Columnist: Methadone not the answer for Eastern Maine’s addicts

So based on his many years, or is it months, in the field, Tyler Francke has decided that Methadone doesn’t always work. This is Earth-shattering news!

Of course he also admits that the Derek House system often fails for some. But that doesn’t bother him because he knows that it only because they aren’t trying hard enough. I remember when I was as young and uninformed as Mr. Francke. And I thank goodness I didn’t send my ill-considered, fact-free theories to the local paper back then.

Dio;
“thank goodness I didn’t send my ill-considered, fact-free theories to the local paper back then.”

I can’t speak for ill-considered, but the theory you’re sending now is certainly fact-free.

I’m inclined to agree with you – I think methadone can work, for certain kinds of addicts, and that in any case, taking the illicit nature of the fix out of the equation generally works to make our communities safer.

For one, methadone allows users to shift their focus – they don’t need to seek out a high on account of an addiction’s craving, and so they can focus on mre positive life factors, like work and family. It also keeps patients out of a circle of enablers – drug pushers and the community – and into a community focused on treatment.

Both of these are good things, but Tyler’s article focuses on a very real negative, which is abuse. Of course, all kinds of drugs get abused, and we don’t resort to cold-turkey solutions.

The real solution, in my eyes (which have never worked in a drug rehab center) seems to be tighter restrictions on methadone, used in conjunction with other treatments to treat the underlying condition of addiction, which is the course suggested by the NIH (http://www.nida.nih.gov/MedAdv/00/NR3-7.html).

I’m not sure if that’s the policy Maine uses – maybe someone else can enlighten me.

(Unrelated, why are the people on Maine’s substance abuse Web site so happy? http://www.maine.gov/dhhs/osa/treatment/opioid.htm )

Unfortunately all forms of chemical dependency treatment have pretty poor outcomes when compared to other treatments for physical health conditions The purpose of replacement therapy is to provide a chance for an individual to pursue exiting a lifestyle driven by undeniable (by that individual) cravings for the drug. Telling someone who can not tolerate withdrawal that they must tolerate withdrawal to get better is really telling them to continue to steal, prostitute, and engage in other highly dangerous activities to avoid withdrawal. Replacement therapies offer another option to engaging a son/daughter/father/mother in stabilizing their life, reducing the risk of death, and begin a process to overcome this condition of addiction. I fear that Mr. Franke’s article just heightens the stigma that if you seek help and select replacement therapy some how you are less. One in three college aged persons in Maine will use an opiate in a non-prescribe way and may become addicted. If that occurs I hope they will seek out and get engaged in some form of help that will reduce the likelihood they will die…. if that is talk therapy great, if that is cold turkey great, and if that is replacement therapy great. “Get help” should be the message delivered from the University of Maine on issues of addiction… not righteousism or elitism over what is the “right way” to get help. I hope this paper will seek out a qualified health professional to explain to those who read it, the pros and cons of available forms of treatment and not sole represent the opinion of Mr. Franke.

Different people find success with different methods. Life counseling works for some, and fails for others. Pretending that it only fails for those who don’t “take it seriously and really work toward their sobriety” immaturely implies character issues that may not be accurate or fair. Casting one imperfect method aside, for another imperfect method, because of potential for abuse, cuts the mooring ropes for a lot of people for whom the first method works.

Blanket assumptions like that have turned American drug policy into a self-defeating, hypocritical fiasco. We label pot a “gateway drug” because most hard drug users tried pot before hard drugs. We don’t mention that most tried alcohol before pot, because, gosh, that would make Budweiser a “gateway drug”. We ignore the evidence that most drug abusers are self-medicating untreated problems like depression. We ignore the evidence that jailing pot users hasn’t cut the usage of harder drugs. We have no logical method for regulating alcohol use, demanding total abstention until 21, and then throwing open the door to the bar, and we’re shocked that the newb’s don’t know how to moderate their consumption.

When it comes to mood altering substances like alcohol, pot, licit and illicit drugs, we behave like Scarlett O’Hara, preferring to ignore the reality around us, and think about it tomorrow.

What Mr Franke does not understand is the biological basis for opiate addiction and how methadone actually works. Like so many he simply assumes it is “trading one addiction for another” and that patients are getting “a legal high”. But he is wrong.

