Rules and Regulations
Manhattan, Riley County, Kansas, 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
Methadone clinics must be certified by SAMHSA and accredited by an independent body approved by SAMHSA. Clinics must follow federal and state regulations for dispensing methadone as medication-assisted treatment for opioid use disorder. Clinicians must complete training on methadone treatment.
Benefits of Medication-Assisted Treatment
- Reduces opioid cravings and withdrawal symptoms
- Allows individuals to regain stability and improve functionality
- Facilitates engagement in counseling and behavioral therapies
- Lowers risk of overdose and contracting infections like HIV/AIDS and hepatitis
How Clinics Operate and Their Purpose
Methadone clinics provide daily supervised methadone dosing for individuals with an opioid use disorder. The medication blocks the effects of opioids and reduces cravings and withdrawal symptoms. Clinics offer counseling and behavioral therapies to address the psychological aspects of addiction. The purpose is to facilitate recovery and prevent relapse.
Insurance Coverage
Most private insurance plans cover methadone treatment. Medicaid covers methadone clinics in Kansas. Some clinics offer sliding-scale fees or arrangements based on income for uninsured patients.
Drug Use in Manhattan
The opioid crisis has been declared a nationwide public health emergency. In Kansas, opioid overdoses killed 322 people in 2020. Manhattan specifically saw a 20% increase in overdose deaths from 2019 to 2020.
Substances Causing Most Harm Statewide:
- Opioids – 45% of overdose deaths
- Methamphetamine – 30% of overdose deaths
- Cocaine – 12% of overdose deaths
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 discharge planning.
Outpatient Treatment
Outpatient treatment allows individuals to live at home while attending counseling and support groups 1-5 times per week for several months. Services take place at clinics, hospitals, or community centers.
Treatment Level Unreported
An estimated 10-15% of people receive addiction treatment without specifying inpatient or outpatient, often at private practices.
Comparison of Treatment Availability
| City | Treatment Facilities | Inpatient Beds | Cost per Month |
| Manhattan, KS | 12 | 356 beds | $6,000 |
| Topeka, KS | 18 | 450 beds | $5,500 |
Methadone Treatment
What is Methadone
Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) programs, also known as opioid treatment programs (OTPs). It binds to opioid receptors and reduces cravings and withdrawal symptoms, allowing patients to focus on recovery.
Methadone activates the opioid receptors in the brain like other opioids, but it does so more slowly and steadily without causing a “high.” This prevents withdrawals and reduces drug cravings. OTPs provide methadone doses daily for patients along with counseling and support services.
Methadone treatment is controversial with differing societal views. Supporters see it as an evidence-based treatment for chronic disease. Critics view it as merely substituting one opioid for another. Stigmatization of MAT persists but education can emphasize its medical nature as assistance rather than replacement.
Simply put, methadone occupies opioid receptors enough to stop withdrawals, block cravings, and stabilize patients, allowing them to work towards long-term recovery goals with counseling. It does not cure addiction but manages it like other chronic diseases requiring ongoing medication.
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 compliance and prevent diversion.
- Take-home requirements: During the first 14 days of treatment, the take-home methadone Supply is limited to a 24-hour dose. More take-homes are allowed over time for compliant patients to reduce clinic visits.
- Monitoring: Methadone treatment programs have an interprofessional team of nurses, counselors, social workers, etc. to provide comprehensive care, monitoring, and support.
- Prescription drug monitoring: Clinicians cross-reference the state PDMP database when titrating methadone doses to ensure safe amounts given the high risk for overdose due to methadone’s narrow therapeutic window.
Kansas designates methadone as a Schedule II controlled substance requiring extra precautions like OTP enrollment, daily witnessed dosage, and inability to call in methadone to a pharmacy. Riley County has zero OTPs resulting in extra transportation barriers to access for residents.
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 for patients who remain in treatment.
Evidence for Effectiveness
Studies show patients on sufficiently high, individualized methadone doses have 33% fewer opioid-positive drug tests versus untreated patients. Methadone patients also remain in treatment 4.44 times longer than without medication assistance. Retention in treatment greatly reduces risks of overdose, HIV and hepatitis C transmission via injection drug use and increases employment opportunities.
Major Drawbacks
Methadone does carry risks including potential for misuse/diversion, severe withdrawal if stopped suddenly, QTc prolongation increasing cardiac issues risks, respiratory depression, and overdose when combined with certain substances like benzodiazepines. Close monitoring and adjustments are necessary to maximize benefits and minimize harms.
Comparison to Other Medications
Methadone and buprenorphine are equally effective for reducing illicit opioid use based on clinical trials.
Methadone is beneficial but also carries risks if not carefully managed. Harm reduction approaches maximize benefits while minimizing risks. Access remains a major barrier for many patients nationwide.
About Manhattan
Manhattan is a city in and the county seat of Riley County, Kansas, United States. It is located in northeastern Kansas at the junction of the Kansas River and Big Blue River.
Location, Riley County, and Neighboring States
Manhattan is located in Riley County in northeastern Kansas. It sits about 120 miles west of Kansas City.
The neighboring states of Kansas are:
Capital and Largest City
Topeka is the capital and Wichita is the largest city in the state of Kansas.
Land Area
Manhattan has a total area of 18.79 square miles.
Infrastructure
Manhattan has a council-manager form of government. Major employers in the city include Kansas State University and the GTM Sportswear company. Manhattan Regional Airport provides air transportation.
Population Statistics
The population of Manhattan is estimated to be 56,069 as of 2021.
Demographics
- Gender: 50.5% female, 49.5% male
- Age brackets: 18.5% under 18, 73.5% 18-64 years, 8% 65+ years
- Occupations: 25.6% education/healthcare/social service, 12.5% retail, 10.3% arts/entertainment/recreation