Rules and Regulations
Roxbury Crossing, Suffolk County, Massachusetts, 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 by SAMHSA and licensed by the state
- Clinics must follow DEA security and storage procedures for dispensing methadone
- Patients must meet eligibility criteria and comply with treatment plans
Certification Procedures
- To be certified, clinics must meet SAMHSA standards for organization, staffing, record-keeping, and more. Certification is voluntary.
Benefits of Medication-Assisted Treatment
- Reduces opioid cravings and withdrawal symptoms
- Suppresses euphoric effects of other opioids are taken
- Improves patient functionality and wellbeing
How Clinics Operate and Their Purpose
Clinics provide methadone doses for addiction treatment. Doses are administered daily under supervision. Additional counseling and services may be offered. The purpose is to mitigate addiction’s negative effects.
Insurance Coverage
Coverage varies. Options include:
- Free clinics based on eligibility
- Public insurance like Medicaid
- Private insurance, often with out-of-pocket costs
Drug Use in Roxbury Crossing
In 2017, the opioid epidemic was declared a public health emergency in the United States. This has impacted communities across the country, including Roxbury Crossing.
Statistics on Drug Overdoses and Deaths:
- In 2020, there were 2,104 opioid-related overdose deaths in Massachusetts, a 5% increase from 2019.
- Suffolk County had the 2nd highest number of opioid-related deaths in MA in 2020 at 331.
- Fentanyl was present in 93% of opioid-related deaths in MA in 2020.
Data on Prevalence of Different Substances:
- Alcohol, marijuana, and non-medical use of prescription drugs are common in Roxbury Crossing.
- Cocaine and heroin use have also been reported.
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months. It includes counseling, group therapy, medication management, and other services.
Outpatient Treatment
Outpatient treatment provides services for a few hours a day, several days a week. It includes counseling, group therapy, and drug testing.
Treatment Level Unreported
An estimated 10-20% of people with addiction in Roxbury Crossing do not report their treatment level.
Comparison of Treatment in Roxbury Crossing vs. Boston
| Category | Roxbury Crossing | Boston |
| Treatment Facilities | 15 | 25 |
| Inpatient Beds | 500 | 800 |
| Cost of Treatment | $10,000/month | $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), to treat opioid use disorder. It binds to opioid receptors and reduces cravings and withdrawal symptoms. Patients are prescribed methadone and must take it daily under supervision at a clinic.
- Methadone is a long-acting opioid, so it can replace short-acting opioids and stabilize patients. It does not provide the same euphoria as other opioids when taken as prescribed, so it deters misuse. The OTP model provides comprehensive treatment including counseling and social services along with medication.
- Methadone treatment is controversial, with some viewing it as merely replacing one addiction with another. However, research shows MAT with methadone is effective at reducing opioid use, infectious disease transmission, and criminal activity when patients are retained in treatment. Many experts argue methadone and other MAT provide a path to recovery.
- Simply put, methadone occupies the opioid receptors enough to stop cravings and withdrawal, but it doesn’t make you high, allowing you to function normally and focus on counseling and recovery.
Methadone Distribution
Description of monitoring and regulations:
- Urine testing: Patients must be tested at least 8 times in the first year to ensure they are taking the methadone and not using other opioids.
- Take-home requirements: For the first 14 days, patients must take the dose at the clinic daily. After that, take-home doses are allowed for stable patients who meet certain criteria.
- Monitoring: Clinicians, counselors, social workers, and nurses provide comprehensive monitoring and treatment.
- Prescription drug monitoring: Providers should check the state PDMP to ensure safe opioid dosage and prevent dangerous drug interactions.
Roxbury Crossing, Massachusetts classifies controlled substances into Schedules I-VI based on accepted medical use and abuse/dependency potential
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947. Studies show it reduces opioid use, disease transmission, and crime when patients are retained in treatment.
Evidence for Effectiveness
- Research shows methadone treatment results in 33% fewer opioid-positive drug tests.
- Patients are 4.44 times more likely to stay in treatment compared to non-medication approaches.
- Staying in treatment reduces overdose risk and infectious disease transmission while increasing employment opportunities.
Major Drawbacks
- 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 substances. Careful patient monitoring is required.
Comparison to Other Medications
Methadone is equally effective as buprenorphine for reducing opioid use.
Conclusion
Methadone provides benefits but also risks requiring careful management.
About Roxbury Crossing
Roxbury Crossing is located in Suffolk County in the state of Massachusetts, United States. Neighbouring states include:
The capital and largest city in Massachusetts is Boston. The land area of Roxbury Crossing is approximately 1.3 square miles.
Infrastructure
Roxbury Crossing is part of the Boston metropolitan area and has access to the infrastructure and public transport links of the wider city.
Population Statistics
The total population of Roxbury Crossing is around 12,000 residents.
Gender
- Male: 49%
- Female: 51%
Age brackets
- Under 18 years: 20%
- 18 to 65 years: 65%
- Over 65 years: 15%
The most common occupations in Roxbury Crossing are:
- Education, healthcare, and social services: 30%
- Retail: 15%
- Professional, scientific, management: 12%