Long term opiate use shits down the brain’s production of natural opiates (endorphins). These are the chemicals that enable a person to enjoy life and feel pleasure in normal amounts. When the patient ceases abusing opiates, it may be some time before the brain resumes production of endorphins and in many cases, especially with long term users, it may NEVER produce them normally again–the damage may be permanent in nature. In addition many doctors and scientists believe that many opiate abusers may have started using opiates in an attempt to self medicate a naturally occuring endorphin deficiency.

Methadone, in a nutshell, replaces the missing endorphins in the same way that insulin replaces the missing chemicals no longer made by the diabetic pancreas. It is not a cure, but a treatment for a chemical imbalance in the brain. Some may only need it for a short time–others may need it for life. It does NOT cause a high in stable patients, contrary to popular belief. Addiction is not just a psychological issue–there are physical components as well and in many cases they require medical treatment as well as counseling, etc. Those who remain in MMT have a success rate of 65% to 90% while those leaving MMT have a relapse rate of 90% within one year, underscoring the need for long term treatment for many. The success rates of abstinence only centers, especially for long term opiate addicts, is abysmal by comparison.

I apologize for my unintentional typo in the first sentence of my second paragraph–I mean to say “shuts”.

Maybe everyone pictured on the OSA web site is happy because they’re all high on methadone.

Joking aside, I agree that methadone treatment can be effective for some people. It’s also true that it could cut down on crime, free people up to work, and stuff like that. However, the disturbing problem I kept running into in researching for this article, both through online sources, and interviews with treatment providers and addicts, is that methadone does make a lot of the promises you mention but not very many of them are backed up with results. I think one of the reasons for that, which is what I mentioned in the article, is that the system is too easy to abuse, and drug abusers are really good at abusing.

Perhaps stricter resolutions could help. They certainly couldn’t make things any worse.

Mr. Franke you have strong opinions on something you know nothing about. I’ve been a methadone patient for almost 3 years and it saved my life. I do NOT get a high from my medication. I feel the exact same way before I take it as I do after I take it, as I do several hours after taking it. The only thing it does for me it keeps me from craving other drugs. I work, I parent, I own a home and 3 vehicles. I’m not as you described “without money or insurance” thank you very much, and that type of statement is exactly why there is so much stigma associated with methadone. Is methadone right for every addict? Of course not. 12 step programs are’nt right for all addicts either. Some have been to 12 step rehabs many, many times and have not found the help they need, and not because they just “did’nt try hard enough” as you stated. Maybe they are just seeking the wrong treatment. Good day to you , and I hope you one day will pass less judgement.

Dio Genes, Dave and Zenith, you all seem to be so personally invested in defending and extolling drug protocols that your agenda has seduced you into argumentum ad hominem. You’ve completely missed the premise of Mr. Francke’s OP-ED piece. He has expressed that this very expensive drug, and the program of distribution, funded by taxpayers has marginal efficacy without attention to “underlying conditions” (such as “depression”) and extraordinary commitment, and therefore often fails and/or is abused. He has stated the problem is a rewired brain from chemical dependency (“shitting down the brain’s production of nature opiates”) and does NOT characterize this assertion as “news”. How that is elitist or righteous probably escapes anyone but those too entrenched (in whatever way) in the global plague of drug abuse.

CCL,is it clairvoyance that allows you to ascertain our personal investments, agendas, and seductions? Having no such powers myself, I’m left to rely on observations and statistics. Contrary to Zenith’s stat’s, you claim MMT has marginal efficacy; could you include some research to back that up? You trot out the cost of MMT as well, so could you please include data comparing the cost/benefit analysis of MMT to other treatment methods? Thanks in advance.

As for addressing the tired old saw about depression requiring dedication or commitment, I thought we’d seen the last of that decades ago. For years people with clinical depression were told such nonsense as You need to stop thinking about yourself. Or You need to get out in the and get some exercise or a hobby. When we discovered that the vast majority of depressives had a physiological imbalance of neurotransmitters, we were able to help them with meds that corrected the imbalance, and give them back their lives. Telling a depressive that they need to fix their problem with lifestyle therapy is as bogus as telling a kid with diabetes that he should give up that insulin crutch, taxpayer-funded, or not. If MMT is useful in restoring the pre-opiate level of endorphins, so that the underlying cause(s) of opiate abuse can be addressed, or so the patient can return to a somewhat normal life, why not employ it? Yes it can be abused, as can pharmaceuticals such as opiates, barbiturates, stimulants, and anti-psychotics. Are you also in favor of denying pain relief to all patients because some people abuse those meds? Or is it just Methadone users who deserve this restriction? If so, why? I believe that’s what Dave was referring to as being self-righteous and elitist. Personally, I would guess it’s just due to lack of information, but I may be too “entrenched in the global plague of drug abuse”, so take that with a grain of salt, or whatever powder you deem suitable.

