Rules and Regulations
North Bethesda, Montgomery County, Maryland, 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 certain standards.
Certification Procedures
To be certified, methadone clinics must:
- Be accredited and licensed
- Follow federal and state regulations
- Provide counseling and other services alongside medication
- Maintain patient records and confidentiality
Benefits of Medication-Assisted Treatment
Methadone and other medication-assisted treatments for opioid addiction can:
- Reduce opioid cravings and withdrawal symptoms
- Allow people to focus on their recovery and rehabilitation
- Lower the risk of overdose and transmission of diseases
- Help people gain stability so they can work, go to school, and maintain relationships
How Clinics Operate and Their Purpose
Methadone clinics provide daily doses of methadone to treat opioid dependence. Clinics offer counseling, drug testing, and other support services. The goal is to help individuals recover and live healthy, productive lives.
Insurance Coverage
Many clinics accept Medicaid, Medicare, and private insurance. Some clinics offer free or low-cost treatment based on income. Public and private insurance policies often cover methadone treatment to varying degrees. Patients should check with their provider for specific coverage details. Some clinics offer financial assistance or payment plans for uninsured patients.
Drug Use in North Bethesda
Opioid Crisis Declared Public Health Emergency
In 2017, the opioid crisis was declared a public health emergency in the United States. Data shows that drug overdoses are now the leading cause of death for Americans under 50 years old.
Statistics on Drug Overdoses and Deaths
- In 2020, there were 2,021 drug overdose deaths in Maryland, a 9.1% increase from 2019.
- Montgomery County, MD specifically saw a 35% increase in overdose deaths from 2019 to 2020.
- The most common drugs involved in overdoses in Maryland are fentanyl and heroin.
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months typically. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.
Outpatient Treatment
Outpatient treatment involves periodically visiting a facility for services like therapy, group counseling, and medication management. It allows the patient to live at home.
Treatment Level Unreported
An estimated 10% of treatment facilities do not report their treatment level. However, research shows effective treatment often combines both inpatient and outpatient.
Comparison of Treatment in North Bethesda vs. Washington, D.C.
| City | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| North Bethesda, MD | 15 | 250 | $15,000/month |
| Washington, D.C. | 25 | 400 | $20,000/month |
Methadone Treatment
What is Methadone
Methadone is a medication used in medication-assisted treatment (MAT) for opioid use disorder. It is an opioid agonist that binds to the same receptors in the brain as opioids like heroin or prescription painkillers. Methadone helps prevent withdrawal symptoms and reduces cravings for other opioids. It is typically administered orally in liquid or tablet form once daily and dispensed through opioid treatment programs (OTPs). Patients must visit an OTP clinic daily to receive their dose of methadone under supervision. The goal of MAT with methadone is to provide a safer, controlled dose of opioids to reduce the harm of illicit opioid use and support recovery.
Methadone Distribution
Methadone distribution through OTPs is heavily regulated to prevent misuse and diversion of the medication. Patients undergo urine drug testing at least 8 times in the first year of treatment to ensure they are taking their prescribed methadone dose and not using illicit substances. Restrictions are also placed on take-home doses of methadone. For the first 14 days of treatment, patients can only receive a maximum 24-hour supply to take home. As treatment progresses and the patient demonstrates stability, more take-home doses may be allowed, but this is carefully monitored. OTPs utilize an interprofessional team including physicians, nurses, counselors, and social workers to comprehensively manage patient treatment.
Clinicians prescribing methadone are also required to regularly check their state’s prescription drug monitoring program (PDMP) database to ensure safe opioid prescribing and prevent dangerous drug interactions. For example, in Maryland methadone is a Schedule II controlled substance requiring extra precautions.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947 and extensive research demonstrates its effectiveness when properly prescribed and monitored. Studies show that methadone significantly reduces illicit opioid use compared to no medication. Patients in MAT with methadone have 33% fewer opioid-positive drug tests. They are also 4.44 times more likely to stay in treatment, which reduces their risk of overdose and disease transmission while increasing employment opportunities.
However, methadone does come with risks requiring careful oversight. There is potential for misuse and diversion of methadone, especially during the initiation of treatment. Patients who attempt to taper methadone too quickly also experience severe withdrawal symptoms. Methadone can cause QTc prolongation and cardiac issues in some patients. It also carries a risk of respiratory depression and overdose when combined with certain substances like benzodiazepines.
In comparison to other MAT medications, methadone, and buprenorphine are equally effective for reducing illicit opioid use and supporting recovery. However, buprenorphine has a lower risk of overdose and fewer regulations attached to its prescribing.
In conclusion, methadone is a well-researched medication for opioid addiction but requires strict monitoring and safety precautions to prevent complications. The benefits of reduced opioid use and improved outcomes must be weighed carefully against the risks.
About North Bethesda
North Bethesda is a census-designated place in Montgomery County, Maryland, United States. It is located just northwest of Washington, D.C.
Neighboring states:
- Virginia
- West Virginia
- Pennsylvania
- Delaware
Capital and Largest City
The capital and largest city of Maryland is Baltimore.
Land Area
North Bethesda has a total area of 9.4 square miles.
Infrastructure
North Bethesda has a major road, Democracy Boulevard, that runs through it. The Washington Metro Red Line serves North Bethesda with the White Flint station.
Population Statistics
According to the 2020 census, North Bethesda has a population of 51,974 people.
Gender
- Male: 25,248 (48.6%)
- Female: 26,726 (51.4%)
Age Brackets
- Under 18 years: 8,252 (15.9%)
- 18 to 64 years: 33,030 (63.6%)
- 65 years and over: 10,692 (20.6%)
Occupations
The most common occupations in North Bethesda are management, business, science, arts, sales, office, production, transportation, material moving, maintenance, repair, production, healthcare practitioners, technologists, education, training, library, construction, extraction, installation, maintenance, and repair.
