Rules and Regulations
Larimore, Grand Forks County, North Dakota, 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 and accredited to prescribe methadone for opioid addiction treatment.
Certification Procedures
To be certified, clinics must:
- Be accredited by an authorized accreditation body like CARF, JCAHO, or COA.
- Meet standards for patient admission criteria, treatment planning, counseling, drug testing, etc.
- Have qualified and credentialed staff including a program physician, nurses, and counselors.
- Maintain detailed records and submit reports regularly.
- Undergo regular inspections and audits.
Benefits of Medication-Assisted Treatment
Methadone maintenance therapy provides:
- Reduced opioid cravings and withdrawal symptoms
- Decreased risk of overdose and transmission of diseases like HIV or hepatitis
- Improved social functioning and employment opportunities
- Lower risk of criminal activity or incarceration
How Clinics Operate and Their Purpose
Methadone clinics provide daily supervised methadone doses and counseling to treat opioid addiction. The goal is to help patients achieve sobriety and become productive members of society.
Insurance Coverage
Many insurance plans including Medicaid cover methadone treatment. Some clinics offer sliding scale fees or arrangements based on income for uninsured patients. Grants and public funding may also be available for low-income individuals.
Drug Use in Larimore
The opioid crisis has been declared a nationwide public health emergency. In North Dakota, drug overdose deaths increased sixfold from 2000 to 2014. The most commonly abused substances in the state are:
- Alcohol (64.2% of treatment admissions)
- Methamphetamine (15.4%)
- Marijuana (13.3%)
- Heroin (3.1%)
Addiction Treatment Overview
Inpatient Treatment
Inpatient drug and alcohol rehab involves living at a treatment facility 24/7 for 1-3 months. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.
Outpatient Treatment
Outpatient treatment involves scheduled services for 4-8 hours a week, totaling less than 20 hours weekly. It is conducted at counseling centers and includes therapy, support groups, and medication management.
Treatment Level Unreported
An estimated 10-20% of addiction treatment in North Dakota is unreported. This may include support groups, religious organizations, and holistic services.
Comparison of Treatment in Larimore vs. Grand Forks
| Category | Larimore | Grand Forks |
| Treatment Facilities | 1 | 10 |
| Inpatient Beds | 8 | 120 |
| Cost of Treatment | $10,000/month | $15,000/month |
Methadone Treatment
What is Methadone
- Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and prevent withdrawal symptoms. It binds to opioid receptors in the brain, reducing cravings and blocking the euphoric effects of other opioids. Methadone is taken orally once daily in opioid treatment programs (OTPs).
- Methadone activates opioid receptors as an agonist, preventing painful withdrawal symptoms without providing a strong high. This allows people dependent on short-acting opioids like heroin to stabilize, stop using illegally, and focus on recovery. Methadone is only provided through monitored OTPs to reduce misuse potential. Patients must visit clinics daily for observed dose administration.
- Society has mixed opinions on methadone. Supporters see it as an evidence-based treatment that improves lives. Critics view it as merely substituting one opioid for another. However, research shows methadone helps patients reduce illegal opioid use, disease transmission, and criminal activity when properly monitored.
- Methadone tricks the brain into thinking it’s getting the problem opioid, stopping withdrawals. This gives time to work on underlying reasons for addiction without illegal drug use or painful detox barriers. It can be a lifesaving treatment if properly managed despite stigma.
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 no illegal opioid use.
- Take-home requirements: During the first 14 days of treatment, the take-home Supply of methadone is limited to a 24-hour Supply, meaning daily observed dosing. More take-homes are allowed over time if patients follow program rules and test negative for illegal substances.
- Monitoring: Methadone treatment programs should have an interprofessional team including counselors, social workers, nurses, and doctors monitoring patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid medications and doses prescribed, as methadone has a narrow therapeutic index.
North Dakota classifies controlled substances into 5 schedules based on medical use and potential for abuse. Schedule I substances have no accepted medical use and high abuse potential, while Schedule V substances have accepted medical use and low abuse potential.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947.
Evidence for Effectiveness
Studies show methadone treatment reduces opioid use, disease transmission, and crime:
- 33% fewer opioid-positive drug tests
- 4.44 times more likely to stay in treatment
- Retention in treatment reduces overdose/disease transmission risk and increases employment
Major Drawbacks
- Potential for misuse/diversion
- Severe withdrawal symptoms if stopped suddenly
- Possible QTc prolongation/cardiac issues
Respiratory depression/overdose risk when combined with other substances
Comparison to Other Medications
Equally effective as buprenorphine for reducing opioid use
Benefits but also risks requiring careful management
About Larimore
Location, County & List of Neighboring States
Larimore is located in Grand Forks County in eastern North Dakota. It borders the following U.S. states:
- Montana (West)
- South Dakota (South)
- Minnesota (East)
Capital and Largest City
Bismarck is the capital and largest city in North Dakota.
Land Area
Larimore has a total area of 0.84 square miles.
Population Statistics
The population of Larimore was 1,392 at the 2010 census.
Demographics:
Gender:
As of the 2010 census, there were 675 males and 717 females residing in the city.
Age brackets:
According to 2019 estimates:
- Under 18 years: 19.1%
- 18 to 64 years: 54.2%
- 65 years and over: 26.7%
Top Occupations in Larimore:
- Education, healthcare & social assistance
- Retail trade
- Manufacturing
- Construction
- Agriculture, forestry, fishing & hunting