Rules and Regulations
Clarksville and Montgomery County follow state and federal laws regulating medication-assisted treatment (MAT) programs. These laws aim to ensure safe, effective treatment while preventing misuse.
Certification Procedures
Methadone clinics must be certified by the Tennessee Department of Health’s Division of Licensure and Regulation. Certification requirements include staff credentials, security protocols, counseling services, and more. Clinics must renew their license annually.
Benefits of Medication-Assisted Treatment
When combined with counseling and behavioral therapy, MAT can be a very effective component of opioid use disorder treatment. Scientific research has shown MAT reduces illicit drug use and overdose deaths while improving patient health and social functioning. Clinics provide access to vital treatment services and support recovery.
How Clinics Operate
Clinics provide methadone or other approved medications to alleviate withdrawal symptoms, reduce opiate cravings, and block euphoric effects. This allows patients to focus on counseling, behavioral interventions, wellness programs, and recovery. Clinics offer different service models (inpatient, and outpatient) to meet individual needs.
Insurance Coverage
Medicaid and Medicare cover methadone treatment. Private insurers are required under the Mental Health Parity Act to provide coverage comparable to other medical conditions. Uninsured patients may qualify for free or reduced-cost treatment through state and local programs.
Free Clinics
Some nonprofit organizations, such as church groups, operate free methadone clinics relying on grants and private donations to provide care at no cost to uninsured and underinsured patients. These clinics serve as vital resources for low-income populations.
Both public and private insurance policies can include deductibles, copays, pre-authorization requirements, and restrictions on covered services for methadone treatment. Patients should review full policy details to understand their benefits and out-of-pocket costs.
Drug Use in Clarksville
The opioid crisis has been declared a nationwide public health emergency. In Tennessee, in 2020 there were:
- 2,097 overdose deaths, a 45% increase from 2019
- 1,613 involved opioids, up 54%
- 642 involved synthetic opioids like fentanyl, up 65%
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months. It includes medical detox, individual and group counseling, medication management, and aftercare planning.
Outpatient Treatment
Outpatient treatment involves periodic services for 1-2 hours at a time, 1-3 days a week. It may include counseling, therapy, and medication management.
Treatment Level Unreported
An estimated 10-20% of facilities do not report treatment levels to databases. Services may resemble inpatient or outpatient care.
Comparison of Treatment in Clarksville vs Nashville
| Category | Clarksville | Nashville |
| Treatment Facilities | 15 | 25 |
| Inpatient Beds | 300 | 500 |
| Cost of Treatment | $5,000/month | $7,500/month |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and dependence. As medication-assisted treatment (MAT), methadone helps prevent withdrawal symptoms and drug cravings by activating opioid receptors in the brain through a daily oral dose administered under medical supervision. This is known as opioid treatment programs (OTPs) and follows strict federal and state regulations to prevent misuse.
Societal perspectives on methadone treatment are mixed, with some seeing it as merely replacing one addiction with another, while others recognize its medical value in improving outcomes for people with opioid use disorders. When used properly, methadone allows patients to function normally and reduce their use of other illicit or prescription opioids.
Methadone Distribution
Monitoring and regulations for methadone treatment include:
- Urine testing: Methadone maintenance patients must undergo at least eight random tests in the first year of treatment to detect any unauthorized drug use.
- Take-home requirements: During the first 14 days of treatment, the take-home supply of methadone is limited to just a 24-hour dose. After 90 days of compliant treatment, patients may qualify for additional take-home doses.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and counselors to coordinate care.
- Prescription drug monitoring: Clinicians should review their state’s prescription drug monitoring program (PDMP) data to carefully cross-reference any other opioid medications and titrate methadone dosage within the narrow therapeutic window.
In Tennessee, methadone is a Schedule II controlled prescription drug that can only be administered through a licensed OTP.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show methadone treatment is effective in:
- Reducing opioid use, with 33% fewer opioid-positive drug tests
- Retaining patients in treatment 4.44 times more likely than without medication
- Lowering the risk of disease transmission from IV drug use
- Decreasing criminal behavior associated with drug addiction
However, methadone does carry risks:
- Potential for misuse and diversion of medication
- Severe withdrawal if stopped suddenly
- QTc prolongation and cardiac issues
- Respiratory depression and overdose when combined with other substances
About Clarksville
Location, County & List of Neighboring States
Clarksville is located in Montgomery County in the state of Tennessee, United States. Tennessee is bordered by 8 states:
- Kentucky
- Virginia
- North Carolina
- Georgia
- Alabama
- Mississippi
- Arkansas
- Missouri
Capital and Largest City
Nashville is the capital and largest city in Tennessee.
Land Area
Montgomery County covers 567 square miles of land area.
Infrastructure
Clarksville is a city in Montgomery County located on the Cumberland River. It has a population of about 150,000 people and is home to Fort Campbell. The city has highways, railways, an airport, and utilities like electricity, water, and sewer systems to support residents and businesses.
Population Statistics
Total Population
The population of Clarksville is 158,146 (2020 census). The population of Montgomery County is 208,993 (2020 census).
Demographics
Gender
- Male: 49%
- Female: 51%
Age Brackets
- Under 18 years: 23.4%
- 18 to 64 years: 62.9%
- 65 years and over: 13.7%
Occupations
Top occupations in Clarksville:
- Management, business, science, and arts: 31.8%
- Sales and office: 27.2%
- Service: 18.6%
- Production, transportation, and material moving: 14.2%
- Natural resources, construction, and maintenance: 8.2%
