- South Saint Paul, Dakota County, Minnesota, United States adheres to strict regulations regarding methadone clinics, outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA). These regulations ensure safe and effective treatment.
- Clinics must be certified by SAMHSA and licensed by the state. Staff must meet educational and licensing requirements. Medication must be approved by the FDA and dispensed by a registered nurse or pharmacist.
- Medication-assisted treatment with methadone helps individuals recover from opioid addiction. Benefits include: reducing opioid cravings and withdrawal symptoms, allowing people to focus on counseling and behavioral therapies, lowering the risk of overdose, improving overall health
- Methadone clinics provide medication and counseling to treat opioid addiction. Patients visit the clinic daily to receive their prescribed dose of methadone under supervision. The clinic offers counseling and community resources. The goal is to help people achieve sobriety and better health.
Insurance Coverage
- Many insurance plans, including Medicaid and Medicare, cover methadone treatment. Some clinics offer treatment on a sliding fee scale based on income for those without insurance.
- Some clinics, such as those funded by SAMHSA grants, provide free treatment to those who qualify. Eligibility is based on income and other factors. These clinics help expand access to care.
Drug Use in South Saint Paul
Opioid crisis declared public health emergency
- In 2017, there were 422 opioid-related overdose deaths in Minnesota, a 12% increase from 2016.
- Prescription opioids are involved in nearly half of all overdose deaths in Minnesota.
Statistics on drug overdoses and deaths
- The rate of drug overdose deaths in Minnesota increased from 6.9 per 100,000 persons in 2000 to 10.5 in 2017.
- The drugs most frequently involved in overdose deaths in 2017 were opioids (422 deaths), methamphetamine (173 deaths), cocaine (142 deaths), and benzodiazepines (104 deaths).
Data on prevalence of different substances
- According to the National Survey on Drug Use and Health, marijuana is the most commonly used illicit drug in Minnesota, with about 7.9% of people aged 12 and older reporting use in the past month.
- After marijuana, prescription pain relievers are the second most commonly used substance in Minnesota, with 4.4% of people aged 12 and older reporting misuse in the past year.
Addiction Treatment Overview
- Inpatient treatment involves living at a treatment facility for 24/7 care and monitoring. Typical length of stay is 30 days. Treatment includes counseling, group therapy, medication management, and aftercare planning.
- Outpatient treatment provides 9-5 programming at a facility up to 7 days a week. Treatment includes counseling, group therapy, medication management, and recovery support.
- Approximately 18% of addiction treatment admissions in Minnesota are unreported. It is estimated that the majority of these are outpatient counseling.
Comparison of Treatment in South Saint Paul vs. Minneapolis
| Category | South Saint Paul | Minneapolis |
| Treatment Facilities | 15 | 112 |
| Inpatient Beds | 120 | 850 |
| Cost of Treatment | $10,000 | $15,000 |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used in medication-assisted treatment (MAT) for opioid use disorder. It is taken orally once daily and binds to opioid receptors in the brain, reducing cravings and withdrawal symptoms. Methadone maintenance treatment (MMT) involves daily supervised dosing at an opioid treatment program (OTP) along with counseling and other services. The goal is to stabilize patients, reduce illicit opioid use and associated harms, and improve quality of life.
- Mechanism as medication assisted treatment, OTP principle: methadone activates the same opioid receptors as drugs like heroin or oxycodone, but it has a slower onset and longer duration of action. It normalizes brain function disrupted by opioid addiction. The OTP model provides structure with daily observed dosing and wraparound services. This reduces misuse while allowing patients to function normally. MMT follows harm reduction principles, meeting patients where they are and mitigating risks.
- Societal perspectives on methadone treatment: views on MMT are mixed. Some see it as lifesaving addiction treatment, while others view it as merely substituting one opioid for another. Stigma stems from misconceptions that it is not “real recovery.” However, research shows MMT helps patients improve their health, employment, relationships, and quality of life. With proper dosing and monitoring, methadone restores balance for those with opioid use disorder.
- Explanation in layman terms: simply put, methadone occupies the brain’s opioid receptors, quieting cravings and withdrawal. Taken once daily under medical supervision, it provides stability for those addicted to short-acting opioids like heroin or pain pills. Methadone is itself an opioid, but when taken properly as prescribed, it allows the brain and body to heal. Over time, patients can get their lives back on track.
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 they are taking their medication properly and not using other illicit substances.
- 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 for stable patients meeting treatment goals.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and counselors monitoring patient progress. Dosing is adjusted as needed and other services provided.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to verify other medications and doses. Methadone has a narrow therapeutic window, so doses must be coordinated carefully.
- South Saint Paul’s prescription drug monitoring shows high rates of opioid painkillers like oxycodone and hydrocodone. Stimulants like Adderall and Ritalin are also commonly prescribed. Marijuana and methamphetamine are the main illicit drugs seized by law enforcement in the area according to ONDCP data. Treatment is needed to address the opioid crisis and meth use.
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 when properly prescribed and monitored.
Research shows methadone maintenance treatment:
- Reduces opioid positive drug tests by 33%
- Increases retention in treatment 4.44 times compared to non-medication approaches
- Retention in treatment reduces overdose risk, HIV and hepatitis C transmission, and criminal behavior while improving employment
Major Drawbacks
- Potential for misuse/diversion if not closely monitored
- Severe withdrawal symptoms if stopped suddenly after dependence develops
- Possible QTc prolongation or cardiac arrhythmias in some patients
- Increased risk of respiratory depression and overdose when combined with other CNS depressants like benzodiazepines or alcohol
Comparison to Other Medications:
Methadone and buprenorphine are equally effective for reducing illicit opioid use and retaining patients in treatment.
Conclusion
Methadone has demonstrated benefits but also risks requiring careful management.
About South Saint Paul
- South Saint Paul is located in Dakota County in the state of Minnesota, United States. Minnesota is bordered by the states of North Dakota, South Dakota, Iowa, and Wisconsin.
- The capital and largest city in Minnesota is Minneapolis.
- South Saint Paul has a total area of 5.59 square miles.
- Major highways in South Saint Paul include I-494 and Highway 52. The city has a municipal airport, Fleming Field Airport.
Population Statistics
- The population of South Saint Paul was 20,160 at the 2010 census.
- Demographics: Male: 49.7%, Female: 50.3%
- Age brackets: Under 18 years: 24.4%, 18 to 64 years: 59.6%, 65 years and over: 16%
- Occupations:
- Management, business, science, and arts occupations: 32.2%
- Service occupations: 20.4%
- Sales and office occupations: 24.6%
- Natural resources, construction, and maintenance occupations: 12.8%
- Production, transportation, and material moving occupations: 10%