ARTICLE OVERVIEW: Learn how Narcotic Treatment Programs operate in CA. This article review how methadone clinics in California work and where can you find help. Plus, a section on the laws and rules that govern the medication.
TABLE OF CONTENTS:
- What is Narcotic Treatment
- How Methadone Clinics in California Work
- California Regulation of Methadone
- California Laws and Rules
- California Methadone Doctors
- California Sponsored Methadone Clinics
- California Methadone for Veterans
- The Drug Epidemic in California
- Methadone Saves Lives
What is Narcotic Treatment?
In the State of California, “narcotic treatment” combines FDA- approved medications like methadone with counseling and behavioral therapies for persons addicted to opiates and opioids. However, methadone is highly regulated by federal government. It is prescribed and administered in controlled conditions for addiction treatment purposes only.
How does methadone work?
Methadone is a full agonist synthetic opioid medication. It works by attaching to the opioid receptors in the brain without creating the sedating and euphoric effects of opioids. It is long-acting and stays in the body for up to 56 hours. This is crucial for controlling cravings and relieving withdrawal symptoms. It helps people addicted to narcotics focus on their recovery and avoid relapse. Also, methadone has opioid blocking properties, thus limiting the effects of other opioids used while methadone is present. [1]
How Methadone Clinics in California Work
Methadone clinics in CA are licensed centers that specialize in medication assisted treatment with methadone. There are 147 narcotic treatment clinics and approximately 32,000 narcotic maintenance patients in California. So, how do methadone clinics in California work?
Initial Assessment
First, you need an initial assessment. In California, a counselor or a nurse will ask you about your medical and psychiatric history, your past and current substance use, and history of withdrawal symptoms. You may also be asked to do a drug test. The purpose of this screening is providing you with the best and safest treatment possible, so it is important that you give honest answers. Based on your initial assessment, an individualized treatment plan will be drafted.
Dosing and Length of Treatment
Receiving MAT with methadone in California involves daily visits to the treatment program, especially in early recovery. You will be ingesting your dose under supervision by nurses and clinic staff. Treatment is personalized and the cost may vary depending on your income, the services you receive, or the method of payment. In average, methadone in California will cost you about $126.00 per week or $6,552.00 per year. [2]
The optimal dose of methadone prescribed is the dose which will relieve your withdrawal symptoms, blocks the euphoria and cravings. The length of methadone maintenance treatment should be no less than 12 months. However, some people will need to be under the maintenance program for many years.
Progress During Treatment
Methadone clinics generally offer you incentives if you progress, or a punishment if you slip up. So, after you stabilize your dose and you have proven that you are following the treatment regiment, you may be given a methadone dose to take at home. These events will increase over time and during different phases of treatment. That will also mean that you don’t have to go to the clinic every day. Another thing to expect is that you’ll need to submit regular or random drug tests. [3]
Counselling and Talk therapy
Methadone maintenance programs should include counselling and talk therapy. In fact, counselling adds to the effectiveness of the methadone program. These services include a wide range of activities and may include: crisis intervention, individual and group counselling, couples or family counselling, vocational counselling, substance use counselling, health and other education programs. [4]
Methadone maintenance treatment is normally a long-term process that may last several years. Once you have achieved stability and begun to make changes in your lifestyle, you may be qualified to be tapered off methadone.
California Regulation of Methadone
Methadone is carefully regulated in CA. These clinics and professionals working there are required to acquire and maintain certifications to legally dispense and prescribe opioid dependency treatments. So before opening a clinic in California, approval must be received from the U.S. Drug Enforcement Administration and the Substance Abuse and Mental Health Service Administration before program operations can start. [5]
The department responsible for methadone clinics in CA is the California Department of Health Care Service via the Substance Use Disorder Compliance Division, or the SUDCD. SUDCD focuses on compliance with State and Federal laws, regulations, and other governing requirements. SUDCD also makes sure that methadone clinics are safe. Then, through the Counselor and Medication Assisted Treatment Section, CMATS, the department oversees licensing and certification functions, monitoring, and complaints for the Narcotic Treatment Programs in California.
Before going to a methadone clinic there are a few things you should consider:
1. The first thing you need to check is if the clinic is licensed to operate in the state. Check the Narcotic Treatment Program Directory managed by the DHCS.
2. Second, the clinic needs to be operating using standard procedures. Narcotic treatment programs should be staffed by a licensed nurse or other personnel lawfully authorized to administer the medication.
3. California has stricter take-home policies than federal policies. Only after the first three months of treatment California allows a one-day supply to take at home. Also, the maximum take-home supply, allowed only in cases when the patient has followed the treatment rules is three days, reached only after two years of treatment.
4. In terms of staffing, there are no specific licensure requirements for counselors, but they are required to receive ongoing training. Also, the state requires one physician for every 200 patients and one counselor for every 40 patients. [6]
Despite all the laws and regulations, some methadone clinics are still not working according to law. You can report a methadone clinic or doctor who prescribed methadone via the DHCS website.
Report a Methadone Clinic to California DHCS.