Once again, I look forward to your stats on MMT failure rates, and the comparative cost/benefit analysis of MMT vs alternatives.

Cheers,
Dio Genes

A chronic relapsing disease.

One should carefully consider all the opportunities for help with this terrible addiction to opiates.

Methadone is effective for people having a problem with opiates including heroin. Clinics in the US offer counseling for those who have problems with other non opiate drugs and alcohol.

Some 12 step groups and some treatment centers are not very “friendly” to those who elect medically assisted treatment. Some 12 step members will suggest, in different ways, that a methadone patient taper off the medication without knowing the relapse statistics.

In the US, one may admit themselves for tapering using methadone or for maintenance which can be eventually tapered from or not. The prognosis for some/many is that they will relapse, even after tapering and some may need to stay on methadone maintenance for a long time due to changes in the brain chemistry (see: http://www.drugpolicy.org/docUploads/aboutmethadone.pdf. Page 6 and page 7.

Methadone is highly effective against opiate addiction when given in the proper individual dose. One of its attributes is that it stops the opiate cravings without the high that is usually associated with other opiates. For most, it is taken just once a day. There are those who need to take it more often due to differences in the speed of liver metabolization. There is no need of impatient treatment as the medication is quite effective, but it would be nice to be able to be a new methadone patient and have the opportunity to go to a “friendly” inpatient methadone treatment center.

Methadone has been around long enough so that it does not cost a lot of money as it is now generic. Suboxone, on the other hand is still quite expensive. If you or a loved one are having a problem with opiates, it would be wise to look into methadone or buprenorphine (suboxone)along with the other possibilites such as inpatient and/or 12 step treatment.

It would be wonderful if some 12 step groups become more “friendly” to medically assisted treatment so they could offer help with the other addictions without asking patients to get off their life saving medication. Oh, there are some Methadone Anonymous groups that have no problem with medically assisted treatment and might very well help with the other addictions problem.

Also, the problems with deaths with methadone being one of the drugs taken or the only drug taken has been more attributed to methadone from pain prescriptions. http://alcoholism.about.com/b/2009/04/22/methadone-deaths-links-to-pain-prescriptions.htm

When making choices it is important to know that this is a chronic relapsing disease that is life threatening. Do your research carefully for yourself or loved one. In my opinion, this should also include a visit or appointment with a nearby local methadone clinic and/or authorized Buprenorphine (Suboxone) MD.

Thanks for being

George

I believe the article posted by Mr. Franke was thought out and well written. I believe Mr. Franke interviewed several different people to gain knowledge in this area before posting any information and as it is stated it is an opinion column. I am amazed at some responses although not surprised. I beleive that methadone used on a taper schedule in a short amount of time (1 month or so) along with counseling and education can assist an addict to get their life back together. This is not how the methadone clinics operate. The clinics get a new client, start them at 20mg to 30mg depending on their level of use and continue to increase the client until they are stable. Who regulates the “stable”? The client does and an addict first getting off opiates still wants to get high. Their dose increases until they are sedated and that is just like the drug they just came off from. Why would they want to have a lower dose if they can still feel “high”? Why would they want to seek counseling if they don’t feel the effects and consequences of living life as opposed to being sedated to a point where nothing really matters?

The withdrawel from opiates causes many addicts to continue to use to avoid it. If clients were given a small dose and mandated to have counseling more than ONE HOUR a month maybe they would actually find the help they need. One hour a month for an addict fresh into recovery is not nearly enough to address the issues that caused the addict to use in the first place. These issues come up again when a client at the clinic decides to taper off. After a few years of methadone and getting a job, house, life back together the effect of withdrawel will still be there no matter how small the taper.Many clients turn around and lose all those things they worked so hard for. Many clients are at doses over 100mg and tapering 2mg a month would take years so they decide to do it faster. To quote the success rate from an above opinion from Zenith: “Those who remain in MMT have a success rate of 65% to 90% while those leaving have a relapse rate of 90% within one year”. What I understand from that statement is that as long as you are taking a drug every day at a dose that meets your own needs, then you can “succeed” but try to taper off and you will fail. Statistically, once you are in the clinic it is a ball and chain. Statistically, one hour of treatment a month is not sufficient. Statistically, people do recover every day without the use of another drug to do so.

