Rules and Regulations
Jamaica, Queens County follows federal and state laws that regulate licensing and operations of substance use treatment facilities including methadone clinics. Clinics must meet standards around medication dispensing, counseling, infection control, etc.
Certification Procedures
- Opioid treatment programs must be certified by SAMHSA and accredited by an organization approved by SAMHSA
- Staff must meet educational and licensing criteria
Benefits of Medication-Assisted Treatment
- Methadone and buprenorphine effectively treat opioid addiction when used as prescribed
- Reduce opioid cravings and withdrawal symptom
- Support stabilization and harm reduction
How Clinics Operate and Purpose
- Provide methadone, buprenorphine, or other medications to treat opioid addiction
- Offer counseling and behavioral therapies
- Connect patients to community resources and support groups
- The goal is to mitigate withdrawals and reduce the risks of opioid use disorder
Insurance Coverage
Most clinics accept Medicaid and other insurance. Uninsured patients pay out-of-pocket on a sliding fee scale based on income. State funding assistance may be available.
Drug Use in Jamaica
The opioid crisis has been declared a nationwide public health emergency. According to the New York State Department of Health:
- In 2020, there were 2,146 overdose deaths involving opioids in New York State
- Overdose deaths involving prescription opioids have stabilized in recent years
- Deaths involving illicit opioids such as heroin and fentanyl continue to increase
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 provides services for several hours a day and allows patients to return home afterward. It includes counseling, group therapy, medication management, and recovery support.
Treatment Level Unreported
An estimated 10% of treatment facilities did not report their treatment level data. However, experts estimate the majority of these provide outpatient services.
Comparison of Treatment Availability
| City | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| New York City | 272 | 1,582 | $10,000/month |
| Newark, NJ | 36 | 245 | $7,500/month |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and prevent withdrawal symptoms. It binds to opioid receptors in the brain, reducing cravings and blocking the euphoric effects of other opioids. As medication-assisted treatment (MAT), methadone is dispensed through opioid treatment programs (OTPs) that provide counseling and monitoring of patients. The goal is to stabilize patients so they can function without using illegal opioids.
Societal perspectives on methadone treatment are mixed. Some view it as simply replacing one addiction with another. However, research shows MAT with methadone significantly reduces opioid use, infectious disease transmission, and crime when patients are retained in treatment. For the individual, MAT provides stability and a chance for a productive life. For society, it reduces public health/safety threats from opioid addiction. Still, the diversion of methadone for misuse and overdose risk if combined with other substances means careful patient monitoring is essential.
Methadone Distribution
OTPs providing methadone MAT have strict federal and state regulations to prevent diversion and ensure patient progress:
- Urine Testing: Patients undergo frequent random urine tests for opioids and other drugs. In the first year, federal regulations require at least 8 random tests. Additional tests can be required for individual patients based on need.
- Take-Home Restrictions: For the first 90 days of treatment, patients must take methadone at the clinic daily with no take-home doses allowed, to reduce the risk of diversion or overdose. After 90 days take-homes are allowed for stable patients showing progress, but limited to 27 take-home days per year in the first 2 years of treatment.
- Interprofessional Team Monitoring: Federal regulations require OTPs to have an interdisciplinary team including a medical director, counselors, nurses, and administrative staff to coordinate care and monitor patient progress.
- Prescription Drug Monitoring: Clinicians should review their state’s Prescription Drug Monitoring Program (PDMP) data when titrating methadone doses to verify other prescriptions and avoid dangerous drug interactions. Methadone has a narrow therapeutic index so the dose must be carefully managed.
As an example, in Jamaica, Queens County, New York methadone is a DEA Schedule II Prescription Only Medication allowed only for OTP treatment of opioid addiction per state and federal laws.
Methadone Treatment Effectiveness Research
Methadone has over 70 years of medical research supporting its effectiveness as a medication-assisted treatment for opioid use disorder since first used in 1947.
Studies show methadone MAT is highly effective in reducing illicit opioid use based on drug tests and self-reports. Patients on MAT have 33% fewer opioid-positive urine tests. They are also 4.44 times more likely to stay retained in treatment compared to non-medication treatment. Staying in treatment is crucial because it greatly reduces the risks of overdose death and disease transmission that come from using illegal opioids. MAT with methadone or buprenorphine cuts the all-cause mortality rate among opioid addiction patients by half or more. It also increases the chances of gaining stable employment.
However, methadone does carry risks including possible cardiac issues like QT prolongation. There is also potential for misuse and diversion. As an opioid agonist, methadone can cause severe withdrawal if stopped suddenly. Most dangerously, methadone can cause fatal respiratory depression if combined with alcohol, benzodiazepines, or other sedatives. Careful patient monitoring and coordination of care between providers is crucial to prevent adverse events.
In terms of effectiveness, research shows methadone and buprenorphine are essentially equivalent to reducing illicit opioid use when used correctly for MAT.
Overall the benefits of MAT for treating opioid use disorder are well proven, but so are the potential harms if not properly managed, making it essential to follow strict protocols.
About Jamaica
Location, County & List of Neighboring States
Jamaica is a neighborhood located in the borough of Queens in New York City. Queens County, commonly known as Queens, is one of the five boroughs comprising New York City. It shares borders with:
- New York County (Manhattan) to the west
- Bronx County (The Bronx) to the north
- Kings County (Brooklyn) to the southwest
- Nassau County to the east
Capital and Largest City
New York City is Jamaica’s capital and largest city.
Land Area
Queens covers an area of approximately 178 square miles.
Population Statistics
The population of Jamaica is estimated at 208,972 as of 2017.
Total Population
There are over 2 million residents in Queens County as per the 2020 census.
Demographics
Gender
As of the 2010 census, there were 1,081,738 females (51.8%) and 1,005,578 males (48.2%) in Queens.
Age Brackets
Over 15% of residents in Jamaica fall in the 45-65 years age group. Around 22% are under 18 years old.
Occupations
According to data from the U.S. Census Bureau, the most common occupations for Jamaica residents include office support, sales, healthcare, transportation, education, and food service.
