
- Male: 47.6%
- Female: 52.4%
Age brackets
- Under 18 years: 19.3%
- 18 to 64 years: 56.7%
- 65 years and over: 24.0%
Occupations
- Management, business, science, and arts occupations: 16.7%
- Service occupations: 46.7%
- Sales and office occupations: 20.0%
- Natural resources, construction, and maintenance occupations: 13.3%
- Production, transportation, and material moving occupations: 3.3%