Macey, and especially Dio Genes, your thin-skinned rants only corroborate that you ARE part of the plague…exactly what sustains the “stigma.” Exploit any “treatment” you want, just stop expecting the taxpayer to bail you out! And calm down!! No one goes off as instantaneously and perniciously unless a nerve has been touched…in other words, “methinks thou doth protest too much!!”

CCL,
So, you offer no data, no studies, no research to back up your claims. And now something about “expecting the taxpayer to bail you out”? Is this a medical discussion or are we drifting into Teabagger territory here?

If you’re not just preaching, and you want learn something, look at George Clark’s post. Note the use of source links. Great info for those who care to look.

Best of luck,
Dio Genes,

p.s. I love the “calm down!!” with twin exclamation points. Perfect satire.

diogenes…heal thyself first.

CCL,

Still waiting on that data. Suspect it may be a while.

Have a swell night,
Dio Genes

“diogenes” (no longer going to humor your disguise) I never said I’d provide “data.” I am not subject to your demands, impressed with your attempt at literary critique, or goaded by your need to engage.

I do not agree totally with this article. Anyone who has not dealt with an addiction themselves I believe has no business saying WHAT is the best way to deal with it. I suffered from opiate addiction to prescription pain pills. I went to traditional rehab 3 times with little success. I would stay clean at most 3 months and then it was right back to using and abusing again. I was finally given methadone and it was like a miracle to me. I was finally able to feel like a sane person again with no desire to go abuse drugs anymore. Yes, after so much time a methadone clinic will give you take outs. I have earned the privelege of a months worth of take outs BUT not ALL of us on methadone sell our take outs. If I don’t take my meds each day, I will start to have withdrawls that no amount of pain pills will help. The majority of us on methadone will work the program like it is suppose to be worked because it has saved our lives, our marriages and our families. Yes, there are some who abuse it, but like with anything else, welfare checks, foodstamps and other things, there are those who abuse the program and give it a bad name for the rest of us who aren’t.

What people don’t realize is that the years of abusing substances does affect our brain chemistry. That is why so many people can’t stay clean because the brain chemistry is out of whack and they don’t feel right. Malise, aches, pains, depression and other symptoms come from this imbalance. Now lets take hypertension for example. There are thousands of ppl with HTN. Some can control it with diet and exercise some have to take medication to control their HTN. The same thing works with addiction. Some people can go the traditional route and go it cold turkey and never touch another drug again, some of us have to have medication to help us control our addictions. You would never blame a diabedic or someone on HTN meds because they have to take the meds would you? No and you shouldn’t for addiction either.

As I said, unless you have been an addict, I don’t think you have any right to judge someone for what helps them be a productive member of society. You have NO idea.

I do not want to be on methadone my whole life. The plan for MMT (methadone Maintenance Treatment) and other forms of ORT (opiate relplacement therapy like the newer drug suboxone) is to eventually taper the addict off the meds, however long that may be……but if it means stay on methadone or live the life of an addict doc hopping, forging scripts and stealing meds from other ppl, then I WILL stay on it my entire life.

I forgot to add in my previous post, Amy asked “Who regulates the “stable” dose? The client does and an addict first getting off opiates still wants to get high. Their dose increases until they are sedated and that is just like the drug they just came off from. Why would they want to have a lower dose if they can still feel “high”? Why would they want to seek counseling if they don’t feel the effects and consequences of living life as opposed to being sedated to a point where nothing really matters? ” that is not true either.

Methadone does not make you “high”. A stable dose of methadone produces no sedation, euphoria or high feeling. That is why it is used for addiction treatment because you don’t get high from it…..You just feel normal. NO withdrawal symptoms, not the depression that comes with the chemical embalance from opiate abuse, no cravings for other drugs.

Also, the patient does not get to say what a stable dose is, the doctor does. A doctor has to approve a dose increase and they monitor you for signs of overmedication which include sedation, drowsiness and sleepiness and if they see these signs, they won’t approve an increase.

