Rules and Regulations
The Plains, Athens County, Ohio, 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).
Certification Procedures
- Clinics must be certified by SAMHSA and accredited by an independent accrediting body.
- Staff must meet educational and licensing requirements.
- Regular inspections are conducted to ensure compliance.
Benefits of Medication-Assisted Treatment
- Methadone reduces opioid cravings and withdrawal symptoms.
- It allows people to focus on their health and participation in positive activities.
- Methadone therapy has been shown to decrease crime, overdose risk, and transmission of infectious diseases.
How Clinics Operate and Their Purpose
- Clinics provide methadone doses for opioid addiction treatment.
- Take-home doses may be allowed after patients demonstrate progress.
- Counseling and other services are offered to support recovery.
- The goal is to help people gain control of their lives and improve their health.
Insurance Coverage
- Medicaid covers methadone treatment in Ohio.
- Many private insurance plans also provide coverage, although benefits may vary.
- Low-income patients may qualify for free or reduced-cost treatment at certain clinics.
Drug Use in The Plains
The opioid crisis has been declared a nationwide public health emergency. According to the Ohio Department of Health, unintentional drug overdose deaths in Athens County have risen from 5 in 2010 to 14 in 2021. The most common drugs involved in overdoses locally are:
- Opioids (prescription pain relievers, heroin, fentanyl)
- Methamphetamine
- Cocaine
Addiction Treatment Overview
Inpatient Treatment
Inpatient facilities provide 24/7 supervised care including detoxification, individual and group counseling, medication management, and aftercare planning. Typical stays range from 28-90 days.
Outpatient Treatment
Outpatient programs offer similar services to inpatient but on a part-time basis, allowing the patient to live at home. Sessions typically occur 1-5 times per week for several hours at a time.
Treatment Level Unreported
An estimated 10-20% of those seeking treatment do not specify whether they receive inpatient or outpatient care.
Comparison to Parkersburg
| Category | The Plains | Parkersburg |
| Treatment Facilities | 2 | 15 |
| Inpatient Beds | 24 | 300 |
| Cost of Treatment | $15,000/month | $25,000/month |
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 doses of methadone dispensed through opioid treatment programs (OTPs) to provide a legal source of opioids, reduce illicit opioid use, and increase retention in treatment.
Methadone activates the opioid receptors in the brain like other opioids, but it has a longer duration of action, allowing it to prevent withdrawal symptoms for 24 hours or more. This allows patients to stop using short-acting opioids like heroin and focus on recovery. OTPs provide comprehensive treatment including counseling and social services along with methadone. Patients must visit the clinic daily to receive their dose under observation, which improves accountability and compliance.
Methadone treatment has been controversial, with some seeing it as merely replacing one addiction with another. However, research shows MMT helps patients improve their health, employment, and social functioning. It is an evidence-based treatment that saves lives by reducing overdoses and disease transmission. Still, stigma remains, and education is needed to increase social acceptance.
Simply put, methadone tricks the brain into thinking it is still getting the opioids it craves, stopping withdrawal and drug cravings. This allows patients to get their lives back on track without being controlled by the need to keep using opioids. While not a cure, MMT helps manage opioid addiction daily.
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 not using other opioids or illicit drugs.
- 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 patients who follow program rules and abstain from illicit drugs.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, counselors, and social workers to provide comprehensive care.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid prescriptions with methadone dosage, as methadone has a narrow therapeutic window.
The Plains drug classifications
Controlled substances:
- Schedule I (no currently accepted medical use)
- Schedule II (high potential for abuse)
- Schedule III
- Schedule IV
- Schedule V
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 treatment is continued for an adequate period.
Evidence for Effectiveness
Research shows methadone maintenance treatment:
- Produces 33% fewer opioid-positive drug tests
- Makes patients 4.44 times more likely to stay in treatment
- Retention in treatment reduces overdose risk, HIV risk behaviors, and criminal activity
- Increases employment
Major Drawbacks
However, methadone does have risks:
- Potential for misuse/diversion of medication
- Severe withdrawal if stopped suddenly
- Possible QTc prolongation and cardiac arrhythmias
- Respiratory depression and overdose when combined with other substances like benzodiazepines
Comparison to Other Medications
Methadone and buprenorphine are equally effective in reducing illicit opioid use.
While not without risks requiring careful management, methadone’s benefits make it a valuable treatment option for opioid addiction.
About The Plains
Location, County & Neighboring States
The Plains is located in Athens County in southeastern Ohio. It is bordered by the states of West Virginia, Kentucky, Indiana, and Pennsylvania.
Capital and Largest City
Columbus is the capital and largest city in Ohio.
Land Area
The Plains has a total area of 0.15 square miles.
Infrastructure
- Roads: The Plains is connected to Athens via State Route 682.
- Public transport: There is no public transportation system in The Plains.
Population Statistics
The population of The Plains was 563 as of the 2020 census.
Gender:
- Male: 47%
- Female: 53%
Age Brackets:
- Under 18 years: 19%
- 18 to 64 years: 52.7%
- 65 years and over: 28.3%
Occupations:
- Management & professional: 42%
- Service sector: 33%
- Sales, office support, etc.: 15%
- Construction, maintenance, production, & transportation: 10%