Methadone and morality

[ac_claire]

Asteryx,

Well, you just laid out exactly what I’ve been trying to ask this whole thread, but I haven’t been able to word it so clearly.

I think maybe a big part of the problem, as far as advice from priests, online, etc., is that people tend to associate methadone --as a treatment for addiction–in the same category with other treatments, like rehab or NA or what have you. The only significant similarity is their classification. Yes, it can help you recover, but it can also still get you high. It sounds like it’s sort of the same on your side of the world as it is here: the big dirty secret about methadone maintenance is that you can still get high from it. (Not all do, dependent on their dosage and, I’d imagine their disopsition and general addictive inclinations…)
Therefore, there is a morality issue.

As far as it provides the cacoon of unreality, the pleasant fuzziness you mentioned, i do believe that it isn’t good for people (morally, spiritually) to take methadone. However, like you I also take comfort from what Mirdath pointed out earlier in the thread:

On the sin question, it’s not so bad: moral culpability requires full and free consent of the will, which addiction by its very nature goes a long way to diminish. And if one is actively trying to overcome that addiction, even if slowly and carefully (cold-turkeying opiates means a few days to a few weeks of absolute hell on earth), I can’t see how the effort could be regarded as anything less than heroic.

The fear of getting clean in and of itself seems to be the biggest obstacle in my addict’s path.

 

[Asteryx]

Yes. I think you have to have a personal contact or an experience with this to understand how this ‘fear of getting clean’ makes it such a big step to take. Opiates work by duplicating a natural class of drugs generated by the body called endorphins. They attach to special receptors in the brain, which unfortunately are capable of multiplying in the presence of high concentrations of opiates, whether endopathic or of vegetable or synthetic origin. Hence the rising tolerance which is such a problem in pain treatment and so expensive for addicts.
Trouble is, it seems that, once made, these little suckers stick around. So a cleaned up addict is going to spend the rest of their lives hankering after opiates. Without my trust in God’s help, I wouldn’t consider coming totally clean after all these years and wouldn’t blame anyone for choosing to stay on a programme. I would just encourage them to keep the dose low enough to stay reasonably clear-headed most of the time.
As for the morality of a medically-maintained addict taking their daily dose, maybe it comes down to this: there are some wrongs which trap us into a dilemma where, in order to get where we need to go we have to keep on doing wrong.
Imagine the position of a petty thief in a third world country who decides to change his ways and starts studying for a trade. But in the meantime keeps stealing because he has a family to feed. The consequences of his initial choice of theft as a profession echo on and on past the point of his repentance.
How does God judge this man? How does he judge himself?
How does he judge me?
There is a funny side to this. It reminds me of the times in Religious Education at school when we would sit around dreaming up dilemmas to throw at Brother Stephen or later Br Michael to see what they would say.
Now it’s real and it’s not even vaguely funny…

 

[ac_claire]

I was ‘rescued’ from my codeine addiction, from which I could have withdrawn in two weeks, and put on methadone.

Off topic—> but I wanted to comment on this…I don’t know the specifics of your situation, Asteryx, but this part of your post reminds me of an important point. I’ve personally known too many people who came into treatment with short-term/small-scale addictions (as much as there is such a thing) and ended up in a long-term methadone maze. It is not a one-size-fits-all treatment for opiate addiction. The kind of narcotics the addict is using, the degree of addiction, how long you were addicted, etc.-- those questions are crucial in determining the appropriateness of methadone. In general, it’s my opinion that most people who are addicted to pain pills, or who have a “light” heroin habit, or haven’t been strung out for at least a year should not be put on methadone. Because, like you said, the addiction you end up with on methadone can be much worse than the addiction which you sought help for in the first place!

In the US, most methadone clinics are private, for-profit clinics. Methadone will be recommended to any opiate addict who calls for a free consultation or counseling. And at the 3 clinics I’ve dealt with over the years with my dad, they tended to encourage ever-increasing maintenence dosages.

(just my opinion/rant…It’s neither here nor there in regards this discussion.)

 

[ac_claire]

Like all opiates, methadone insulates the heart…Since we talk to God and he talks to us though the heart, for some hours after I take my dose He is unavailable to me and I to Him. However since those hours are pleasantly fuzzy, often imbued with a general sense of love and bonhomie for my friends and family it doesn’t matter, does it?

Thanks again, Asteryx, for an honest and very helpful testimony.

If you don’t mind my asking, when you say “after I take my dose He is unavailable to me and I to Him,”…Is this something that you intuited as soon as you started your methadone detox? Or was it more of a gradual realization?

