Methadone clinic law may be reworded
Changes would encompass new drugs
By Kim Swindell Wood
Published: Thursday, May 5, 2011 8:13 AM CDT
A bill that will be review in the State Senate, on May 5, 2011, would change the wording of a law about methadone clinics.
According to SB1284/HB1201, the words “non-residential methadone treatment facility” would be replaced with “non-residential substitution-based treatment centers offering treatment for opiate addiction.”
Under present law, Tennessee Health Services and Planning Act provides for the regulation of the establishment and modification of health care institutions, facilities and services, including non-residential methadone treatment facilities. The Act requires a ‘Certificate of Need’ be acquired prior to the construction, development or other establishment of any type of healthcare institution; certain modifications of a healthcare institution; or a change in the number of beds.
The new law would revise the type of drug treatment facility subject to the Act from “non-residential methadone treatment facility” to “non-residential substitution-based treatment centers offering treatment for opiate addiction, including but not limited to, stand-alone clinics offering Suboxone, Subutex and methadone as treatments.”
One of methadone’s uses is to prevent withdrawal symptoms in patients who were addicted to opiate drugs and are enrolled in treatment programs to stop taking or continue not taking the drugs.
It works as a substitute for opiate drugs of abuse by producing similar effects and preventing withdrawal symptoms in people who have stopped using these drugs.
Buprenorphine (Subutex) and buprenorphine and naloxone (Suboxone) are used to treat opioid dependence (addiction to opioid drugs, including heroin and narcotic painkillers). Buprenorphine is in a class of medications called opioid partial agonist-antagonists, and naloxone is in a class of medications called opioid antagonists. Buprenorphine alone and the combination of buprenorphine and naloxone prevent withdrawal symptoms when someone stops taking opioid drugs by producing similar effects to these drugs.
According to Tennessee General Assembly Fiscal Review Committee, under the existing law, physicians may get the Drug Enforcement Administration’s approval to provide opiate substitution-based treatment using buprenorphine for up to 30 patients and up to 100 patients with an exception. There are 359 physicians in Tennessee with DEA approval.
Physicians, who provide opiate treatment within the DEA 30/100 patient limit for buprenorphine, will be operating within their medical practice under the Board of Medical Examiners regulatory authority and will not be required to obtain a Certificate of Need.
Physicians, who exceed the 30/100 patient limit, will be required to open a free-standing facility, separate from their regular medical practice and would have to apply for a Certificate of Need.
Department of Mental Health estimates 10 new facilities dispensing buprenorphine as part of opiate addiction would obtain CON’s and get licensed by DMH.
Based on the existing active caseload of 6,600 for 12 licensed methadone clinics, each newly licensed facility would maintain an active clientele of 550 clients for a total caseload of 5,500,
In July 2009, The Expositor had received information about possible attempts to locate a methadone clinic, in Sparta, after permits were denied for proposed locations in Monterey and Spencer. However, the attempts were apparently abandoned after local and state officials spoke out against a methadone clinic locating in this area
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