FARGO - A year ago, there were no clinics in North Dakota offering methadone treatment for people trying to kick addictions to opioids, such as heroin and fentanyl. Now there are three, and patient numbers continue to grow.
Community Medical Services (CMS) opened the state's first methadone clinic in Minot in August, and a second location in Fargo in April. The Heartview Foundation in Bismarck began offering methadone treatment in March.
Mark Schaefer, the regional manager of CMS, said the number of clients at the Fargo clinic has grown faster than he expected. The clinic currently serves about 60 patients, a number that took about two months to reach, Schaefer said.
At the Minot location, it took six to seven months to attain that same number. "Even with the difference in size (of towns), that's still faster than you'd expect to see," he said.
There are now 75 patients being treated in Minot, Schaefer said. At the Heartview Foundation, 30 people are undergoing methadone treatment, said Executive Director Kurt Snyder.
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All three clinics run similarly, with morning hours that allow patients to come in before work for their daily doses of methadone. Because methadone can be sold on the street and used illegally, nurses watch patients take the drug, which can alleviate withdrawal symptoms and help combat cravings.
After three to five days of using methadone, clients with withdrawal symptoms experience reduced cravings, better sleep and less sickness, Schaefer said. For someone who was using heavily up until treatment, it takes several weeks for the dose to be considered therapeutic.
Schaefer said it typically takes one to two years of methadone treatment for someone to completely recover from an opioid addiction. However, there's a small set of people who take five years or longer.
Regardless of the time span, Schaefer and Snyder agree that medication-assisted treatment is the best route for opioid users. When methadone is taken, patients are able to function well enough to look for jobs, attend counseling and focus on family, Schaefer said.
"They no longer deal with withdrawal and cravings, and can return to very productive lives," Snyder said.
Snyder noted that the medication is combined with addiction counseling. At the Heartview Foundation, the cost of methadone treatment is $65 per week, but does not include counseling services, Snyder said.
At CMS, patients must attend counseling at least once a month, although most start off going weekly, Schaefer said. Counseling, physician and nurse services, along with the methadone, costs $85 per week at CMS.
In North Dakota, methadone treatment is only available at the three clinics, which accept state substance use disorder vouchers. Other clinics can prescribe similar medications used to treat opioid addiction, such as buprenorphine, but not methadone.
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Pamela Sagness, director of North Dakota's Behavioral Health Division, said the process of opening a methadone clinic involves significant oversight from the Drug Enforcement Administration and the state. Right now, there are no applications under review for additional methadone clinics in North Dakota, she said.
As for the existing centers, it appears they haven't had any problems in the communities where they're located. Fargo Deputy Police Chief Joe Anderson said there have been no calls to the Fargo clinic's address since April, and that call was not related to the clinic.