 

[VietCatholic83]

A common perception is that the use of methadone treatment is simply encouraging the opiate addict to continue in their drug abusing ways. However this is not the case. Methadone is highly regulated under the Controlled Substances Act which seeks to ensure that methadone treatment is done correctly and to the benefit of the individual. Since it is a scheduled controlled substance, more research and study has been done on the effects and effectiveness of methadone treatment and the evidence has overwhelmingly been that it is successful in treating opioid dependence. It remains controversial because many feel that true recovery involves solely abstaining from a particular substance. If one subscribes to opioid addiction and chemical dependency as a medical illness, then they would not object to using medication to treat such an illness. The stigma of methadone treatment and addicts in general contribute to the difficulties in accessing treatment and help for these individuals. Methadone is a medicine to treat the illness. Patients receive a dose that is enough to keep them stable and feeling normal, not to get high off “cheap government dope” as some think. So I do not see the immorality of such a treatment. Yes, a number of opiate addicts have quit cold turkey, but they are in the extreme minority. opiate addiction is tremendously difficult to overcome and research has shown that addicts are unlikely to to able to simply “decide not to do it anymore”. Physiologically the odds are against them. Relapse is very common. Methadone intervention has been shown to help addicted individuals get their lives back on track. However the stigma still remains and that is, in my humble opinion, uncharitable.

 

[ac_claire]

VietCatholic – Thanks for replying to the thread. Speaking from my own experience, I’d say everything you just described is true…under the best of circumstances. Unfortunately, the best case scenerario isn’t a reality for a lot of people, esp. addicts. Sometimes the system doesn’t help. And the truth is, methadone (like all opiates) is very frequently abused-- although I’m not interested in that aspect here…I don’t think methadone maintenance is immoral. Sorry if that’s the impression I gave in the above posts. The thread was intended to be mainly about people who believe that their personal reliance on methadone is a moral issue.

 

[Asteryx]

I guess I have to thank you, Vietcatholic83, for your post, which is certainly true as a general observation and a wake-up to me that I may have inadvertently put the hard word on people who are on a journey from degradation and street opiate use to stability and recovery. Yes, methadone maintenance is absolutely the best thing they can do and yes, no amount of self-flagellation is going to change their behaviour.
They need to connect with normalcy, with a life which centres around something other than scoring and getting high. Methadone does that brilliantly and the fact that they only have to come in once a day to pick up is brilliant.
I feel I was speaking from a different perspective, that of someone who was put on methadone as a cure for something much less addictive and harmful because of administrative convenience.
I was already running my own business and my codeine was coming from a doctor and I simply should not have been put on methadone.
At a moral level, I am simply reporting my experience that, by an act of my own hand, I am placing a wall between myself and God and enjoying doing so. This is not good. It doesn’t feel good. It feels wrong. I feel, even if it is not generally true, that I could do something else. In the particular moment I could. I could say “Not now. Later. Now I will pray.Now I will work. Now I will be with my family. I can take this stuff later.”
Instead I am saying “Yummy -bring it on.” Intellectually I know this is the habit of mind. Intellectually I know I have to do this if I’m going to keep working to feed and house my family.
It’s very weird, actually. Perhaps I should have kept my trap shut. There is no way out of this, other than to go to Mass & Confession often and trust that Grace will grow and nudge me out at the right moment.
As for your question AC Claire, when did I realise the effects of what I was doing? Always. Every user knows that when their tank is low they are unusually awake to everything - to music, to emotion, to temperature, to fatigue or energy and of course to a sense God among us.
As the 'done kicks in, this is replaced by an indiscriminate and entirely chemical sense of wellbeing and a general and quite bogus empathy with all and sundry.
Where I am at the moment with my return journey to the Catholic faith I have to rely on my feeling responses to Mass and the sacraments, because 90% of my head still says “No way. This is delusional.”
So I should be very very careful about putting out anything that others might take aboard when the things I am expressing are very particular to me and me alone.
All the same thanks for hearing and being supportive and responsive.

Arohanui, as we say down here. (It means ‘Big love’)

 

[Asteryx]

Oh, and one last thing: when I wrote “Since we talk to God and he talks to us though the heart, for some hours after I take my dose He is unavailable to me and I to Him” I was spouting rubbish. God is always available to us. I may be unavailable to him but He is surely there for me and for all of us. It is I who cut myself off.

 

[ac_claire]

Oh, and one last thing: when I wrote “Since we talk to God and he talks to us though the heart, for some hours after I take my dose He is unavailable to me and I to Him” I was spouting rubbish. God is always available to us. I may be unavailable to him but He is surely there for me and for all of us. It is I who cut myself off.

