Rules and Regulations
Methadone clinics in Alexandria must adhere to federal, state, and local laws regarding licensing, security, dispensing of medication, record keeping, etc. Regulations aim to ensure safe, effective treatment while preventing diversion of medication.
Certification Procedures
Clinics must meet certification standards regarding staffing, counseling services, facility safety and security, patient policies, etc. Staff must complete the required training. The certification aims to ensure quality of care.
Benefits of Medication-Assisted Treatment
Methadone and other medications, combined with counseling, help people in recovery reduce withdrawal and cravings, allow normal functioning, and stay in treatment. It is an evidence-based treatment for opioid addiction.
How Clinics Operate and Their Purpose
Clinics provide methadone doses, health monitoring, counseling support, referrals, and community resources. Their purpose is to facilitate recovery from opioid addiction.
Insurance Coverage
Public and private insurance may cover methadone treatment to varying degrees. Uninsured patients may qualify for state/local program support or clinic payment plans.
Drug Use in Alexandria
The opioid crisis has been declared a nationwide public health emergency. In Virginia, drug overdose deaths have increased over the past decade:
- Prescription opioids are involved in over half of overdose deaths
- Over 1,500 fatal overdoses in 2020
The most commonly used substances in Virginia are:
- Alcohol
- Marijuana
- Prescription opioids
- Cocaine
- Heroin
Addiction Treatment Overview
Inpatient Treatment
Inpatient treatment involves staying at a facility 24/7 for 1-3 months. It includes medical detox, counseling, group therapy, medication management, and aftercare planning.
Outpatient Treatment
Outpatient treatment allows the patient to live at home while attending sessions 1-5 times a week for several hours a day. Services include therapy, support groups, and medication management.
Treatment Level Unreported
An estimated 10% of facilities do not report treatment levels. However, experts estimate a steady increase in admissions in recent years.
Comparison of Treatment in Alexandria vs. Washington DC and Arlington
| City | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| Alexandria, VA | 15 | 500 | $15,000/month |
| Washington, DC | 32 | 850 | $20,000/month |
| Arlington, VA | 12 | 375 | $12,000/month |
Methadone Treatment
What is Methadone
Methadone is a long-acting opioid agonist medication used to treat opioid use disorder and dependence. As medication-assisted treatment (MAT), methadone helps prevent withdrawal symptoms and drug cravings by activating opioid receptors in the brain, while also blocking the euphoric effects of other opioids. It is taken orally once daily in supervised opioid treatment programs (OTPs).
Societal perspectives on methadone treatment range from seeing it as lifesaving addiction treatment to potentially replacing one opioid dependence with another. However, research shows that properly monitored methadone treatment can be an effective part of recovery by improving health and social outcomes.
Methadone Distribution
Methadone distribution is strictly regulated with required monitoring to prevent misuse:
- Urine testing: Methadone maintenance patients must undergo at least eight random drug tests in the first year of treatment to detect any unauthorized drug use.
- Take-home requirements: During the first 14 days of treatment, the take-home Supply of methadone is limited to a one-day (24-hour) Supply that must be ingested on-site under supervision.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and counselors monitoring patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid prescriptions and titrate methadone dosage, as it has a narrow therapeutic index.
In Fairfax County, Virginia, methadone is a Schedule II controlled prescription drug monitored by the state PDMP.
Methadone Treatment Effectiveness Research
Methadone has been used to treat opioid addiction since 1947. Studies show it is an effective MAT medication that:
- Reduces opioid use, based on 33% fewer opioid-positive drug tests
- Improves treatment retention, making patients 4.44 times more likely to stay in treatment
- Lowers risk of disease transmission and overdose death
- Increases employment opportunities
However, methadone does carry risks including potential for misuse/diversion, severe withdrawal if stopped suddenly, QTc prolongation and cardiac issues, and respiratory depression/overdose when combined with other substances, requiring careful monitoring and management.
Research shows methadone and buprenorphine are equally effective in reducing opioid use. So while beneficial, methadone also has risks that require careful oversight.
About Alexandria
Location, Fairfax County & Neighboring States
Alexandria is located in Fairfax County in northern Virginia, approximately 6 miles south of downtown Washington, D.C. Virginia borders Maryland, West Virginia, Kentucky, Tennessee, North Carolina, and the District Of Columbia.
Capital and Largest City
Virginia’s capital and largest city is Richmond.
Land Area
Alexandria has a total area of 15.5 square miles.
Infrastructure
- Historic buildings and architecture
- Public transportation (bus and railway systems)
- Major highways including Interstates 95 and 495
- Three hospitals
Population Statistics
Total Population
The population of Alexandria is 159,428 as of 2019.
Demographics:
Gender
- Female: 53%
- Male: 47%
Age Brackets
- Under 18 years: 15.6%
- 18 to 65 years: 69.5%
- Over 65 years: 14.9%
Occupations
- Management, business, science, and arts: 61.4%
- Sales and office: 24.2%
- Service: 14.4%