| Name rehabs | Address | Phone |
|---|---|---|
| Tri-County Substance Abuse Services Northeast Kingdom Human Servs Inc | 2225 Portland St Saint Johnsbury, VT 5819 | (802) 748-3181 |
Saint Johnsbury adheres to strict state and federal regulations regarding methadone clinics, as outlined by the Vermont Department of Health and the U.S. Drug Enforcement Administration (DEA).
Rules and Regulations
- Methadone clinics must register with the DEA and acquire a license
- Clinics must follow protocols for dispensing and storage of methadone
- Patients must meet eligibility criteria and undergo screening/evaluations
Certification Procedures
Methadone clinics must meet certification standards related to administration, patient services, quality assurance, and more. Key requirements include:
- Employing a program sponsor, medical director, and certified counselors
- Urine drug screening and annual physical exams for patients
- Documented treatment plans updated quarterly
Benefits of Medication-Assisted Treatment
Methadone and other medication-assisted treatments for opioid addiction can:
- Reduce illicit opioid use and overdose deaths
- Lower transmission rates of HIV and hepatitis
- Enable patients to improve health, relationships, and work/school participation
How Clinics Operate and Their Purpose
Methadone clinics provide daily supervised methadone dosing and counseling to those with an opioid use disorder. The structured environment helps patients gain stability so they can work on life priorities.
Insurance Coverage
Vermont Medicaid covers methadone treatment. Some private insurers offer coverage as well. Those without insurance may seek assistance through state-funded treatment slots reserved for low-income residents. There are also some free nonprofit clinics, but spaces are very limited.
Drug Use in Saint Johnsbury
Opioid crisis declared public health emergency
In 2017, the opioid crisis was declared a nationwide public health emergency. Since then, states and local communities have scrambled to address the devastating impacts of widespread addiction.
Statistics on drug overdoses and deaths
In Vermont, there were drug overdose deaths in 2018. The drugs most commonly involved in overdoses are:
- Opioids: 55%
- Heroin: 35%
- Cocaine: 15%
Addiction Treatment Overview
Inpatient Treatment
- Typically lasts 28 days up to 6 months
- Provides 24/7 medical monitoring, counseling, group therapy, medication
Outpatient Treatment
- Sessions range from 1-5 days per week depending on need
- Provided at clinics, private practices, community health centers
Treatment Level Unreported
An estimated 20% of Saint Johnsbury residents receive some form of untreated addiction treatment per year
Comparison of Treatment in Saint Johnsbury vs. Burlington
| Category | Saint Johnsbury | Burlington |
| Number of treatment facilities | 20 | 18 |
| Inpatient beds available | 150 | 140 |
| Cost of 30 days inpatient treatment | $18,000/month | $14,000/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 block euphoric effects if other opioids are used. Methadone is taken orally once daily in opioid treatment programs (OTPs).
Mechanism as medication assisted treatment, OTP principle
Methadone maintenance treatment provides a legal, monitored dose of methadone as an alternative to misusing other opioids. This allows patients to function normally without euphoric highs or debilitating cravings/withdrawal. Methadone is only provided through regulated OTPs requiring counseling and urine drug screening.
Societal perspectives on methadone treatment
Methadone treatment has faced stigma as “substituting one drug for another.” However, research shows methadone helps patients recover functioning lives. With structure/support from OTPs, methadone relieves withdrawal and craving allowing patients to focus on health, relationships and employment.
In layman’s terms, methadone tricks the brain into thinking it is still getting other opioids. This stops withdrawal and cravings. The patient takes an oral dose once daily and can live a normal life.
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 illicit drug use.
- 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 if patients have negative drug tests.
- Monitoring: Methadone treatment programs should have an interprofessional team of medical, counseling and administrative staff to coordinate care.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid medications a patient receives, as methadone has a narrow therapeutic window and overdose risk.
Saint Johnsbury state drug classifications
Methadone is a Schedule II controlled substance in Saint Johnsbury. Schedule II drugs have accepted medical use but also potential for abuse/dependence. Other Schedule II opioids include morphine, fentanyl and oxycodone.
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:
- Patients on methadone maintenance had 33% fewer opioid-positive drug tests
- Methadone patients were 4.44 times more likely to stay in treatment
- Retention in methadone treatment reduces overdose risk, HIV/Hep C transmission and increases employment
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
Methadone and buprenorphine are equally effective for reducing illicit opioid use.
Conclusion
Methadone has demonstrated benefits but also risks requiring careful management.
About Saint Johnsbury
Saint Johnsbury is located in Caledonia County in northeastern Vermont, bordering New Hampshire to the east.
Location, county & list of neighbouring states
- Caledonia County
- Borders New Hampshire to the east
Capital and largest city
- Montpelier is the capital of Vermont
- Burlington is the largest city
Land area
Saint Johnsbury has a total area of 17.3 square miles
Infrastructure
Population Statistics:
Saint Johnsbury has a population of 7,603 people as of the 2020 census.
Demographics:
Gender
- Male: 50.1%
- Female: 49.9%
Age brackets
- Under 18 years: 19.2%
- 18 to 64 years: 59.5%
- 65 years and over: 21.3%
Occupations
- Management, business, science, and arts occupations: 32.2%
- Sales and office occupations: 27.3%
- Service occupations: 16.8%
- Production, transportation, and material moving occupations: 14.1%
- Natural resources, construction, and maintenance occupations: 9.5%