Rules and Regulations
La Push, Clallam County, Washington, 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 facility inspections are conducted.
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 illicit opioid use, criminal activity, 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 social services are offered to support recovery.
- The goal is to help people gain control of their lives and reintegrate into society.
Insurance Coverage
Many clinics accept:
- County health departments and nonprofits may offer free or low-cost treatment.
- Medicaid covers methadone treatment.
- Most private insurers cover treatment but may require pre-authorization after initial visits.
Drug Use in La Push
Opioid Crisis Declared Public Health Emergency
In 2017, the opioid crisis was declared a nationwide public health emergency by the U.S. Department of Health and Human Services.
Statistics on Drug Overdoses and Deaths
- In 2020, there were 1,839 overdose deaths involving opioids in Washington – a rate of 24.2 deaths per 100,000 persons compared to the national rate of 20.6 deaths per 100,000.
- Overdose deaths increased substantially during the COVID-19 pandemic. Preliminary data shows there were 1,295 overdose deaths from January to June 2021 compared to 1,174 deaths during the same period in 2020.
Data on Prevalence of Different Substances
- Alcohol, marijuana, and non-medical use of prescription drugs are the most commonly used substances in Washington among people aged 12+.
- In 2020, about 6.5% of Washingtonians aged 12+ had an illicit drug use disorder. This includes abuse of or dependence on illegal drugs or misuse of prescription medications.
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 provides services for 4-8 hours a day, 3-5 days a week while living at home. It includes counseling, group therapy, medication management, and recovery support.
Treatment Level Unreported
An estimated 10-20% of people with substance use disorders do not report their treatment level. Reasons may include privacy concerns or treatment through unconventional programs.
Comparison of Treatment in La Push vs. Port Angeles
| Location | Treatment Facilities | Inpatient Beds | Cost of Treatment |
| La Push | 2 | 16 | $5,000/month |
| Port Angeles | 5 | 45 | $15,000/month |
Methadone Treatment
What is Methadone
Methadone is an opioid agonist medication used in medication-assisted treatment (MAT) programs, also known as opioid treatment programs (OTPs). It binds to opioid receptors and reduces cravings and withdrawal symptoms, allowing patients to focus on recovery.
Mechanism as Medication-Assisted Treatment, OTP Principle
As an MAT, methadone normalizes brain function disrupted by opioid addiction. Patients receive a daily oral dose under medical supervision. This structure provides stability while deterring misuse. The optimal dose blocks the euphoric effects of other opioids.
Societal Perspectives on Methadone Treatment
Methadone MAT remains controversial despite its demonstrated effectiveness. Supporters view it as allowing functional recovery. Critics argue it substitutes one opioid for another. Stigma also stems from associations with substance abuse. However, medical experts consider MAT an evidence-based treatment for a chronic disease.
Explanation in Layman Terms
Methadone activates opioid receptors enough to prevent cravings and withdrawal but not enough to induce a euphoric high. This helps patients stabilize their lives and reduce risk.
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 appropriate use and detect additional substance use.
- Take-home requirements: During the first 14 days of treatment, the take-home methadone Supply is limited to a 24-hour dose dispensed daily under observation to prevent misuse.
- Monitoring: Methadone treatment programs should have an interprofessional team including physicians, nurses, and behavioral health staff monitoring patient progress.
- Prescription drug monitoring: Clinicians should review prescription drug monitoring program (PDMP) data to carefully cross-reference other opioid prescriptions with methadone dosage, as it has a narrow therapeutic window.
Marijuana is legal for recreational use by adults 21 and over in Washington state. Other drugs like heroin, LSD, ecstasy, and cocaine are illegal. Washington has a prescription drug monitoring program.
Methadone Treatment Effectiveness Research
Methadone is an effective medication for treating opioid use disorder used since 1947.
Evidence for Effectiveness
Studies show methadone MAT 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 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 La Push
Location, County & List of Neighboring States
La Push is located in Clallam County in the state of Washington, United States. It is situated on the Olympic Peninsula. Neighboring states to Washington include Oregon, Idaho, and the Canadian province of British Columbia.
Capital and Largest City
The capital and largest city in Washington is Olympia.
Land Area
La Push has a total area of 4.344 square miles.
Infrastructure
La Push contains a small airport, as well as a marina. The Quileute Tribe provides utilities and services to the town.
Population Statistics
Total population
The population of La Push was 371 at the 2010 census.
Gender
As of the 2010 census, there were 184 males and 187 females.
Age Brackets
- Under 18 years: 115
- 18 to 64 years: 180
- 65 years and over: 76
Occupations
Common occupations in La Push include fishing, forestry, and jobs with the Quileute Tribal Council. Tourism and services related to visitors are also major sources of employment.