Outpatient methadone rehabs currently serve 254,000 clients throughout the US. Approximately 12% of all outpatient methadone clients, or a total of 30,000 people, are in New York City. Some new research reports shed light on their situation.
Methadone is the most highly regulated outpatient treatment available, on both the state and federal level. It is mainly confined to clinics where clients must line up every morning to receive their daily dose. This brings with it some horrible unintended consequences. Most visibly, and this has been the reason why many communities have sought to keep outpatient methadone treatment centers from opening, this setup causes a daily convergence of substance users, all with differing levels of commitment to change, and many with no intention to change. The influence of the less committed on the more well intentioned or moderately intentioned clients can be devastating. When they should be moving on with their lives, instead, the active substance user subculture remains a part of their daily life.
While it was found that a shocking 1 out of 10 outpatient methadone clients in New York City had experienced an overdose within the last 2 years, it’s important to realize that their problems aren’t even contained to these troubled users, but rather touch many more outpatient methadone clients. More than 21% reported being with someone while they overdosed – for a total of one-third involved directly with overdose episodes. What’s more, 73.5% said they know people who mix both licit and illicit substances with their methadone. What we have is a culture in which the vast majority of people attending outpatient methadone treatment programs in New York City are still heavily involved with active high risk substance users. The continuing substance use at outpatient methadone clinics in New York City is so bad that 73% of clients believe free needles should be provided at the clinics.
This report certainly paints a grim picture of the outpatient methadone treatment scene in New York City. Typically, the regulation of methadone clinics also requires that clients attend a number of individual and group counseling sessions, at least once a week – but many clients are required to attend even more often. This can only compound the problem, further drawing each client into the “recovery” subculture, which as we’ve seen, at least in New York City’s outpatient methadone treatment rehabs, includes a large proportion of active substance users. What’s more, another recent study found that these counseling sessions may be unnecessary, and may actually decrease retention rates.
Now, whether or not outpatient methadone drug treatment is actually an effective solution for opioid abuse is another question altogether, but as far as the comparison between counseled and non-counseled clients goes, this latter study doesn’t bode well for the counseling component of outpatient methadone treatment. The researchers focused on the first four months of outpatient methadone treatment (due to regulatory limitations), and found that 92% of clients who were allowed to take methadone without attending the typically required outpatient counseling sessions, stayed in treatment for at least 4 months – while only 81% of those who attended counseling actually stayed in treatment! Both groups equally reduced drug intake, but the non-counseling group was actually involved in less criminal activity than the group who received outpatient counseling! This may be one more important piece of evidence which points to the counterproductive nature of most substance abuse counseling methods.
Beyond these problems, the former study also cites many complaints of outpatient methadone clients that the staff are hard to get along with, that police regularly stake out the clinics looking to entrap people, and that many of them miss doses due to difficulty complying with the many bureaucratic traps involved in New York City’s outpatient methadone programs.
When looking for an effective long-term solution to a substance use problem, you should consider carefully whether you want to become a part of the rollercoaster ride of New York City’s outpatient treatment rehabs. There are more effective programs that do not include the ingestion of drugs as a solution! Call 1-800-497-3086 for more information on other options available to you.