Before you ever get any take outs, they make sure you are on a stable dose and you have to be in the program at least 90 days with no bad drug screens and stable before you get ONE day of take outs. Then it progresses to more takeout with the time of treatment and no bad drug screens.

If you get ANY take outs, the Clinic are also required to call you back in to the clinic unannounced several times a year to do a “med check”. That is where they check to see that you have the amount of take outs you are suppose to have so they can make sure you aren’t selling them or taking more than you are suppose to.

Another requirement of a methadone clinic, we have to see the counselor at least once a month and some clinics even require you to go to group sessions in addition to the counselors sessions so it isn’t like we are just there to “get our fix” and go floating out of their on a cloud of drug induced oblivion. Beleive me, with all the strict requirements and cost of methadone clinics, it would be cheaper and much easier for me to get my fix the old way.

Again, yes, there are drawbacks to ORT as well as benefits and there are those that abuse the system, but in the long run ORT is the lesser of two evils and I as a recovering addict on ORT am thankful it does work as well as it does.

“Me,” you say nothing any other addict hasn’t already said…including in these responses (here’s your cue, diogenes). You got yourself in a mess, are still in a mess, and now accuse someone who suggests that taxpayers aren’t responsible for YOUR mess, of being judgmental because you “suffer” for your choices. Original.

“…this very expensive drug, and the program of distribution, funded by taxpayers has marginal efficacy without attention to “underlying conditions” (such as “depression”) and extraordinary commitment, and therefore often fails and/or is abused.” – CCL

“I never said I’d provide “data.” ” – CCL

Like I said; fact-free. If you make assertions about a program, you might consider having the evidence to back it up. Otherwise one might surmise that you’re pulling things out of thin air to support your prejudices.

People suffering from opiate addiction are not evil. Neither are methods that help those people. Studying the data is the only logical way to determine what works. Moaning about taxpayer bailouts may convince head-bobbing talk-radio listeners, but it doesn’t do anything for grownups trying to solve a real problem.

G’nite,
Dio Genes

Shame on you, CCL. Someday, when you or yours need help from your fellow man, you’ll regret having said that.

You’re bouncing now, “sufferer/master of facts,” so time for lights out for you and your roomies—fall asleep smiling about your next free dose and your delusion that you are a “grown-up solving problems.”

Oh now, you “shame” me, diogenes? Isn’t that a little judgmental, hypocrit?

(Lord, what a dim bulb) CCL, I am not on Methadone. I have never been addicted to anything. I guess you made that mistake because you can’t conceive of anyone sympathizing with the troubles of another.

You should look up the definition of “sociopath”.

Indeed. I judge that you are lacking in compassion for your fellow man. You started out talking about the efficacy of the treatment, but now you’ve revealed yourself as a moralistic miser, more worried about who is paying for what, than what works the best for the patients.

I can sympathize with ignorance of the facts, but not with heartless stupidity.

By the way, taxpayers DO NOT pay for my treatment. There are many states that take self pay only. Methadone is one of the cheapest medications to prescribe, that is one of the reasons it is prescribed so often in a pain setting. I agree that not all MMT patient are compliant, but most are and we should’nt be punished for something we are not doing. There are bad apples in every bunch, but that does’nt mean you should throw out the entire barrel.

Mr. Francke, I believe you are an intelligent, caring individual, and that is what worries me. So many just do not understand addiction because if they did, they wouldn’t be so cruel as to condemn the medicine that helps it. Granted, irresponsible behavior may have been the origin of the disease of addiction for many, but that’s no reason for society to discriminate against such patients. We have people who overeat and become diabetic. Do we tell them to use willpower to regulate their sugar levels? Of course not. We are a caring, merciful society in every other respect except when it comes to addiction. I just cannot figure it out. You said in your article that addicts’ brains have been rewired due to their chemical dependence. This is true, and willpower, alone, cannot make the brain healthy again, especially as the years go on. Addiction is a progressive disease. Furthermore, I would like to add that it has been established that the increase in methadone-related deaths have been due to the increase in methadone being prescribed for pain. Methadone has been a viable option for addicts since the mid-1960′s, but not until doctors started prescribing it for pain did we hear of methadone-related deaths. The medical community and our government concede that addiction is a disease. Methadone treats addiction successfully. We are no longer the society that treated lepers cruelly and threw people with mental illnesses into insane asylums. We are supposed to be an intelligent, civilized society. So, what makes it okay to be so hypocritical and discriminatory against addiction patients? I just do not understand.

