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Rules and regulations: North Carolina adheres to federal and state laws governing opioid treatment programs. Clinics must register with the DEA and acquire state certification to dispense methadone.
- Certification procedures involve inspections, policy reviews, and personnel background checks to ensure standards of care are met.
- Benefits of medication-assisted treatment include reduced opioid cravings and illicit drug use. It allows people to focus on their health and social functioning.
- Clinics provide daily supervised methadone doses and counseling to support recovery. Their purpose is facilitating rehabilitation for those with opioid use disorder.
Insurance Coverage
- Some clinics may offer free or reduced-cost treatment for those in need.
- Coverage varies across public and private insurance plans in NC. Those interested should check with their provider for specifics.
Drug Use in North Carolina
- The opioid crisis was declared a statewide public health emergency in 2017.
- In 2021 there were over 3,000 opioid overdose deaths, a nearly 40% increase from 2020. Over 1,400 involved fentanyl.
- Data shows continued issues with heroin, prescription opioids, cocaine and methamphetamine abuse statewide.
Addiction Treatment Overview
Inpatient Treatment
- Inpatient facilities provide 24/7 structured care including detox, individual and group counseling, medication management and aftercare planning.
- Typical stays range from 28-90 days depending on individual needs.
Outpatient Treatment
- Outpatient programs offer counseling, therapy, medication management and other services for those able to maintain everyday responsibilities.
- Patients attend programs for several hours multiple days a week. Many outpatient centers have flexible schedules.
Treatment Level Unreported
An estimated 18% of those receiving addiction treatment in North Carolina do not specify inpatient or outpatient care. This may include temporary housing or transitional programs.
Comparison of Treatment in North Carolina vs. Neighboring Major City
| Category | Raleigh, NC | Charlotte, NC |
| # of treatment facilities | 32 | 53 |
| Inpatient beds available | 490 | 1,120 |
| Cost of treatment per day | $300-800 | $250-750 |
Methadone Treatment
What is Methadone
- Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) programs to treat opioid use disorder. It binds to opioid receptors, reducing cravings and withdrawal symptoms.
- There are differing societal perspectives on methadone treatment. Some view it as lifesaving while others see it as replacing one opioid for another.
- In layman’s terms, methadone relieves the symptoms of opioid addiction in a safe medical setting.
Methadone Distribution
Methadone distribution is highly regulated with strict federal and state guidelines:
- Urine testing: Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment.
- Take-home requirements: During the first 90 days of treatment, the take-home methadone Supply is typically limited to a 1-week maximum.
- Monitoring: Methadone clinics should have an interdisciplinary team overseeing treatment including counseling and medical staff.
- Prescription monitoring: Clinicians review PDMP data to carefully manage methadone dosage, as it has risks in overdose.
In North Carolina, methadone is a Schedule II controlled substance.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947.
Evidence for Effectiveness
Studies show methadone reduces opioid use, HIV transmission, and criminal activity:
- 33% fewer opioid-positive drug tests
- 4.44 times more likely to stay in treatment
Retention in methadone treatment is correlated with lower overdose mortality risk and higher rates of employment.
Major Drawbacks
- Potential for misuse and diversion to illicit markets
- Severe withdrawal if stopped suddenly
- Risk of QTc prolongation and cardiac issues
- Respiratory depression and overdose when mixed with certain drugs
Comparison to Other Medications
Research shows methadone and buprenorphine are equally effective for reducing illicit opioid use.
Conclusion
Methadone has demonstrated benefits but also risks requiring careful medical management.
About North Carolina
- North Carolina is located on the southeastern Atlantic coast of the United States. It shares borders with Virginia, Tennessee, Georgia, and South Carolina.
- The capital of North Carolina is Raleigh and the largest city is Charlotte.
- North Carolina covers 53,819 square miles of land area.
- Major infrastructure includes interstate highways, international airports, deepwater seaports, and freight rail systems.
Population Statistics
As of the 2020 census, North Carolina has a population of 10,439,388 residents.
Demographics:
Gender:
51% female, 49% male
Age brackets:
- 22% under 18 years
- 60% between 18-64 years
- 18% over 65 years
Top Occupations:
- Management, Business, Science & Arts
- Sales & Office Occupations
- Service Occupations