Methadone Clinics in Kansas City

Rules and Regulations

Kansas City, along with Jackson County and the state of Missouri, has strict regulations regarding methadone clinics and medication-assisted treatment programs outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA).

Certification Procedures

All clinics must be certified by SAMHSA and licensed by the DEA. Staff must undergo background checks and extensive training. Clinics must meet security, counseling, and dosing requirements.

Benefits of Medication-Assisted Treatment

• Reduces illicit opioid use and overdose deaths
• Improves patient survival and retention in treatment
• Increases patients’ ability to gain and maintain employment
• Improves birth outcomes for pregnant women with opioid use disorder

How Clinics Operate

Methadone clinics provide methadone and other medication-assisted treatment to people diagnosed with an opioid use disorder. The medication blocks the euphoric effects and withdrawal symptoms associated with opioids. Clinics provide counseling, and case management, and connect patients to social services.

Insurance Coverage

Public and private insurance plans, including Medicaid and Medicare, cover methadone treatment. Some clinics operate on an income-based sliding scale for uninsured patients.

Drug Use in Kansas City

Missouri has seen rising rates of opioid overdoses and deaths in recent years, leading to a public health emergency declaration in 2017. Key statistics include:

• In Jackson County specifically, there were 310 opioid overdose deaths in 2020, a 45% increase from 2017 levels.
• Across Missouri, prescription opioid deaths rose to 518 in 2020 from 232 in 2012. Illicit opioid deaths hit 722 in 2020 from 120 in 2012.
• Alcohol and methamphetamine are also widely used substances in the state.

Addiction Treatment Overview

Inpatient Treatment

Inpatient facilities provide round-the-clock supervised care including detoxification, individual and group counseling, medication management, and aftercare planning. Typical stays range from 30-90 days.

Outpatient Treatment

Outpatient programs offer similar services to inpatient but allow the individual to live at home. Frequency of services ranges from weekly to daily depending on patient needs. Many outpatient programs are located within hospitals or community mental health centers.

Treatment Level Unreported

Due to limited reporting, estimates suggest at least 100,000 Missouri residents need but are not receiving any addiction treatment annually. Significant gaps remain in treatment availability statewide.

Comparison of Treatment in Kansas City, Missouri vs. St. Louis

Methadone Treatment

What is Methadone

Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) programs, also known as opioid treatment programs (OTPs). It binds to opioid receptors and reduces cravings and withdrawal symptoms, allowing patients to focus on recovery.

Societal Perspectives on Methadone Treatment

There are mixed societal attitudes towards methadone treatment. Some view it positively as an evidence-based treatment for opioid addiction. Others remain skeptical of “replacing one drug with another” or enabling addiction. Stigma can deter people from seeking this form of MAT. Education on the scientifically-proven benefits may help address misconceptions.

Methadone Distribution

Methadone distribution is strictly monitored and regulated:

• Urine testing: Methadone maintenance patients must undergo at least eight urine drug tests in the first year of treatment to detect any unauthorized drug use.
• Take-home requirements: During the first 14 days, take-home supply is limited to a 24-hour dose used onsite daily. More take-home doses are allowed over time if progress demonstrated.
• Monitoring Methadone treatment programs have an interprofessional team overseeing treatment including counseling, urine tests, etc.
• Prescription drug monitoring: Clinicians should review PDMP data to carefully cross-reference other opioid prescriptions with methadone dosage due to its narrow therapeutic window.

In Kansas City, methadone is a Schedule II Controlled Substance with dispensing regulations overseen by the Drug Enforcement Agency and state agencies.

Methadone Treatment Effectiveness Research

Methadone is an effective MAT for opioid use disorder used since 1947. Studies demonstrate methadone:

• Reduces opioid use based on 33% fewer opioid-positive drug tests
• Improves retention rates, with methadone patients 4.44 times more likely to stay in treatment
• Lowers risk of overdose and disease transmission through retention in treatment
• Increases employment opportunities with treated addiction

However, methadone does carry risks:

• Potential for misuse and diversion
• Severe withdrawal if stopped suddenly
• QTc prolongation and cardiac issues
• Respiratory depression/overdose when combined with other substances

Methadone has comparable efficacy to buprenorphine in reducing illicit opioid use in patients. However, it requires careful management by a specialized OTP team given additional risks.

About Kansas City

Location, County & List of Neighboring States

Kansas City is located in Jackson County in western Missouri, bordering Kansas. The neighboring states are:

• Kansas
• Oklahoma
• Arkansas
• Iowa
• Nebraska
• Illinois

Capital and Largest City

Kansas City is the largest city in Missouri with a population of over 500,000 residents.

Land Area

The land area of Kansas City, Missouri is 319 square miles.

Infrastructure

Kansas City has an international airport and is a major railroad hub. The city has an extensive highway system and public transportation including buses and light rail.

Population Statistics

Total Population

The population of Kansas City, Missouri is over 500,000 residents.

Demographics:

Gender

• Male: 49%
• Female: 51%

Age Brackets

• Under 18 years: 22%
• 18 to 65 years: 63%
• Over 65 years: 15%

Occupations

The major industries and occupations in Kansas City include:

• Services: 48%
• Finance, insurance and real estate: 20%
• Trade: 15%
• Government: 10%
• Manufacturing: 7%