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Rules and regulations
Montana adheres to strict federal and state regulations regarding methadone clinics, outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) and Montana Department of Public Health and Human Services. All clinics must be licensed and accredited.
Certification procedures
To open a new opioid treatment program in Montana:
- Submit application to state opioid treatment authority
- Undergo facility inspections and plan reviews
- Demonstrate capacity to provide required services
- Have certified medical director and staff
- Meet security standards
Benefits of medication-assisted treatment
Benefits of methadone maintenance therapy include:
- Reducing opioid cravings and withdrawal
- Allowing focus on recovery and rehabilitation
- Lowering risk of overdose and infectious disease
- Improving overall health and functioning
How clinics operate and their purpose
Methadone clinics provide supervised methadone dosing, counseling, case management to support recovery from opioid addiction. The goal is harm reduction and improved wellbeing.
Insurance Coverage
- Montana Medicaid covers methadone treatment
- Some private insurers may offer limited coverage
- Uninsured individuals may qualify for state-funded treatment slots
Drug Use in Montana
- Over 300 opioid overdose deaths in 2021 representing a 33% increase from 2020
- Around 300,000 Montanans misused prescription opioids from 2015-2019 per CDC data
- Methamphetamine, alcohol, and cannabis also widely used
Addiction Treatment Overview
Inpatient Treatment
- Focuses on medical stabilization, counseling, group therapy in a residential facility
- Typical stay ranges from 30-90 days
Outpatient Treatment
- Services while living at home – counseling, medication management
- 1-5 days a week for several hours per day
Treatment Level Unreported
An estimated 18% did not specify treatment level
Comparison of Availability
| City | Treatment Centers | Inpatient Beds | Cost of Treatment |
| Billings, MT | 28 | ~300 beds | $5,000+/month |
| Denver, CO | 125 | ~1,900 beds | $15,000+/month |
Methadone Treatment
What is Methadone
Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) and opioid treatment programs (OTPs). It binds to opioid receptors, reducing cravings and withdrawal symptoms. Society has conflicting perspectives on methadone treatment – some view it as replacing one addiction with another, while supporters emphasize its efficacy as harm reduction. Simply put, methadone stabilizes patients and enables functioning.
Methadone Distribution
Montana has strict regulations for methadone distribution:
- Urine testing: Patients undergo at least eight random drug tests in the first treatment year to ensure compliance.
- Take-home doses: Patients are limited to a 24-hour methadone Supply for the first 14 days, with more take-homes allowed over time if patients meet certain criteria.
- Monitoring: Methadone clinics have interprofessional teams overseeing treatment, including counseling, case management, and care coordination.
- Prescription drug monitoring: Clinicians review the PDMP to carefully cross-reference methadone dosage with other medications, as methadone has a narrow therapeutic range and risk of interactions.
Montana categorizes methadone as a Schedule II controlled substance, indicating potential for abuse and dependence.
Methadone Treatment Effectiveness Research
Methadone has been effectively used to treat opioid addiction since 1947.
Evidence for Effectiveness: Studies show participation in a methadone program is associated with reduced opioid use, infectious disease transmission, and criminal behavior:
- 33% fewer opioid-positive drug tests
- 4.44 times more likely to stay in treatment
Retention in methadone treatment lowers overdose and disease risks while increasing employment opportunities.
Major Drawbacks:
- Potential for misuse/diversion
- Severe withdrawal if stopped suddenly
- Possible QTc prolongation/cardiac issues
- Respiratory depression/overdose when combined with other substances
Comparison to Other Medications: Research shows methadone and buprenorphine have equal effectiveness for reducing illicit opioid use.
About Montana
Montana is located in the Northwestern United States, bordering North Dakota, South Dakota, Wyoming, Idaho, and Canada. The capital city is Helena and the largest city is Billings. Montana covers 145,546 square miles, making it the 4th largest U.S. state by land area. Infrastructure includes highways, airports, railroads, and ports along the Missouri River system.
Population Statistics
The total Montana population is approximately 1 million residents.
Demographics:
- Gender: 50% female, 50% male
- Age brackets: 21% under 18 years, 61% between 18-64 years, 18% over 65 years
Occupations:
- Healthcare and social assistance (17% of jobs)
- Retail trade (11%)
- Accommodation and food services (10%)
- Construction (10%)