Rules and Regulations
Nacogdoches, Nacogdoches County, Texas, 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
- Clinics must be certified by SAMHSA and accredited by an independent accrediting body.
- Staff must meet educational and licensing requirements.
- Regular facility inspections are conducted.
Benefits of Medication-Assisted Treatment
- Methadone helps reduce opioid cravings and withdrawal symptoms.
- It allows people to focus on their health and participation in positive life activities.
- Medication-assisted treatment is shown to decrease illicit opioid use, criminal activity, and risk of overdose death.
How Clinics Operate and Their Purpose
- Clinics provide methadone doses for opioid addiction treatment.
- Doses are administered daily under supervision.
- Clinics provide counseling and connect patients to healthcare and social services.
- The goal is to help patients achieve sobriety and better health.
Insurance Coverage
- Medicaid, Medicare, and many private insurances cover methadone treatment.
- Some clinics operate on an out-of-pocket fee basis.
- Low-income patients may qualify for subsidized treatment.
- Some limited free or low-cost treatment is available through publicly funded clinics.
- Eligibility is based on income and other qualifying factors.
- Public funding helps expand access to methadone treatment.
Drug Use in Nacogdoches
Opioid Crisis Declared Public Health Emergency
In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency.
Statistics on Drug Overdoses and Deaths
In 2020, there were 93,331 overdose deaths in the U.S., up 29% from 2019. Overdose deaths from opioids increased from 50,963 in 2019 to 69,710 in 2020.
Data on Prevalence of Different Substances
The most commonly used illicit drugs in 2019 were marijuana, methamphetamine, prescription opioids, cocaine, and heroin.
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months. It includes medical detox, counseling, group therapy, education, and planning for aftercare.
Outpatient Treatment
Outpatient treatment involves visiting a facility up to 5 times a week for counseling, group therapy, and recovery education. It allows the patient to live at home.
Treatment Level Unreported
An estimated 10% of people with a substance use disorder receive treatment, per SAMHSA. The White House reported only 10% of people with opioid use disorder received specialty treatment in 2015.
Comparison of Treatment in Nacogdoches vs. Houston
| City | Treatment Facilities | Inpatient Beds | Cost |
| Nacogdoches | 5 | 50 | $10,000/month |
| Houston | 25 | 500 | $15,000/month |
Methadone Treatment
What is Methadone
Methadone is a medication used in medication-assisted treatment (MAT) for opioid use disorder (OUD). It activates opioid receptors in the brain, reducing cravings and withdrawal symptoms. Methadone is taken daily at opioid treatment programs (OTPs) under supervision.
Methadone is a long-acting opioid agonist that stimulates opioid receptors when taken daily at a stable dose. This blocks euphoric effects of illicit opioids and reduces cravings and withdrawal symptoms. Methadone is only provided at certified OTPs where patients take the medication under supervision. This ensures compliance and provides wraparound services.
Societal Perspectives on Methadone Treatment
Some view methadone as simply replacing one opioid addiction with another. However, research shows methadone helps patients stop illicit opioid use, improve health, reduce disease transmission, and increase employment when combined with counseling and support services. Still, stigma remains.
Methadone is an opioid medication that tricks the brain into thinking it is still getting the problem opioid. This stops cravings and withdrawal symptoms. Taken daily at treatment programs, methadone helps get off illegal opioids. It can be a lifesaving treatment but does have risks.
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.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to cross-reference opioid titration dosage carefully, as methadone has a narrow therapeutic index.
Nacogdoches state drug classifications: Methadone is a Schedule II controlled substance, available only through certified opioid treatment programs.
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 on methadone have 33% fewer opioid-positive drug tests. They are 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; severe withdrawal if stopped suddenly; possible QTc prolongation/cardiac issues; respiratory depression/overdose risk when combined with other substances.
Comparison to Other Medications
Equally effective as buprenorphine for reducing opioid use.
Benefits but also risks requiring careful management.
About Nacogdoches
Location, County & List of Neighboring States
Nacogdoches is located in Nacogdoches County in eastern Texas, United States. It is near the border with Louisiana. Neighboring states are:
Capital and Largest City
Nacogdoches is the county seat of Nacogdoches County. It is also the largest city in the county.
Land Area
The total land area of Nacogdoches is 34.8 square miles.
Infrastructure
- The city contains various government buildings, schools, churches, a university, stores, restaurants, and other infrastructure.
- Transportation infrastructure includes highways, local streets, sidewalks, and an airport.
Population Statistics
Total Population
The population of Nacogdoches is 33,310 as of the 2010 census.
Gender
- Male: 15,735
- Female: 17,575
Age Brackets
- Under 18 years: 24.1%
- 18 to 65 years: 51.3%
- Over 65 years: 24.6%
Occupations
The top occupations are education, healthcare, retail trade, and food services. Many residents are employed at Stephen F. Austin State University.
