Coeur d Alene, Kootenai County, Idaho, 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).
Rules and Regulations:
- Clinics must be certified by SAMHSA
- Clinics must register with the DEA to dispense methadone
- Patients must meet eligibility criteria to enroll in a methadone treatment program
To become a certified methadone clinic, facilities must:
- Submit an application and fees to SAMHSA
- Pass inspections verifying security, counseling services, etc.
- Ensure staff complete required training
Medication-assisted treatment with methadone can:
- Reduce opioid cravings and withdrawal symptoms
- Lower the risk of overdose
- Help patients focus on recovery goals
Certified methadone clinics provide:
- Methadone dosing under medical supervision
- Counseling and behavioral therapies
- Drug testing and monitoring
- Referrals for health services
Insurance Coverage
Free clinics:
- Provide free basic healthcare services
- Located in low-income neighborhoods
- Rely on donations and volunteers
Public and private insurance coverage:
- Medicaid available for low-income residents
- Medicare for seniors and disabled
- Private plans available to purchase
Drug Use in Coeur d’Alene
The opioid crisis has been declared a nationwide public health emergency.
In Idaho, drug overdose deaths have increased sixfold since 1999. The most commonly identified drugs in overdose deaths in Idaho are prescription opioids (e.g. oxycodone, hydrocodone), heroin, and synthetic opioids like fentanyl.
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months typically. Services include medical detox, individual and group counseling, medication management, aftercare planning for transition back into the community.
Outpatient Treatment
Outpatient treatment allows the person to live at home while attending structured programming at a facility up to 7 days a week for 2-4 hours a day. Services are similar to inpatient.
Treatment Level Unreported
Over half of admissions in Idaho did not specify treatment level. However, it is estimated 80% were outpatient, 10% inpatient, 10% residential.
Comparison of Treatment in Coeur d’Alene vs. Neighboring Major City
| City | # Treatment Facilities | Inpatient Beds | Cost of Treatment |
| Coeur d’Alene | 15 | 250 beds | $15,000 for 30 days |
| Spokane, WA | 23 | 400 beds | $20,000 for 30 days |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and prevent withdrawal symptoms. It binds to opioid receptors in the brain, reducing cravings and block euphoric effects of other opioids.
Methadone maintenance treatment provides stable opioid replacement therapy using methadone dispensed through opioid treatment programs (OTPs). Patients take daily oral methadone doses under medical supervision. This allows people with opioid addictions to function without the highs and lows of short-acting opioids.
Methadone treatment reduces illegal opioid use and associated crime while allowing patients to hold jobs and improve health. However, some view it as merely substituting one opioid for another. Careful patient selection, dosing, and monitoring are necessary to ensure benefits outweigh risks.
Methadone activates the same brain receptors as other opioids but acts slowly and steadily over 24+ hours. This prevents withdrawal and drug cravings without causing a strong high. Taken properly under medical supervision, it allows people dependent on shorter-acting opioids like heroin to stabilize their lives.
Methadone Distribution
- Urine Testing. Methadone maintenance patients must undergo at least eight random urine drug tests in the first year of treatment to ensure they are taking doses as prescribed and avoiding illegal opioids.
- Take-Home Requirements. Patients must follow program rules to earn take-home methadone doses beyond an initial 24-hour Supply. This reduces diversion risks while allowing responsible patients flexibility.
- Monitoring. In addition to urine testing, methadone treatment programs have interprofessional teams including doctors, nurses, and counselors monitoring patient progress. They coordinate care to maximize benefits and minimize methadone risks.
Prescription Drug Monitoring
Clinicians should review Prescription Drug Monitoring Program (PDMP) data when prescribing methadone to carefully calibrate doses. As methadone has a narrow therapeutic window, checking for interactions with patients’ other medications reduces overdose risks.
According to the Idaho PDMP, in Kootenai County there were 10.5 methadone prescriptions dispensed per 100 persons in 2020. The state of Idaho classifies methadone as 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 treatment reduces opioid use, disease transmission through injection, and drug-related crime.
- Methadone patients have 33% fewer opioid-positive drug tests.
- They are also 4.44 times more likely to stay in treatment long-term compared to non-medication treatment.
- Retention in treatment reduces risks of overdose and disease transmission while increasing employment opportunities.
However, methadone does carry risks including potential for misuse and diversion, severe withdrawal if stopped suddenly, QTc prolongation and cardiac issues, respiratory depression and overdose when combined with other sedating substances. It also requires daily clinic visits initially.
Methadone and buprenorphine are equally effective for reducing illicit opioid use and retaining patients in treatment. Both opioid agonist therapies must be carefully managed to maximize benefits and minimize risks.
In summary, methadone has demonstrated benefits but also unique risks requiring careful patient monitoring and management.
About Coeur d’Alene
Coeur d’Alene is located in Kootenai County in the northern part of the U.S. state of Idaho. It borders the states of:
The capital and largest city in Idaho is Boise. The land area of Coeur d’Alene is 32.83 sq miles.
Population Statistics
The population of Coeur d’Alene is around 50,000 residents.
Demographics:
The gender distribution is about 50% male and 50% female.
Age brackets:
- Under 18 years: 19%
- 18 to 65 years: 59%
- Over 65 years: 22%
Occupations:
The primary occupations are in healthcare, retail trade, education, construction, accommodation and food services, and manufacturing. Over 85% of residents work in the service industry.