Methadone clinics can provide methadone for on-site administration. Additionally, some methadone clinics provide the following: oversight of treatment, observed dosing, consultation services, urine drug test, naloxone distribution, mental health services, primary care services, and HIV and HCV services.
Methadone clinics in the United States operate under strict regulations by state and federal laws. Before entering treatment, a patient must be given adequate information to provide informed consent about starting treatment. This information includes reasons for treatment and recommendations, the side effects and risks of treatment, and rules that must be followed to receive methadone treatment. After a physician ensures that the patient voluntarily chooses to receive treatment through a consent form, treatment planning can begin. The patient must show current addiction to an opioid, using accepted medical criteria such as those listed in the DSM-5 and have evidence that he or she became addicted at least 1 year before admission for treatment. Before administration of treatment, a clinical evaluation is required asking about drug use history, co-occurring disorders, and impact of substance use on life, along with providing information about the treatment goals and guidelines. A medical evaluation is also given in the form of a urinalysis test, a review of past and current health history, and a test for certain conditions which are known to be prevalent in addict populations, such as HIV, hepatitis, and tuberculosis. The medication is monitored by nursing staff and is prescribed by a physician. As of 2013, due to the strict changes in receiving prescription pain medication as well as decreases in non-medical prescription use, the requirements to be accepted into methadone clinics have changed in areas such as New York State.
In the United States, there are approximately 1500 methadone clinics that are federally certified opioid treatment programs. There are generally two types of methadone clinics, public and private. The public clinics are generally cheaper to attend. However, there is usually a waiting list due to limited funding. The private clinics are more expensive to attend but usually have either a short or no waiting list. In many parts of the United States, methadone clinics are few and far between, which presents problems for addicts seeking methadone treatment who live far from a clinic. The greatest concentrations of clinics are in California, Maryland, New York, and New Jersey. All methadone clinics must register as an accredited opioid treatment program with the Substance Abuse and Mental Health Service Administration and renew yearly or every three years based on the accreditation time frame awarded. Additionally, methadone clinics must register with the Drug Enforcement Administration before methadone can be dispensed. While not restricted to adults, this treatment method is generally not considered for people under the age of 18.
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When faced with an addiction issue, the future may seem bleak and hopeless. One seems to be living only to get their next ‘high’ so they can survive. Images of happiness, joy, and being a healthy part of society are all but gone—and for many, they have given up hope completely.