Polacca, Navajo County, Arizona, 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). Clinics must be certified and accredited to prescribe methadone for opioid addiction treatment.
Certification procedures:
- Clinics must apply for certification from SAMHSA.
- Staff must meet training and education requirements.
- Facilities must meet safety and security standards.
- Regular inspections and oversight are conducted.
Benefits of medication-assisted treatment:
- Methadone reduces opioid cravings and withdrawal symptoms.
- It allows people to focus on their health and recovery.
- It is part of a comprehensive treatment plan including counseling and support services.
- It can enable people to live productive, stable lives.
How clinics operate and their purpose:
- Clinics provide daily supervised methadone doses and counseling.
- The goal is to help people recover from opioid addiction.
- Long-term maintenance treatment may be recommended for some patients.
- Services aim to improve health, reduce criminal activity, and help people function normally.
Insurance Coverage
- Public insurance like Medicaid covers methadone treatment.
- Private insurance plans often include substance abuse treatment coverage.
- Uninsured individuals may qualify for free or reduced cost treatment through state and local programs.
Drug Use in Polacca
In 2017, the opioid crisis was declared a nationwide public health emergency by the U.S. Department of Health and Human Services. This impacts rural communities like Polacca, where opioid overdoses and deaths have been on the rise.
Statistics on Drug Overdoses and Deaths:
- In 2020, there were 22 overdose deaths involving opioids in Navajo County, a rate of 20.3 deaths per 100,000 persons compared to the national rate of 20.6 deaths per 100,000.
- Prescription opioids are involved in more than half of all overdose deaths in the county.
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 allows the patient to live at home while attending counseling and therapy sessions 1-5 times per week for several months. Services are provided at clinics, hospitals, or private practices.
Treatment Level Unreported
An estimated 10-20% of addiction treatment in Polacca is unreported, often involving support groups or religious organizations.
Comparison of Treatment in Polacca vs. Neighboring Major City
| City | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| Polacca | 2 | 50 | $10,000/month |
| Flagstaff | 12 | 200 | $15,000/month |
Methadone Treatment
What is Methadone
- Methadone is an opioid medication used in medication-assisted treatment (MAT) programs, also known as opioid treatment programs (OTPs). It activates opioid receptors in the brain, blocking euphoric effects of other opioids. It reduces opioid cravings and withdrawal symptoms.
- Methadone is a long-acting opioid taken orally once daily. It relieves withdrawal symptoms and cravings. This allows patients to focus on counseling, vocational training, family support, and other services to improve health and socioeconomic outcomes. OTPs provide comprehensive treatment plans.
- Methadone treatment is controversial, with some viewing it as trading one addiction for another. However, research shows MAT with methadone is more effective for opioid disorder than abstinence-only models. MAT has support from major medical organizations as the gold standard of care. Still, stigma remains.
- Simply put, methadone tricks the brain into thinking it’s still getting the problem opioid. This stops withdrawal and cravings. Over time, the patient can stabilize and work on underlying issues with counseling. The methadone buys time to make lasting changes.
Methadone Distribution
Description of monitoring and regulations:
- Urine testing: Methadone maintenance patients must undergo at least eight tests in the first year of treatment to ensure no illicit opioid use.
- Take-home requirements: During the first 14 days of treatment, the take-home Supply of methadone is limited to a 24-hour Supply. More take-home doses are allowed over time with demonstrated progress.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, counselors, social workers, etc. to monitor patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference opioid dosage, as methadone has a narrow therapeutic window.
Polacca, Navajo County, Arizona has one OTP clinic registered with the DEA and state PDMP. Methadone is a Schedule II controlled substance.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947.
- Studies show methadone reduces opioid use, disease transmission, and crime.
- Patients on MAT had 33% fewer opioid-positive drug tests.
- They were 4.44 times more likely to stay in treatment.
- Retention in treatment reduces overdose/disease transmission risk and increases employment.
However, methadone does have risks including potential for misuse/diversion, severe withdrawal if stopped suddenly, possible QTc prolongation/cardiac issues, respiratory depression/overdose when combined with other substances.
Methadone and buprenorphine are equally effective for reducing opioid use.
Conclusion: Methadone has demonstrated benefits but also risks requiring careful management.
About Polacca
Polacca is located in Navajo County in northeastern Arizona. It is situated on the Hopi Reservation.
Neighbouring states:
The capital and largest city in Arizona is Phoenix. The land area of Polacca is 4.2 square miles.
Population Statistics:
The population of Polacca is approximately 960 residents.
Occupations:
The primary occupations are in education, health care, social services, arts, entertainment, and recreation. Many residents are also employed in construction.