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- Rules and regulations: North Dakota adheres to strict federal and state regulations regarding methadone clinics, outlined by the Drug Enforcement Administration (DEA) and North Dakota Board of Pharmacy.
- Certification procedures involve licensing reviews, staff requirements, security measures, patient policies, and regular reporting procedures.
- Benefits of medication-assisted treatment (MAT) with methadone include reduced opioid cravings, decreased illicit opioid use and overdose deaths.
- Clinics provide daily supervised methadone dosing, drug testing, counseling, and case management to support recovery.
Insurance Coverage
- Free clinics: Some clinics offer treatment free of charge or on a sliding scale based on patient income and hardship.
- Public and private insurance coverage details: Most clinics accept Medicaid, Medicare and various private insurances. Co-pays, preauthorization requirements and covered treatment services can vary by plan. Uninsured patients may qualify for state-funded treatment or apply for emergency Medicaid to cover methadone therapy costs.
Drug Use in North Dakota
- North Dakota faces opioid and methamphetamine crises, declared public health emergencies in 2017.
- In 2021 there were 105 opioid overdose deaths, a 34% increase from 2020. Meth overdoses increased by 38%.
- High rates of binge drinking, marijuana, and prescription drug misuse are also concerns.
Addiction Treatment Overview
Inpatient Treatment
- Inpatient facilities provide 24/7 care including medically-managed detox, counseling, case management, and discharge planning.
- Typical stays last 1-3 months depending on condition severity.
Outpatient Treatment
- Outpatient programs offer therapy, support groups, and medication management. Patients live on their own.
- Treatment is typically a few hours, 1-3 days a week. Some clinics offer evening appointments.
Treatment Level Unreported
Approximately 14% of those receiving addiction treatment in North Dakota do not specify outpatient or inpatient care.
Comparison of Treatment in North Dakota vs. Neighboring Major City
| Category | Fargo, ND | Minneapolis, MN |
| # of treatment facilities | 25 | 217 |
| Inpatient beds available | 156 | 1,302 |
| Cost per day | $250-800 | $300-900 |
Methadone Treatment
What is Methadone
- Methadone is an opioid medication used in medication-assisted therapy (MAT) for opioid addiction and dependence. It activates receptors reducing withdrawal and cravings.
- There are mixed societal opinions on methadone treatment. Supporters emphasize its benefits while critics argue it substitutes one opioid for another.
- In basic terms, methadone relieves the symptoms of opioid use disorder in a medical setting.
Methadone Distribution
Methadone distribution has strict federal and state regulations:
- Urine testing: Patients undergo at least 8 random urine tests the first treatment year.
- Take-home requirements: Maximum 1 week’s Supply after 90 days compliant treatment.
- Monitoring: Interdisciplinary teams oversee dosing, counseling, case management.
- Prescription monitoring: Clinicians check the PDMP to coordinate care and prevent adverse events.
In North Dakota, methadone is a Schedule II controlled substance.
Methadone Treatment Effectiveness Research
Methadone has treated opioid addiction effectively since 1947.
Evidence for Effectiveness
Studies show methadone reduces opioid use and related issues:
- 33% fewer opioid-positive urine tests
- 4.44 times more likely to stay in treatment
Retention in methadone treatment lowers mortality risk while improving employment.
Major Drawbacks
- Potential for diversion and misuse
- Severe withdrawal if stopped suddenly
- Risk of QTc prolongation and cardiac dysfunction
- Respiratory depression and overdose combined with certain substances
Comparison to Other Medications
Research finds methadone and buprenorphine equally effective for reducing illicit opioid use.
Conclusion
Methadone has benefits yet risks requiring careful oversight.
About North Dakota
- North Dakota is located in the Midwestern United States, bordering South Dakota, Minnesota, Montana, and the Canadian provinces of Saskatchewan and Manitoba.
- The capital and second largest city is Bismarck. The largest city is Fargo.
- North Dakota covers 70,762 square miles of land area.
- Major infrastructure includes railways, highways, airports, and the Port of North Dakota.
Population Statistics
As of the 2020 census, North Dakota has 779,094 residents.
Demographics:
Gender:
49% female, 51% male
Age brackets:
- 23% under 18
- 59% between 18-65
- 18% over 65
Top Occupations:
- Management, Business, Science & Arts
- Sales & Office Occupations
- Natural Resources, Construction, Maintenance Occupations