Methadone Clinics and Needle Exchange Programs

            Methadone is a synthetic opioid that is used to lessen the withdrawal symptoms in those who are addicted to opiates, particularly heroin.  Its effects last between 24-36 hours and it is used predominately to block the cravings that are associated with opiate addiction.  Methadone does not cause the euphoric effects associated with opiate abuse and it will not lead to tolerance.  Opiate addicts seek treatment for their addiction at Methadone Clinics, which operate legally under supervision in the United States.  Replacement Treatment is provided in two types of Methadone clinics: public clinics have limited funding and a longer wait, and private clinics are more expensive and will have shorter wait times.  The National Institute on Drug Abuse (NIDA) suggests methadone treatment should last for at least one year (The efficacy of needle exchange and methadone programs, n.d.).

            While some promote the benefits of methadone clinics, I do not have a high opinion of them.  As a police officer assigned to a DUI Enforcement squad, I taught several classes on alcohol and drug impaired drivers.  We would frequently take students to the methadone clinic in our city and patients would volunteer to be interviewed and examined by the students.  The majority of these patients were frequently already impaired by Opiates (predominately heroin) which they had purchased on the street, when they arrived for their methadone dose.  Several of the patients were also impaired by multiple drug classes, predominately CNS Depressants and CNS Stimulants, and sought the methadone to supplement their “high.”  The Florida Department of Law Enforcement (FDLE) examined methadone use from 2001-2006.  The FDLE discovered deaths related to methadone increased during this time period and heroin related deaths declined.  In 2006, there were more deaths in Florida attributed to methadone than any other substance (Graham, Merlo, Goldberger, & Gold, 2008).

            Needle exchange programs were stared in the 1980’s in an effort to decrease the spread of blood borne diseases such as HIV and Hepatitis-C.  In exchange for a dirty needle, users receive a clean needle and may receive substance abuse and HIV education, as well as HIV and STD testing.  Needle exchange programs are only available in a limited number of states and none of them receive federal funding for the program.  In the states where data is available, there has been a significant decrease in new HIV cases (The efficacy of needle exchange and methadone programs, n.d.).

            Needle exchange programs are not currently available in Florida.  Rep. Katie Edwards (D-Plantation) is currently introducing legislation that would create a 5 year pilot program monitored by the University of Miami to allow needle exchange programs in South Florida.  There was a 25% increase in reported HIV cases in South Florida in 2013.  The costs of treating HIV is $385,200 to $618,900 while the cost of one syringe is 97 cents (Sunshine State News, 2015).  While I do not like the idea of using methadone in the treatment of opiate addiction, I find myself leaning toward favoring the needle exchange programs.  If Rep. Edwards’ bill passes, the data can be used to further pursue the efficacy of the program at the end of the 5 year trial.

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Reference

The efficacy of needle exchange and methadone programs [Video file]. (n.d.). Retrieved from https://learn.liberty.edu/bbcswebdav/pid-5709631-dt-content-rid-40854078_1/courses/HLTH252_B06_201520/Presentations_iSpring/Module%203/Module%203%20NEPs%20and%20Methadone%20%28LMS%29/res/index.html

Graham, N. A., Merlo, L. J., Goldberger, B. A., & Gold, M. S. (2008). Methadone and heroin related deaths in Florida. American Journal of Drug and Alcohol Abuse,34(3), 347-353. doi:10.1080/00952990802010892

Sunshine State News. (2015, January 22). Edwards Files Bill to Create Needle Exchange Program | Sunshine State News. Retrieved from http://www.sunshinestatenews.com/story/rep-edwards-files-bill-create-needle-exchange-program

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