An Opioid Treatment Program (OTP) of Hamilton Center Inc.
Hamilton Center, Inc., based in Terre Haute and serving multiple counties throughout central and west central Indiana, is committed to supporting the State of Indiana in responding to the opioid crisis which has been growing in recent years. As a community mental health center, Hamilton Center, Inc. has been treating individuals with substance use disorders and a variety of other behavioral health issues for over 47 years. It recently received a license from the State of Indiana to develop and operate an opioid treatment program (OTP) to be based in Vigo County. Western Indiana Recovery Services will be one of several program expansions to address the growing need for evidence-based addiction treatment.
I. The problem:
II. Who is at risk?
III. Medication Assisted Treatment (MAT):
IV. Hamilton Center/Western Indiana Recovery Services:
For additional information contact Hamilton Center, Inc. at (800) 742-0787 or visit:
History and Effectiveness of Methadone Maintenance Treatment
Methadone treatment provides the patient who is opioid dependent with medication, health, social, and rehabilitation services that relieve withdrawal symptoms, reduce physiological cravings, and allow normalization of the body’s functions. Methadone treatment has been available for over 30 years and has been confirmed effective for opioid dependence in numerous scientific studies.
Moreover, in 1997, the U.S. Department of Health and Human Services’ National Institutes of Health (NIH) Consensus Panel found the following concerning methadone treatment: “Of the various treatments available, methadone maintenance treatment, combined with attention to medical, psychiatric and socioeconomic issues, as well as drug counseling, has the highest probability of being effective.”
Methadone treatment programs are staffed by professionals with medical, clinical, and administrative expertise. Patients receive medication from a health professional. Patients routinely meet with a primary counselor (social worker, caseworker, or certified substance abuse counselor), attend clinic groups, and access medical and social services.
Methadone’s effectiveness, and the absence of any serious, long-term side effects from using it, have been demonstrated in numerous studies conducted over the past 30 years. Among the most commonly cited outcomes are:
Heroine vs. Methadone vs. Suboxone
|Onset of action||A few seconds||30 minutes||30-40 minutes|
|Duration of action||4-6 hours||24-36 hours||About 24-48 hours|
|Route of administration||Injection, snorting, smoking||Oral||Sublingual|
|Frequency of administration||Several times a day||Daily or more frequently as needed||Every day or every other day|
|Effective dose||Ever increasing||Blocking dose usually 80-120mg||2-32mg|
|Tolerance||Increasing tolerance||Tolerance is stable||Tolerance is stable|
|Euphoric effects||Euphoria for up to 2 hours||No euphoria when stabilized||No euphoria when stabilized|
|Overdose potential||High and increasing||Rare (potential is mixed with other depressants)||Very rare|
|Overall safety||Potentially lethal||Very safe||Overall good. Suboxone injection will cause serious withdrawal symptoms in dependant person. Not recommended for pregnancy and caution with liver disease|
|Withdrawal||Within 3-4 hours after last dose||Within 24-36 hours after last dose||Within 36-48 hours after last dose|
|Craving||Recurring||Eliminated with adequate dose||Craving may not be totally eliminated due to ceiling effect|
|Pregnancy/Nursing||Grave risk for mother and fetus||Safe during pregnancy||Not indicated/study underway|
|Experience of pain and emotions||Blunted||Normal and full range of emotions||Normal pain but opioid analgesics may not be effective – may need to switch to methadone. Full range of emotions|
|Mood||Constant mood swings||Normal||Normal|
|Reaction time and intellectual functioning||Impaired||Reaction time normal. Intellectual functioning unimpaired on stable dose||Reaction time presumed to be normal like methadone. FDA cautions driving/operating machinery in the beginning of treatment|
|HIV & Hepatitis C transmission||High rate with needle use and unprotected sex||Reduced/eliminated||Reduced/eliminated|
|Immune system for HIV positive persons||Rapid progression to AIDS||Progrssion slowed||Progression presumed same as methadone – data not available|
|Immune/endocrine system functioning||Impaired||Normalized during treatment||Presumed normalized. Data not available|
|Stress Response||Suppressed||Normaized during treatment||Normalized during treatment|
|Criminal activity||High level||Reduced/eliminated||Reduced/eliminated|
|Community impact||Destructing impact. High crime, high death rate, transmission of disease||Contributed to public safety, low mortality, increased health||Contributed to public safety, low mortality, increased health|
Frequently Asked Questions
Does methadone treatment impair mental function?
Methadone treatment has no adverse effects on intelligence, mental capability or employability. Methadone treated patients are comparable to non-patients in reaction time, in ability to learn, focus and make complex judgements. Methadone treated patients do well in a wide array of vocational endeavors, including professional positions, service occupations and skilled, technical and support jobs.
How is success in methadone and other pharmacotherapy treatments defined?
The primary goals are to help addicts cease heroin use and lead more stable, productive lives. But, as knowledge about heroin addiction and effective treatment practices has grown, so too have the objectives of most methadone treatment programs, which also aim to:
Why do drug-addicted persons keep using drugs?
Nearly all addicted individuals believe at the outset that they can stop using drugs on their own and most try to stop without treatment. Although some people are successful, many attempts result in failure to achieve longterm abstinence. Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences including an inability to exert control over the impulse to use drugs despite adverse consequences – the defining characteristic of addiction.
How effective is drug addiction treatment?
In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community . According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment, and related services used to address those problems and the quality of interaction between the patient and his or her treatment providers.
How long does drug addiction treatment usually last?
Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum and some opioid addicted individuals continue to benefit from methadone maintenance for many years.
How do other mental disorders coexisting with drug addiction affect drug addiction treatment?
Drug addiction is a disease of the brain that frequently occurs with other mental disorders. In fact, as many as 6 in 10 people with an illicit substance use disorder also suffer from another mental illness; and rates are similar for users of licit drugs-i.e., tobacco and alcohol. For these individuals, one condition becomes more difficult to treat successfully as an additional condition is intertwined.
Is the use of a medication like methadone simply replacing one drug addiction with another?
No – as used in maintenance treatment, methadone is not a heroin/opioid substitute. It is prescribed or administered under monitored, controlled conditions and is safe and effective for treating opioid addiction when used as directed.
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