Methadone Clinics in Durham

Rules and Regulations

Durham, Durham County, North Carolina, 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).

Certification Procedures

To be certified, clinics must meet SAMHSA standards for patient admission, treatment planning, counseling services, drug testing, diversion control, and record keeping. Staff must complete specialized training. Clinics are inspected routinely.

Benefits of Medication-Assisted Treatment

Methadone helps opioid addicts stabilize, reduce opioid cravings, and avoid withdrawal symptoms so they can focus on recovery. It is taken under medical supervision for optimal safety and effectiveness. Research shows that medication-assisted treatment improves patient survival rates and recovery outcomes.

How Clinics Operate and Their Purpose

Clinics provide daily supervised methadone dosing, addiction counseling, case management, and other services to support patient recovery. Treatment is customized to each patient’s needs. The ultimate purpose is to help patients achieve sobriety and restored health.

Insurance Coverage

Many clinics accept Medicaid, Medicare, and private insurance. Some clinics offer free or low-cost treatment based on patient income. Public and private insurance policies increasingly provide coverage for medication-assisted opioid addiction treatment.

Drug Use in Durham

Opioid crisis declared public health emergency

• In 2017, there were 353 opioid-related overdose deaths in North Carolina, a rate of 12.9 deaths per 100,000 persons compared to the national rate of 14.6.
• Heroin overdose deaths increased from 258 in 2016 to 343 in 2017.
• Synthetic opioids excluding methadone (mainly fentanyl) caused the most overdose deaths in the state.

Addiction Treatment Overview

Inpatient Treatment

Inpatient treatment involves living at a treatment facility for 30-90 days. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.

Outpatient Treatment

Outpatient treatment involves attending treatment sessions 1-5 times per week for 1-6 hours per day. It includes counseling, group therapy, medication management, and recovery support services.

Treatment Level Unreported

An estimated 10-20% of treatment facilities do not report treatment levels. These are often small counseling practices or court-mandated programs.

Comparison of Treatment in Durham vs. Raleigh, NC

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 activates opioid receptors and reduces cravings and withdrawal symptoms. Methadone is taken orally once daily and administered through opioid treatment programs (OTPs). Patients must visit an OTP clinic daily to receive their dose.

Societal perspectives on methadone treatment are mixed. Some view it as lifesaving addiction treatment, while others see it as merely replacing one opioid addiction with another. However, research shows methadone helps patients stop using illegal opioids, avoid painful withdrawal symptoms, and live healthier lives. When taken as prescribed, methadone is safe and non-euphoric. It allows patients to function normally without the compulsion to seek out and use opioids.

Methadone Distribution

Methadone distribution is highly regulated to prevent misuse and diversion:

• Urine testing: Patients must undergo at least eight urine tests for illicit drugs in the first year of treatment. This ensures they are taking methadone as directed and not using other opioids or substances.
• Take-home requirements: For the first 14 days of treatment, methadone doses can only be consumed on-site at the clinic. After 90 days of compliance, patients can earn take-home doses.
• Monitoring: Methadone programs have an interprofessional team including doctors, nurses, and counselors to monitor patient progress.
• Prescription drug monitoring: Clinicians check the state’s prescription drug monitoring program (PDMP) to ensure safe methadone dosage and prevent dangerous drug interactions.

In Durham, methadone is a Schedule II controlled substance requiring a prescription.

Methadone Treatment Effectiveness Research

Methadone is an effective medication for treating opioid use disorder that has been used since 1947. Studies show methadone reduces opioid use, disease transmission through injection, and drug-related crime. Patients on methadone have 33% fewer opioid-positive drug tests than untreated patients. They are also 4.44 times more likely to stay in treatment, which reduces overdose risk and increases employment.

However, methadone does have risks requiring careful management. Potential for misuse and severe withdrawal symptoms if stopped suddenly. Methadone can also prolong the QTc interval, increasing cardiac issues. Especially risky is combining methadone with other substances like benzodiazepines, which increases respiratory depression and overdose deaths.

Compared to other medications like buprenorphine, methadone is equally effective for reducing illicit opioid use in patients. With careful monitoring and management, methadone’s benefits can outweigh its risks for many opioid use disorder patients.

About Durham

Location, County & List of Neighboring States

Durham is located in Durham County in the U.S. state of North Carolina. It is surrounded by the following counties: Orange, Wake, Chatham, and Person. Durham is part of the Research Triangle metropolitan region, along with Raleigh and Chapel Hill.

Capital and Largest City

Durham is the county seat and largest city in Durham County.

Land Area

Durham has a total area of 108.1 square miles.

Infrastructure

Durham is home to many major research universities, including Duke University and North Carolina Central University. The city has a public transit system called GoDurham. Major highways include I-85 and I-40.

Population Statistics

Total Population

The population of Durham is 278,993 as of 2019.

Demographics:

Gender

• Male: 47.7%
• Female: 52.3%

Age Brackets

• Under 18 years: 21.9%
• 18 to 64 years: 69.3%
• 65 years and over: 8.8%

Occupations

Major occupations in Durham include healthcare, education, and technology. Top employers are Duke University and Health System, IBM, Durham Public Schools, and the city and county of Durham.