California Laws and Rules
As mentioned before, methadone clinics are strictly regulated in the State of California. In order to work, each clinic must follow the federal and the state laws. The following federal and state laws and regulations are applicable to Narcotic Treatment Programs in California:
California Health and Safety Code, Sections 11839 – 11839.34: This code outlines which medications will be used in narcotic replacement therapy and medication-assisted treatment by licensed narcotic treatment. It also outlines who is responsible for licensing, funding, fees, and the penalties for not following the regulations. [7]
Title 9, California Code of Regulations, Division 4, Chapter 4, Sections 9995 – 10425: This Title outlines the application process and protocol for narcotic treatment programs. [8]
Title 42, Code of Federal Regulations – Part 8–Certification of Opioid Treatment Programs: This federal law outlines the accreditation, certification and treatment standards of opioid treatment programs that prescribe methadone. According to this law, patients must receive counseling and behavioral therapies in addition to methadone. [9]
California Methadone Doctors
By law, only a medical doctor may prescribe methadone in U.S. and it can only be dispensed through a narcotic treatment program certified by SAMSHA. Each narcotic program is under the supervision of a medical director, who is a licensed medical doctor. The same is true in the State of California. What are the main protocols?
Before prescribing methadone, a medical doctor should conduct an assessment on which the decision to prescribe methadone is based. The methadone doctor will also take part in treatment planning and treatment reviews. After a period of stabilization and compliance with the rules of the program you may be given a take-home supply of methadone.
You can find all California state and federally licensed methadone programs and doctors through the Substance Abuse and Mental Health Services Administration and the California Department of Health Care Services. Check out the following link and find treatment centers who are authorized to offer patients methadone in California.
SAMHSA OTP Treatment Directory for California.
State Sponsored Methadone Clinics in California
Methadone clinics in California can be both private and state funded. Federal, state, and local funds go to programs through county and direct provider contracts to assist with payment for services to patients who can’t afford treatment. Funding also includes Medi-Cal, and insurance companies.
Medi-Cal currently covers methadone under Fee-For-Service (FFS) plans but not Managed Care (MC) plans. In order to receive coverage for methadone for the treatment of opioid use disorder, federal law mandates that patients are enrolled in, or have documented proof of substance use disorder counseling. The state of California covers methadone as a medical benefit under FFS plans. Methadone is covered in accredited outpatient narcotic treatment programs (NTPs) under FFS plans. [10]
California Methadone for Veterans
Addiction problems are common among war veterans. The U.S. Department of Veteran Affairs offers numerous options for veterans seeking treatment. These options include methadone. Methadone can only be obtained in methadone maintenance programs located at some VA hospitals.
Veterans can apply for state funded treatment through the Office of Veterans Affairs, the VA. With the application you must include your most recent tax return, social security numbers for yourself and your qualified dependents, and account numbers for any current health insurance you already have like Medi-cal, private insurance, or insurance from your employer. After approval you should to find a VA facility in California and begin treatment with methadone.
You can apply for VA benefits online, by phone, by mail, or in person. Usually, you’ll have to wait a week or less for your application to be approved.
Remember, methadone can only be obtained in methadone maintenance programs located at VA hospitals. To find a clinic closest to you, contact your local VA Medical Center and ask for the Mental Health clinic. Many Vet Centers and VA Community Based Outpatient Clinics also offer SUD treatment. Check out the California VA Directory for a listing of VA centers in California.
The Drug Epidemic in California
Opioid addiction has reached epidemic levels in the U.S. It is one of the worst drug crises in history destroying families, individuals, and communities. California, too, is not immune to this troubling trend.
In order to address the opioid epidemic, the California department of Public Health has developed an overarching strategy that includes safe prescribing, access to treatment, naloxone distribution, and educational campaigns. This strategy resulted in overall drug overdose and opioid‐ related death rates being lower than the national average. However, California is the most populous state in the U.S. and the number of people affected by overprescribing and misuse is quite substantial. [11]
The following statistics from California Opioid Overdose Surveillance Dashboard will give you a real picture of the opioid epidemic in California. [12]
2,196: The total number of opioid overdose deaths in California in 2017.
429: The number of fentanyl overdose deaths in CA in 2017.
4,281: The number of painkiller overdose ED visits in 2017 in the State of CA.
21,787,042: The number of opioid prescriptions in California in 2017.
Methadone Saves Lives
Methadone maintenance therapy is one component of a comprehensive treatment program for opioid addiction. For best results, it should be combined with addiction counselling and support services. It will help you stabilize, prevent withdrawal symptoms, reduce cravings. It can give you a sense of well-being and eliminate your drug use.
Methadone therapy can also help you return to a stable social, economic and home environment. This treatment has been shown to decrease illicit drug use, assist in preventing the transmittable infectious and communicable disease, reduce infant mortality, increase employment and decrease criminal activity.
Addiction to opiates can be treated with the right treatment program. Don’t struggle alone. Reaching out could save your life. Take the first step toward your new life and call us. We know addiction and will can help you.
Reference Sources: [1] NCBI: Western Journal of Medicine: Use of methadone
[2] NIDA: Medications to Treat Opioid Use Disorder
[3] SAMSHA: Methadone
[4] SAMSHA: Medication and Counseling Treatment
[5] DHCS: Narcotic Treatment Programs
[6] NCBI: Federal Regulation of Methadone Treatment: Methadone Treatment
[7] California Legislative Information: California Health and Safety Code, Sections 11839 – 11839.34.
[8] California Code of Regulations: Title 9, California Code of Regulations, Division 4, Chapter 4, Sections 9995 – 10425
[9] Title 42: Public Health, PART 8—MEDICATION ASSISTED TREATMENT FOR OPIOID USE DISORDERS
[10] DHCS: Substance Use Disorder (SUD) – Compliance Division Narcotic Treatment Programs (NTP)
[11] California Department of Public Health: Prescription Drug Overdose Prevention Initiative
[12] California Department of Public Health: California Opioid Overdose Surveillance Dashboard
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