Rules and Regulations
Canterbury, Merrimack County, New Hampshire, United States adheres to strict regulations regarding methadone clinics, outlined by the New Hampshire Department of Health and Human Services.
Certification Procedures
- Methadone clinics must be certified by the State Opioid Treatment Authority and accredited by an approved accreditation body.
- Staff must meet educational and licensing requirements.
- Regular inspections are conducted.
Benefits of Medication-Assisted Treatment
Methadone and other medications help treat opioid addiction and prevent withdrawal and cravings.
Medication-assisted treatment has been shown to:
- Reduce illicit opioid use
- Improve survival rates
- Increase retention in treatment
- Decrease criminal activity
- Increase employment
How Clinics Operate and Their Purpose
Methadone clinics provide medication-assisted treatment to help individuals recover from opioid addiction. Patients receive methadone doses under medical supervision as part of a comprehensive treatment plan including counseling and other services.
Insurance Coverage
- Many insurance plans, including Medicaid and Medicare, cover methadone treatment. Some clinics also offer free or low-cost treatment.
- Some clinics offer free methadone treatment based on financial need. Patients without insurance may qualify.
Drug Use in Canterbury
The opioid crisis has been declared a nationwide public health emergency. In New Hampshire, drug overdoses have increased exponentially in recent years.
- In 2016, there were 437 drug overdose deaths in NH, with opioids involved in 81% of cases.
- Fentanyl has become increasingly prevalent, found in almost 3/4 of opioid-related deaths.
- Other commonly abused substances include heroin, prescription pain relievers, and cocaine.
Addiction Treatment Overview
Inpatient Treatment
Typically, 28 days, with medically supervised detox, counseling, group therapy, education, and aftercare planning. Provides 24/7 structured care.
Outpatient Treatment
Varies from 1 to 5 days per week for 1–6 hours, providing counseling, therapy, and support groups. Patients live at home.
Treatment Level Unreported
Approximately 40% of patients nationwide receive a mix of inpatient, outpatient, and other treatment services.
Comparison of Treatment in Canterbury vs. Concord
| City | Facilities | Inpatient Beds | Cost |
| Canterbury, NH | 2 | 18 | $10,000/month |
| Concord, NH | 5 | 150 | $15,000/month |
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 in opioid treatment programs (OTPs) that provide comprehensive treatment and monitoring. Methadone occupies opioid receptors, preventing withdrawal and cravings without inducing euphoria. It allows patients to stabilize, improve functioning, and reduce illicit opioid use.
Societal perspectives on methadone are mixed. Some view it negatively as simply replacing one opioid with another. However, research shows MAT with methadone is associated with reduced mortality, crime, and transmission of HIV/HCV compared to no treatment. It enables patients to hold jobs, secure housing, and reconnect with families. Still, stigma remains a barrier. Education is needed, so society understands MAT is legitimate medical treatment, not “substituting one addiction for another.”
Methadone Distribution
OTP programs providing methadone must follow strict federal and state regulations to prevent misuse and diversion:
- Urine testing: Patients undergo randomized urine drug screens at least 8 times in the first year to ensure compliance.
- Take-home doses: Limited to a 1-day supply for the first 2 weeks of treatment, with gradual increases in take-homes based on time in treatment and progress.
- Monitoring: Interprofessional teams of doctors, counselors, and nurses oversee dosing, urine screens, counseling, and coordination of care.
- Prescription monitoring: Clinicians check the state prescription drug monitoring program (PDMP) when determining dosage, due to risks like QTc prolongation.
In New Hampshire, methadone is a Schedule II controlled substance requiring a prescription. In Merrimack County, methadone accounted for 22% of OTP admissions in 2020.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show it is an effective MAT option.
Evidence for Effectiveness
Multiple studies demonstrate methadone reduces opioid use, infectious disease transmission, criminal activity, and mortality compared to no treatment:
- 33% fewer opioid-positive drug tests for methadone patients
- 4.44 times more likely to stay in treatment vs. non-medication treatments
- Retention in treatment reduces overdose risk and improves employment
Major Drawbacks
However, methadone does carry risks requiring careful management:
- Potential for misuse/diversion requires OTP structure
- Sudden discontinuation can cause severe withdrawal
- Can prolong the QTc interval on EKGs, causing cardiac issues
- Still an opioid, so can cause respiratory depression and overdose, especially when combined with other substances
Comparison to Other Medications
Research shows methadone and buprenorphine are equally effective for reducing illicit opioid use and retaining people in treatment.
Methadone is beneficial but also has risks, requiring strict oversight.
About Canterbury
Canterbury is located in Merrimack County in central New Hampshire. It borders the cities of Loudon, Gilmanton, Belmont, and Tilton. The neighboring states are Maine, Massachusetts, and Vermont.
Capital and Largest City
Concord is the capital and largest city in New Hampshire.
Land Area
Canterbury has a total area of 43.1 square miles, of which 42.2 square miles is land and 0.9 square miles is water.
Infrastructure
Canterbury has a public library, elementary school, town hall, post office, and several local parks. The town is connected to major highways like Interstate 93.
Population Statistics
As of the 2020 census, the population of Canterbury was 2,352.
Gender
The gender breakdown is 49% male and 51% female.
Age Brackets
The median age is 42.3 years old. The age breakdown is:
- Under 18 years old: 19%
- 18 to 64 years old: 61%
- 65 years and older: 20%
Occupations
The top occupations are education, healthcare, retail, construction, and manufacturing. Many residents commute to nearby cities for work.
