International Perspectives in Methadone Treatment

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Today I wanted to take a look back at a June 2019 study from Calcaterra et al which looks at international perspectives on medication-assisted treatment. Medication-assisted treatment, or MAT, is the process of using approved medications to help people recover from opiate use disorder and substance use disorder in general. The best drug rehabs in Florida and the United States use best practices and techniques that have been studied around the world, but sometimes the United States can be insular in it’s outlook, and it is good to get a more global perspective on MAT. It should also be said that the United States has historically never been a leader in substance abuse treatment and care, and even methadone itself, a common MAT medication, was brought back to the US from Germany after World War 2 as a sort of spoil of war. 

In the study from Calcaterra et al, the researchers looked at different countries’ approaches to MAT and methadone treatment, and the countries spotlighted included Canada, Australia, and the United Kingdom. According to the study, Canada has an accreditation system for pharmacies to dispense methadone. Across the country of Canada, many pharmacies are permitted to dispense methadone in daily doses to their patients for the treatment of opiate use disorder, greatly reducing the overall stress on the methadone clinic system, which also exists in Canada. The rules and regulations that govern these methadone dispensing pharmacies seem very similar to our own rules governing methadone programs, so it would seem they have greatly increased the volume of patients that are able to be treated in a given area without sacrificing the careful nature of dispensing methadone. In my opinion, this is one of the best ideas that I came across when looking at international medication-assisted treatment. 

Australia is arguably even a step better than that. In Australia, a family physician writes a prescription for methadone for opiate use disorder, something that is not currently done in the United States. After that prescription is written, both clinics and local pharmacies work together to serve those patients who have methadone prescriptions, as the Canadian model. However, in Australia, those patients who are not insured and cannot afford their medication are provided their medication without copay at the countries’ clinic system, while insured and self-paying patients can go to either a local pharmacy or a methadone clinic for their medication. It is possible that Canada also has a no-copay system for low-income people that is not mentioned in the study. The United States has a major issue with access to specialty clinics in rural areas, and Australia has solved that issue by including pharmacies, which exist in all areas. Australia is yet another western nation with a better treatment model than the United States.

The United Kingdom was the last country that the study I found focused on. The UK model is different from both the US and Australia and Canada, but from an outsider’s perspective, it also seems to work better than our American model. In the UK, specialists in addiction start a patient on methadone and see that patient until they are stable, a process that can take about a month. Once the patient is stable, that patient goes to a general practitioner or family physician for their medication from that point forward. This model would be immediately possible in the United States, as would the Canadian and Australian models, and seems to improve upon our own, at least with the added benefit of the involvement of general practitioners, something sorely lacking in this country. 

If you or a loved one is seeking information on substance use disorder treatment, both for alcohol or drug addiction, Florida Springs in Panama City, Florida is one of the best drug rehabs in Florida or anywhere else. It should also be noted that Florida Springs has a medication-assisted treatment (MAT) program that used buprenorphine to help patients stabilize after discontinuing illicit opioid use. 

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)

 

References

CALCATERRA, S. L. et al. Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction. Journal of general internal medicine, [s. l.], v. 34, n. 6, p. 1039–1042, 2019. DOI 10.1007/s11606-018-4801-3. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=30729416&authtype=geo&geocustid=s8475741&site=ehost-live&scope=site. Acesso em: 12 nov. 2020.