What Else Happens in a Methadone Treatment Program?

Millions of Americans are suffering from opiate addictions, with many losing their lives to overdose or the dangerous complications of abuse. Because the need is so great, methadone treatment programs have been, increasingly, made more accessible to help opiate dependent individuals detox from illicit opioids and maintain stable functioning to live more satisfying and hopeful lives.

Methadone is a long lasting opioid medication that helps to smooth out the ups and downs of opioid dependence by preventing cravings for opioids and withdrawal symptoms, while blocking the euphoric effects of opioids to decrease the desires to use them. It is not a cure for opiate addiction, but, when used in combination with counseling, psychosocial services, and comprehensive treatment approaches tailored to the individual’s needs, it can strengthen motivations to remain engaged in treatment and recovery.

Increased Access

Some methadone programs offer counseling and other treatments in addition to methadone.

It’s no longer necessary to go to a methadone clinic, daily, which may or may not be in your local area, to wait in long lines for your methadone dose. More methadone treatment programs are available in many private facilities that are qualified to provide methadone detox and maintenance services as registered opioid treatment programs (OTP’s). According to the U.S. Government Accountability Office, “methadone must be dispensed by an OTP that is certified by SAMHSA and registered with DEA.” They must also be licensed by their relevant states of operations.

While the DEA has the authority to regulate methadone use for addiction treatment, treatment protocols have advanced to integrate methadone treatment programs with mainstream medical practices that treat addiction as a chronic and relapsing disease rather than a character flaw. Historically, the rules and oversight of methadone dispensing left many providers unwilling to participate in these types of services, but, as of 2012 nearly 10% (1,026) of the outpatient substance abuse treatment facilities (10,144) were OTPs according to SAMHSA’s N-SSATS report.

Counseling Services

Methadone treatment programs that provide substance abuse counseling have better outcomes than those who don’t and many programs offer individual, family, and group counseling to educate and help facilitate recovery efforts. Counseling may focus on:

• Providing guidance and support to eliminate substance use
• Education about addiction, effects, and relapse prevention strategies
• Helping patients comply with program rules and monitoring problematic behaviors
• Identifying problems, barriers to treatment participation, and the needs for extended psychosocial services including referral assistance
• Motivating treatment retention, engagement, and healthy lifestyle changes

Monitoring Progression

Methadone detox programs are focused on stabilization with medication, tapering off the medication after a designated time which could be up to 6 months, and referrals for continuing care, usually outside of the program. During this time, the patient’s basic living needs, social support, and co-occurring disorders may be identified and addressed. They should be educated regarding health risks and other concerns for possible recruitment into follow up care.

Many opiate addicts choose to switch to methadone maintenance and should have the options to do so whenever they change their minds, their methadone detox was unsuccessful in eliminating opiate use or there remains a considerable risk for relapse as long as they meet the necessary federal and state criteria.

Treatment plans can, then, be defined and monitored for progression with appropriate methadone doses to help the patient achieve their personal goals as well as the common goals of treatment which, according to the SAMHSA are:

• Elimination of symptoms of withdrawal, discomfort, or craving for opioids and stabilization
• Expressed feelings of comfort and wellness throughout the day
• Abstinence from illicit opioids and from abuse of opioids normally obtained by prescription, as evidenced by drug tests
• Engagement with treatment staff in assessment of medical, mental health, and psychosocial issues
• Satisfaction of basic needs for food, shelter, and safety

Medical Services

Health care is a common initiative among methadone treatment providers. Ensuring methadone use safety and preventing the spread or contracting of communicable diseases is a high priority within the methadone treatment programs.

Opiate addicts commonly engage in unhealthy behaviors such as IV use, sharing of needles and other paraphernalia, engaging in unprotected sex, sex for hire, or sex with multiple partners. Pre-treatment services may provide testing for HIV, AID’s, Hepatitis, STD’s and bacterial or other infections.

Medical services and referrals are important because co-existing medical conditions can limit the treatment outcome or jeopardize the patient’s safety and other special treatment services benefits not only the addict, but, society as well.

Psychosocial Services

People who suffer from opiate addiction may present a wide range of mental health disorders, social difficulties, environmental, criminal justice, domestic, or employment problems. They may be victims of abuse, homeless, unemployed, financially distraught, or have domestic problems that require psychosocial interventions or services to help them remain vigilant in the recovery efforts.

Helping people to regain stable functioning in society whether it involves vocational, employment, housing, or transportation assistance can boost their confidence and willingness to remain abstinent. Methadone treatment providers have various outreach sources and most are able to provide the necessary referrals when needed.

According to the Substance Abuse and Mental Health Services Administration, “Over half of OTP facilities used motivational interviewing and cognitive behavioral therapy always or often, over a third used brief intervention, and over a quarter used contingency management and 12-step facilitation always or often.”