Rules and regulations
Sandwich, Barnstable County, Massachusetts, USA 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
- Clinics must be certified by SAMHSA and licensed by the state.
- Staff must meet educational and licensing requirements.
- Regular patient drug testing and counseling are mandated.
Benefits of medication-assisted treatment
- Methadone reduces opioid cravings and withdrawal symptoms.
- It allows people to focus on their health and participation in positive activities.
- Methadone therapy is proven to decrease illicit opioid use, criminal activity, and transmission of infectious diseases.
How clinics operate and their purpose
- Clinics provide methadone doses for opioid addiction treatment.
- Take-home doses may be allowed after patients demonstrate progress.
- Counseling and social services are offered to support recovery.
- The goal is to help people gain control of their lives and reintegrate into society.
Insurance Coverage
- Medicaid and Medicare cover methadone treatment.
- Private insurance often covers treatment, but copays and limits may apply.
- Sliding-scale fees are available at some clinics based on income.
Drug Use in Sandwich
Opioid crisis declared public health emergency
- In 2017, President Trump declared the opioid epidemic a public health emergency. Massachusetts has been hit hard by the crisis.
Statistics on drug overdoses and deaths
- In 2020, there were 2,104 opioid-related overdose deaths in Massachusetts, up from 1,981 in 2019.
- Barnstable County had 134 opioid-related deaths in 2020.
Data on prevalence of different substances
- The most commonly cited drugs in opioid deaths in Massachusetts are fentanyl and heroin. Methamphetamine and cocaine are also prevalent.
Addiction Treatment Overview
Inpatient Treatment
- Inpatient treatment involves staying at a rehab facility 24/7 for 1-3 months. It includes medical detox, counseling, group therapy, etc.
Outpatient Treatment
- Outpatient treatment involves visiting a treatment center up to 5 days a week for several hours a day over a period of weeks or months.
Treatment Level Unreported
- An estimated 10% of addiction treatment in Massachusetts is unreported.
Comparison of Treatment in Sandwich vs. Boston
City | Treatment Centers | Inpatient Beds | Cost of Treatment |
Sandwich | 2 | 50 | $10,000-30,000 |
Boston | 12 | 300 | $15,000-40,000 |
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 monitoring of patients.
- Methadone relieves withdrawal symptoms and cravings by activating opioid receptors like heroin or prescription opioids, but it does so in a slower, less euphoric way. This allows patients to function normally and focus on recovery.
- There is stigma around methadone as just “replacing one drug with another.” However, research shows methadone helps patients stay in treatment, reduce opioid use, and improve social functioning when properly monitored. Still, diversion and misuse do occur and can lead to overdose. Careful patient selection and oversight are needed.
- Methadone tricks the brain into thinking it is still getting the problem opioid by fitting into the same brain receptors and stopping withdrawal sickness. This helps people stop or cut down on problem opioid use.
Methadone Distribution
Methadone treatment has strict monitoring:
- Urine testing: Patients get at least 8 urine tests in the first year to check for ongoing drug use.
- Take-home doses: For the first 14 days, patients must take methadone at the clinic daily. After that, take-home doses are allowed for stable patients who follow program rules.
- Oversight: Methadone clinics have doctors, counselors, and nurses to monitor patient progress and methadone use.
- Prescription monitoring: Doctors check the state prescription database before prescribing methadone to ensure safe dosing and prevent interactions with other medications.
In Massachusetts, methadone is a Schedule II controlled substance that can only be dispensed to patients enrolled in a licensed opioid treatment program.
Methadone Treatment Effectiveness Research
- Methadone has been used to treat opioid addiction since 1947.
Studies find methadone helps reduce opioid use, HIV risk behaviors, and criminal activity when used as prescribed.
- Methadone patients have 33% fewer opioid-positive urine drug tests.
- They are also 4.44 times more likely to stay in treatment compared to non-medication approaches.
- Staying in treatment is crucial to prevent return to opioid use, overdose risk, and disease transmission from injection drug use.
However, methadone does have risks:
- There is potential for misuse and diversion of methadone.
- Stopping methadone suddenly can lead to severe withdrawal.
- It can cause QTc prolongation and cardiac issues in some patients.
- Combining methadone with other substances like benzodiazepines increases the risk of overdose and respiratory depression.
- Careful patient selection and monitoring are essential.
Comparison:
- Methadone and buprenorphine are equally effective for reducing illicit opioid use in patients who take them as prescribed.
Conclusion:
- Methadone is beneficial but also has risks requiring careful management.
About Sandwich
Location, county & list of neighbouring states
Sandwich is located in Barnstable County on Cape Cod in the state of Massachusetts. It is bordered by the following towns:
- Bourne to the west
- Mashpee to the east
- Falmouth to the south
Capital and largest city
The town of Sandwich is the capital and largest city in the town.
Land area
Sandwich has a total area of 44.3 square miles, of which 35.0 square miles is land and 9.4 square miles is water.
Infrastructure
Population Statistics
Total population
The population of Sandwich is 20,675 as of the 2010 census.
Demographics:
Gender
- Male: 10,064 (49%)
- Female: 10,611 (51%)
Age brackets
- Under 18 years: 19.7%
- 18 to 64 years: 59.3%
- 65 years and over: 21.0%
Occupations
The top occupations in Sandwich are:
- Management, business, science, and arts: 34.2%
- Sales and office: 24.8%
- Service: 18.9%
- Production, transportation, and material moving: 11.4%
- Natural resources, construction, and maintenance: 10.7%