“Mr. Francke, [sniff, sniff] I don’t know you, so first I’m going to tell you I believe you are caring and intelligent, then I’m going to call you cruel, discriminatory (because I don’t understand what protected classes under the Constitution are), and hypocritical because by golly, you just don’t want society to pay for drug addicts’ self-inflicted harm! I’m also going to analogize this to diabetes and obesity and pretend I am oblivious to the fact that doctors DO tell ALL their fat patients to lose weight for optimum health benefits. Then I’m going to stick my head in the sand with all the entitlement generation bloggers who have gone before me (but I’m not sticking my HAND in there…it’s still open for a hand-out!) and pretend that there’s no end to what society should be responsible for…’cause I’M sure not going to take responsibility for myself. [sniff, sniff]. In closing, I’ll adopt the credo everyone else has: Let’s keep curing addiction with addictive drugs because just like fighting wars to bring peace, it works so well!! Signed, Ringo. P.S. I’m not as scorched-earth, acrid-tongued as diogenes, but that’s only because neither the chip on my shoulder nor my ego is as gargantuan as his. If he can find his way out of his room, I hope he considers putting his undisciplined rage to use in Iraq or Afghanistan…go fight for peace, dude! Because it’s pathetic to spew such venom in a small-town college rag.”

Hey Ringo,

Thank you for your response and I hope maybe I can clear up some of the misconceptions you and others seem to have about what I believe regarding methadone.

First of all, I am tired of people thinking that because I don’t support drug replacement therapy it means that I don’t care about drug addicts and I don’t want them to get better. I don’t really know where this ridiculous thought comes from, since I stated very clearly in my column that I WORK FOR DRUG ADDICTS. It’s not an easy or high-paying job, and I wouldn’t do it if I didn’t love these addicts and sincerely want to help them. I am against drug replacement therapy because I think it does more harm to most addicts than it does good, NOT because I don’t care about them.

That leads me into my next point. I am not an addict. Neither are most of the policy makers, health clinic directors, and doctors who are perpetuating the drug replacement therapy system, but I guess we won’t go there. I am not an addict, but I do understand addiction, and I have a heart for the people who are trapped in it. Methadone does not help people out of this trap, it only gives them a new, slightly more convenient trap to be stuck in.

You freely admit, Ringo, that “… willpower, alone, cannot make the brain healthy again, especially as the years go on. Addiction is a progressive disease.” I agree that willpower alone cannot make the brain healthy again. What the addict needs is new neural pathways to be forged and new ways of dealing with life to be learned and made second nature. Drug replacement therapy does neither of these things. Willpower can’t do it either, but it can give one the motivation for doing it.

Finally, you are correct, that at least SOME of the methadone-related deaths over the past decade are due to methadone in pill form being abused. However, not all of these deaths are due to pill form methadone, in fact, a man in Houlton just died recently due to an overdose on Xanax and “methadone in liquid form” (only available from clinics). In 2002, in the months following the opening of the first Portland methadone clinic, the number of methadone-related deaths more than doubled, to the point where the clinic had to alter their policy on take-homes. There is a clear problem here, and it shouldn’t be ignored.

Once again, to sum up, I DO sympathize with drug addicts, I do understand them, and I do want to help them. I do not support a policy of “You made your bed and now you have to lie in it,” or anything like that. I just do not trust drug replacement therapy in any way as a good method for treating addiction. It can help some people, as a couple here have testified, but I believe it is abused far more often than it helps.

If you don’t believe me, ask one of the “patients” at these clinics how much they help people. If they’re honest they’ll probably tell you something similar to what I’ve been saying. I asked this question to a former patient of the clinic yesterday and he told me this: “There are more [illicit] drugs being dealt [by the patients] at that clinic than you can find on the streets.”

Scary huh? Hope this helps, Ringo.

“…go fight for peace, dude!” – CCL

Brilliant! Ranks right up there with “rape for chastity”. CCL, are you by any chance from South Carolina?

How many people did you interview for your article, Mr. Z?

There are about 2500 addicts in Maine on methadone…I would say you probably interviewed, at the most, six?

I wrote an LTE to you–long and very quickly composed–but an LTE all the same. I hope you will take the time to read it, even if it’s not published.

