Rules and Regulations
Saipan adheres to strict federal and local regulations regarding substance abuse treatment programs, including methadone clinics, as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Commonwealth Healthcare Corporation.
Certification Procedures
- Clinics must be certified by SAMHSA
- Staff must meet educational and licensing requirements
- Programs must offer counseling and case management
Benefits of Medication-Assisted Treatment
- Reduces opioid cravings and withdrawal
- Supports long-term recovery
- Improves health and wellness
How Clinics Operate and Their Purpose
Methadone clinics provide medication, counseling, and support to those recovering from opioid addiction. The highly regulated medications relieve withdrawal symptoms and drug cravings without inducing a high, allowing people to focus on their recovery.
Insurance Coverage
- Medicaid covers methadone treatment
- Some private insurers cover treatment
- Grant funding supports uninsured patients
Drug Use in Saipan
In 2017, the Governor of the Northern Mariana Islands declared the opioid crisis a public health emergency.
Statistics on Drug Overdoses and Deaths
- In 2016, there were 34 drug overdose deaths in the Northern Mariana Islands.
- The overdose death rate was 10 per 100,000 persons.
Addiction Treatment Overview
Inpatient Treatment
Typically 28 days, with detox, counseling, behavioral therapies, medication, and discharge planning.
Outpatient Treatment
1-5 days per week for 1-6 months, with counseling, therapy, and medication management.
Treatment Level Unreported
Estimates from the White House and SAMHSA indicate approximately 15% of those needing treatment do not access formal programs. Some may receive support from mutual aid groups.
Compares Addiction Treatment Resources Between Saipan and Agana
| City | Treatment Facilities | Inpatient Beds | Approx. Treatment Cost |
| Saipan, Saipan County | 3 | 25 beds | $5,000 – $10,000 |
| Agana, Guam | 5 | 50 beds | $7,000 – $15,000 |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used in medication-assisted treatment (MAT) for opioid use disorder. It helps prevent withdrawal symptoms and cravings for other opioids by activating opioid receptors in the brain without causing the same level of euphoria or high as illicit opioids. Methadone maintenance treatment (MMT) involves daily doses of methadone dispensed through opioid treatment programs (OTPs) to provide a legal, safe source of the medication under medical supervision.
Methadone activates the same opioid receptors as drugs like heroin or oxycodone, which reduces cravings and blocks the euphoric effects of other opioids. The OTP model provides methadone doses daily for stable blood levels, along with counseling and other services to support recovery. Frequent urine drug screens and gradually earned take-home doses help ensure compliance.
Though it is an evidence-based treatment, methadone maintenance is controversial with some seeing it as merely “replacing one drug with another.” However, research shows MMT helps people recover functioning lives. With proper medical oversight, methadone reduces opioid overdoses, disease transmission, and crime compared to continued illicit opioid use.
Simply put, methadone tricks the brain into thinking it is still getting the problem opioid by activating the same receptors. This stops withdrawal and cravings. The patient takes a daily dose in liquid form at the clinic, which provides medical supervision. With time, stable patients can earn take-home doses as a privilege for compliance.
Methadone Distribution
Description of monitoring and regulations:
- Urine testing: Methadone maintenance patients must undergo at least eight tests in the first year of treatment.
- Take-home requirements: During the first 14 days of treatment, the take-home supply of methadone is limited to a 24-hour supply.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and counselors to monitor patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid medications a patient receives, as methadone has a narrow therapeutic window.
In Saipan methadone is a Schedule II controlled substance requiring extra prescribing regulations like PDMP checks and OTP distribution.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947.
Evidence for Effectiveness
Studies show methadone reduces opioid use, disease transmission, and crime. Patients had 33% fewer opioid-positive drug tests and were 4.44 times more likely to stay in treatment. Retention in treatment reduces overdose/disease transmission risk and increases employment.
Major Drawbacks
Potential for misuse/diversion exists. Severe withdrawal if stopped suddenly. Possible QTc prolongation or cardiac issues. Respiratory depression or overdose can occur if combined with other substances.
Comparison to Other Medications
Equally effective as buprenorphine for reducing opioid use.
Benefits but also risks requiring careful management.
About Saipan
Location, Saipan County & Neighboring States
Saipan is one of the Northern Mariana Islands, a U.S. commonwealth in the western Pacific Ocean. The Northern Mariana Islands are located north of Guam. Saipan is governed as a single municipality, Saipan County.
Saipan is the largest and most populated island in the Northern Mariana Islands chain. The islands neighboring Saipan include Tinian, Rota, Farallon de Medinilla, Anatahan, Sarigan, Guguan, Alamagan, Pagan, Agrihan, Asuncion, Maug Islands, and Farallon de Pajaros.
Capital and Largest City
The capital and largest city of the commonwealth is Capitol Hill, Saipan.
Land Area
Saipan’s land area measures approximately 44.55 square miles.
Population Statistics
The population of Saipan as of the 2020 census was 48,220.
Demographics
- Gender: The island has slightly more males (51.1%) than females (48.9%).
- Age Brackets: Approximately 29.3% of the population is under age 18. Around 59.7% are aged 18 to 64. The remaining 11% are aged 65 or older.
Occupations
Major industries include tourism, construction, banking services, transportation, retail, healthcare, education and local government. Popular jobs include hotel & food positions, landscaping, childcare and tradespeople.
