“We haven’t seen such a dramatic increase in the industry since the 1970s,” says one expert.
The methadone treatment industry has exploded from 2014 to 2018, growing more in those four years than in the past two decades, the Boston Globe reports.
In the past four years, according to Drug Enforcement Administration (DEA) data, the industry has added 254 new clinics. The clinics allow for the administration of methadone, which is a type of long-acting opioid that can help short-acting opioid users manage withdrawals and allow them more time to detox, WebMD states.
“We haven’t seen such a dramatic increase in the industry since the 1970s,” Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, told the Globe.
Critics of methadone treatment say it is just replacing one substance for another. Yngvild Olsen, an addiction doctor in Baltimore and board member of the American Society of Addiction Medicine, tells the Globe that needs to change.
“There has been an underlying stigma against methadone for so many years that the industry naturally maintains a low profile,” she said. “Even now, access to methadone is highly geographic. It depends on where you live.”
Indiana, Maryland, and New York have been at the forefront of states with access to methadone treatment, implementing dozens of new clinics in the past two years alone. Ohio and Florida plan to follow suit with expansions in the works.
There are some states where laws limit the availability of such clinics. These include Georgia, Indiana, Louisiana, Mississippi, West Virginia, and Wyoming.
Even so, the clinics are becoming more common, as in the past four years Medicaid has expanded its coverage and reimbursement for such services for low-income adults. And, in 2020, Medicare coverage of the treatment for those 65 and older will begin as part of the Opioid Crisis Response Act, meaning the need could become even greater.
If a state wishes to open such a clinic, they must apply for a license, Parrino tells the Globe.
While there are other medications to assist in curbing opioid withdrawals, such as buprenorphine, methadone is the most highly regulated.
The Globe reports that often, patients are given methadone through a plexiglass shield. Patients are often screened to make sure they are not combining methadone with other drugs. At first, they are only given the medication in the clinic, under the watch of a professional. Eventually, some patients are allowed take-home doses.
In contrast, buprenorphine can be prescribed for 30 days at a time by doctors, nurse practitioners, and physician assistants and is viewed as the more obvious treatment by some.
“There’s no question that better access to methadone maintenance would save lives,” Andrew Kolodny, co-director of opioid treatment research at Brandeis University, told the Globe. “But for an addiction epidemic that is disproportionately rural and suburban, an intervention that relies on people visiting a clinic every day isn’t the best option. Buprenorphine would be better, but it’s not growing quickly enough.”