Finally I will say just one thing: if your goal is to help methadone patients find recovery, then your not going to do it by alienating them and making them feel bad about their decision to treat their addiction differently than you would treat yours if you were an addict. If you truly wanted to help them then you would start working on getting methadone patients the recovery support they need in the community….which they can’t get right now because of articles like this that make them unwelcome and stigmatized everywhere they go.

If your goal is to help methadone patient get better treatment, your going about it ass backwards. You have to start by understanding that you have NO IDEA what they are going through and that you are in no position to judge ANYTHING they do!

By the way Amy—sedation is not at all “just like the drug they came from”….most opiate addicts will tell you that their experience with opiates made them feel energetic and happy–not “sedated”.

The goal of methadone treatment isn’t to quickly taper and drop off methadone. The goal of methadone treatment is the same goal we have for treatment of ANY OTHER illness: first we save the addicts life-then we work on stabilizing the illness and bringing back quality of life. For many opiate addicts this isn’t possible without medication. It doesn’t matter if YOU think addicts should be able to feel better without medications–because what you THINK they should feel isn’t what they ACTUALLY feel.

Hmmm….labrat you accuse Mr. Z (are you talking about the guy that wrote this, because he said he works in a rehab) of interviewing only 6 addicts, but you make comments like you think YOU know what the goal of methadone treatment is FOR ALL OF US! Speak for yourself and the small percentage that long term MMT actually works for. The rest of us, the over 1200 recovering methadone and suboxone addicts, and the other 800 or so still getting high off methadone or still in denial – some of whom still sell our doses less than 50 feet from where they were “dosed” will tell you a different story. WE’RE the ones getting descriminated against not you and the chosen few poster children that long term actually works for. WE need some rehabs where our favorite high isn’t being prescribed to others in the SAME REHAB WE’RE TRYING TO GET OFF THIS CRAP IN as a glorified wonder drug! Tell all your friends (doctors & counselors included) to let go of their GOD COMPLEX! Some of us want to learn how to be sober not learn how to get to the clinic.

Stigma: Methadone Mainteannce Treatment is swamped by stigma.

http://www.thebody.com/content/art30848.html

In the above is a direct reference to the Stigma that comes from from 12 step groups.

As in my prior post, I honor the paths of other groups trying to help the opiate addict. It is true that some can find recovery through abstinence recovery. Yet others are not able to find it there, and/or turn towards the medical treatment model.

It sems that acceptance of the medical treatment model is beyond the capability of many in some 12 step programs which treat methadone patients as still using. A friendly approach, without out strong suggestion to leave the treatment that is working for them, could be a better way.

A meeting could declare themselves MMF Methadone Maintainance Friendly and allow full memebership privledges to methadone patients (like being allowed to openly share and even chair a meeting)

This small change may still seem impossible..

Ahh well..

George

Willy, it doesn’t sound like methadone maintenance has worked for you, but as you concede, it has worked for others. How many? That’s a number that we rarely learn because successful methadone patients are invisible. They blend into society and know that they can never tell anyone how grateful they are that they have medicine that helps them to be healthy, productive members of society. Methadone is a medicine that works, but it’s not a wonder drug. There’s more to recovery than just taking medicine. Your entire way of life has to change. You have to change it–the medicine cannot do it for you. If people are selling their doses “50 feet” away from their clinics, then these people are not ready to be in recovery, or they should be in a different type of treatment program other than methadone maintenance. There are other avenues that may work for them. Furthermore, those people who are treating methadone as a drug of choice rather than medicine are only serving to sabotage the treatment of those people for whom methadone is a God-send.

Facts of interest concerning the numbers of opiate addicts in methadone assisted treatment. (some clinics and other authorized MD’s are providing buprenorphine treatment).

“there are approximately 260,000 patients being treated with methadone in 1,203 registered and certified OTPs. There are more than 700,000 patients who receive prescriptions for methadone from private physicians in treating chronic pain.” Comments by Marl Parino

Source:

http://nama-president.blogspot.com/search?updated-min=2009-01-01T00%3A00%3A00-05%3A00&updated-max=2010-01-01T00%3A00%3A00-05%3A00&max-results=1

In my opinion, it is sad that some/many? 12 step groups will support those who are trying to taper and will not understand, recognize and honor with full membership privledges those who need to stay on medically assisted treatment. The same goes for some treatment centers.

George Clarke

MORE ON THE HISTORY OF STIGMA AGAINST METHADONE PATIENTS.

http://www.methadonetoday.org/dole_nys.htm

Thank you, George, for all the valuable information. Your input has been much appreciated.

