Critical Stages in Development - Identification and Verification of Need

Methadone Maintenance Treatment: A Community Planning Guide

On this page:

• Gather Information from Community Sources
• Verification of Need

Gather Information from Community Sources

In order to justify the need for a methadone treatment program, it will be necessary to clearly show that there is evidence to support this initiative. Some of the initial questions that will need to be addressed are "How many people in this community are opioid users?" and "How many of these opioid users are potential candidates for a methadone program?" These are two questions that will come up time and time again and it will be vital to have some information to address both of these issues.

Unfortunately, there are probably no surveys or statistics from your community that will answer these questions. There are agencies and services in the community that should be able to shed some light on the local situation. The needle exchange program can be an excellent source of information. This program should be able to provide information on such aspects as the number of needles that have been exchanged over the years since the program's inception, the percentage of clients who are opioid users, the percentage of opioid users who are enquiring about the availability of methadone treatment and the number of clients from the area who may be accessing methadone treatment in other communities. If there are no needle exchange programs within the district, programs in nearby jurisdictions should be consulted since residents from the area may be utilizing these services.

The College of Physicians and Surgeons of Ontario (CPSO) should be able to provide information on the latter two points as well. There are likely other community agencies that should also be consulted to get their input on the need for this treatment. These agencies include addiction treatment providers, police services, social service departments, corrections agencies, public health units, mental health agencies and the District Health Council. Based upon information from other countries (e.g.. Australia, Switzerland), it is estimated that there is a range of 100 -200 methadone patients per 100,000 population (8). Of course, this is just an estimate and actual numbers will vary from community to community. However, this number can give the planning group an idea if other means as discussed above do not yield any significant information.

As information is gathered, community partners should be informed of the purpose for collecting this material. It should be explained that they may be invited to participate in a working group to further review and discuss the needs of opioid-dependent individuals and the viability of methadone treatment in the community.

Sources of Information on Opioid Users
Needle Exchange Programs Centre for Addiction and Mental Health College of Physicians and Surgeons of Ontario Addiction TreatmentPrograms Public Health Units Police Services District Health Councils Consumers

Verification of Need

As information is collected, it may be useful to share this material with other community stakeholders since they might be able to verify or even add further insight. New information may surface as a result of discussions. For example, through interviews, discovery of vital information such as learning of a physician who is exempted but has decided to discontinue prescribing methadone or that some addiction providers may have philosophical differences with methadone treatment. The group can begin to prepare to deal with potential problematic issues. This exploration stage can be very helpful in providing facts that can be used at the development and implementation stages. The information can be taken back to the community partners for further discussion.

The information gained through this process should be organized in a clear and succinct report since this will play a key role in demonstrating whether the development of a methadone program should become a project for a community working group.

Tips and Pointers
While interviewing community agencies, try and get an idea of the acceptability of the treatment model. For example, Who are the potential allies?, What groups have problems with the model and what are their concerns? At some point in time, these areas must be addressed and the planning group can get a head start in dealing with these issues.

Next>> Establishment of a Community Working Group

Methadone Maintenance Treatment: A Community Planning Guide

1. Preface
2. Introduction - How to Use the Guide
3. Methadone Maintenance Treatment - Rationale and Benefits
4. Methadone Maintenance Treatment - Service Components and Delivery Models
5. Critical Stages in the Development of Methadone Maintenance Treatment Services
   1. Identification and Verification of Need
   2. Establishment of a Community Working Group
   3. Methadone Maintenance Treatment Model Development
   4. Implementation
   5. Evaluation
6. Continuity of Care for Methadone Patients
7. Special Treatment Issues
8. Community Development Troubleshooting Guide
9. Appendix - Methadone Fact Sheet
10. References
11. Recommended Resources

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