Friday, November 11, 2016

Misinformation about methadone making it difficult for rural opioid addicts to receive treatment

Stigma surrounding methadone is making it difficult for rural opioid addicts to kick the habit, Christine Vestal reports for Stateline. Methadone is one of three medications available to treat addiction to heroin and prescription pain pills. The other two, buprenorphine and Vivitrol, "can be prescribed by doctors. But for some patients, particularly those who have built up a high tolerance for opioids through prolonged use or high doses, methadone can be the only addiction medication that works."

Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, said "350,000 patients receive daily methadone doses along with counseling and other health services from 1,460 opioid treatment centers, a number that has grown by less than 25 perceqant in the last decade," Vestal writes. "During the same time, the number of people misusing prescription opioids more than doubled, and opioid overdose deaths have quadrupled since 1999." Opioid rates have been increasing at a rapid rate in rural areas.

One problem is rampant misinformation about methadone, Vestal writes. "Many in the medical community and addiction counseling field adhere to the discredited belief that because the methadone molecule is similar to heroin its use amounts to 'trading one drug for another' or 'one addiction for another' and does not mark true recovery."

Another misconception is that methadone from addiction clinics ends up being sold on the street, leading to increased overdose deaths, Vestal writes. " According to data collected by the Centers for Disease Control and Prevention, the methadone that is killing people is the tablet form of the medication, which originates in pain clinics and is widely prescribed to low-income Medicaid patients."

The truth is that "methadone is highly regulated, requiring patients to show up at a specialized clinic every day to take their dose while a medical professional watches," Vestal writes. "Under federal rules, patients who take the medication consistently for six months and are able to stay away from drugs can be granted permission to take home a week to a month’s supply of methadone."

"For financial reasons, methadone clinic operators are also discouraged from locating in the 16 states—Arkansas, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, West Virginia and Wyoming—where Medicaid, the federal-state health program for the poor, does not pay for the medication and related services.  Lack of funding is also a deterrent in the 19 states that have not expanded Medicaid to the low-income adults who make up a disproportionately large segment of the opioid-addicted population." (Read more)

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