Why do Methadone patients get a free pat on the back and understanding from the Community!
Smokers don’t!
Also a Methadone user can get behind the wheel of a car and drive after their fix and there is no law against it but, guess what their addicted, their stoned, there driving.
I think I will just stand on the sidewalk and smoke my ciggarette and hopefully, I won;t kill to many people that day!

Some research shows that persons taking their methadone properly are very close to the same risk as the average driver. It is not a get high drug when taken properly as prescribed and not mixed with certain other drugs and alcohol.(please read on)

http://www.whitehousedrugpolicy.gov/publications/factsht/methadone/index.html

This driving misunderstanding is often used as a way to try to prevent a clinic from opening. Methadone properties are not the same as other opioids and opiates.

Methadone for pain is prescribed very differently (taken several times a day instead of once a day) from methadone for opiate addiction. (with some exceptions for fast metabolizers.) The properties saught in opiate treatment are the elimination of cravings and the blocking dose where the abuse of other opiates becomes mute.

The community is helped by a methadone clinic because the addicts are no longer craving opiates for a day at a time and this reduces the potential for the spreading of needle born disease HIV Hep-C etc. and reducing the market for illicit opiates and opioids.

In my opinion, if they used some of the money on methadone treatment and buprenorphine treatment that now being spent on trying to interdict heroin from Mexico and the sale of guns and money from the US going the other way, the results might be much better.

If some of the 12 step groups eased up on their “dislike” of methadone and helped methadone patients with the other drugs of abuse – like alcohol & cocaine etc. a lot of good could come from there too. Ahhh well. Sigh…

http://www.na.org/?ID=bulletins-bull29

Thanks for being.

Ringo…I nvite you to speak with me. I’m in long term recovery with the use of methadone. It has saved and changed my life for the better. It boils down to many patients still abuse other drugs. If you are serious, methadone is no more dangerous to the user as insulin to a diabetic. I respect your opinions, I’m a success story that is trying to just give people something to think about. Thanks!
Brian

This is crazy.

Methadone can help people live normal lives. Many people simply won’t quit taking opiates because they don’t WANT to — their lives are BETTER with opiates. They’re supposed to be living in a free country — why shouldn’t they have access to methadone (or any other opiate, for that matter) on the free market?!?!?!

Why should they be tortured with laws that restrict their freedom? Methadone is plenty regulated already… Why on earth would it need more regulations?!?! In fact, regulating it does MUCH MORE HARM!

Making people go to a clinic every day just gives them opportunities to meet other drug users who can get them into trouble!

Moreover, it’s a ridiculous waste of time, time that could be spent being productive.

The real answer, of course, is just to LEGALIZE ALL DRUGS. OUT OF ALL THE DRUGS, THE OPIATES ARE THE *SAFEST*, AND USERS REGULATE THEIR DOSES WHEN GIVEN UNRESTRICTED ACCESS ON THE FREE MARKET. The drugs are also very cheap in a free market situation.

Besides, it is IMMORAL TO KEEP DRUGS ILLEGAL — LOCKING MEN AND WOMEN IN CAGES IN THE LAND OF THE FREE FOR TAKING CERTAIN SUBSTANCES IS ABSURD AND THOSE WHO PROPAGATE THIS SYSTEM WILL OCCUPY THE SAME CIRCLE OF HELL AS MURDERERS — they’re stealing people’s lives, day by day, with jail sentences and absurd bull**** that stands in the way of people who simply prefer to take opiates living enjoyable, productive lives.

Definitly has no idea what he is talking about. Its fine if your opinion is methadone is bad and doesnt work and I agree that some people do abuse it, but if your going to write an article on it do some research first. The cost of methadone is definitly not 80 per dose. Its about $100 per week. People who get takehomes (the max is 6 days a week) must have a year or longer of clean drug screens and complete compliance with all of the state and methadone clinic’s rules. This for some can be up to four hours of counseling a month, along with group meetings as well. Methadone, if used correctly, does help people a great deal. It helps people live normal lives and probably lowers the crime rate in the area if anything. People aren’t out stealing for drug money and dealing with street dealers. I cant believe someone would write an article on such a controversial topic and not even take a little bit of time to do some research. These facts are very easy to find out…..the facts in this article are way off. What a joke.