Understood, asteryx. That’s the meaning I got from what you wrote. In my family there is one person who has that same opinion re: being on methadone, and another who has never had any of these concerns because after his extraordinary life, he’s just grateful to have found something that handles his chronic pain and his addiction. I guess, in my mind, I’ve been judging the second person by the standards of the first. Which doesn’t make sense. For him, he believes that to stop taking it would be immoral.

 

[drafdog]

Back in the late 60’s early 70’s there was a priest at a parish I attended who was a councilor at an addiction treatment program which used methadone as a tool to help people get off heroin. Since that time it has become apparent that methadone is more powerfully addictive than heroin and harder to kick. Thus the dilemma. We try a lot of things to help people who have become hooked on various drugs. All of the medications currently in use must be handled very carefully because many are at least psychologically addictive if not physically addictive.
The church wants us to use due care and caution when helping others with their problems.

Matthew

 

[Asteryx]

I want to thank you all on what is probably your Good Friday, while I prepare to head off to the vigil for Midnight Mass, for turning your mind to this problem.
I have resolved it now for myself, for my situation and my experience. I am sure this sharing has helped,.
I have realised that, to a certain extent I have been sucked into the fallacy, started by that wicked old dog Harry Anslinger in the early part of the 20th Century, that tobacco and alcohol are not drugs, while all the other buzzes popular in one place or another are.
It’s not true and never was. So what I should be doing is asking if my controlled methadone dose is more or less intoxicating and alienating from God that a couple of shots of scotch? How much booze is a sin? And how much is a mortal sin?
What I feel after my dose is comparable to one double shot of whisky. So, that makes it a comparatively minor sin.God is not interested in distinctions as they are made by the authorities.
I have made a commitment to be clean by Christmas. I will achieve that, and I know my success will be more likely if I avoid bashing myself up over trivial questions about what I have to take between now and then,
Arohanui ki te katoa.
Ki te Ingoa, ke te Tamaiti me ki te Wairua Tapu.
Amene

 

[Mirdath]

Good luck, Asteryx!

 

[ac_claire]

I want to thank you all on what is probably your Good Friday, while I prepare to head off to the vigil for Midnight Mass, for turning your mind to this problem.
I have resolved it now for myself, for my situation and my experience. I am sure this sharing has helped,.
I have realised that, to a certain extent I have been sucked into the fallacy, started by that wicked old dog Harry Anslinger in the early part of the 20th Century, that tobacco and alcohol are not drugs, while all the other buzzes popular in one place or another are.
It’s not true and never was. So what I should be doing is asking if my controlled methadone dose is more or less intoxicating and alienating from God that a couple of shots of scotch? How much booze is a sin? And how much is a mortal sin?
What I feel after my dose is comparable to one double shot of whisky. So, that makes it a comparatively minor sin.God is not interested in distinctions as they are made by the authorities.
I have made a commitment to be clean by Christmas. I will achieve that, and I know my success will be more likely if I avoid bashing myself up over trivial questions about what I have to take between now and then,

Asteryx – I think you will achieve that, too. You remain in my prayers. Good luck!

 

[ac_claire]

I’d like to bump up this thread I started several months ago, see if any new members are interested in replying.

 

[RobHom]

I’d like to bump up this thread I started several months ago, see if any new members are interested in replying.

I cannot really see how the Church would have a moral issue with the use of methadone in palliative care…as in helping someone to break an addiction, nor can I see it as being a moral problem if it is used if properly prescribed medicinally by a Doctor for a proper intended purpose.

Here is a site that has a lot of information regarding Methadone and its purpose driven uses.

medicalassistedtreatment.com/35601/index.html?sessionidkey=sessionidval

I think its a “PLUS” in the treatment of opiate addiction.

Reduction of crime.

Reduction in the spread of HIV/AIDS.

Reduction of criminal behaviors.

Costs less to administer than to incarcerate, and the receiver is still able to function productively and work toward full recovery.

Additionally…for every 1 Dollar spent on Methadone treatments, there is a 4 to 5 Dollar savings realized on other health-care costs incurred due to the opiate abuse.

One interesting benefit…is that a pregnant woman can take methadone with no apparent deleterious effects.

Makes sense to me…and its use serves not only the good of the person its prescribed to, but all the greater good of society.

 

[ac_claire]

I cannot really see how the Church would have a moral issue with the use of methadone in palliative care…as in helping someone to break an addiction, nor can I see it as being a moral problem if it is used if properly prescribed medicinally by a Doctor for a proper intended purpose.

Here is a site that has a lot of information regarding Methadone and its purpose driven uses.

medicalassistedtreatment.com/35601/index.html?sessionidkey=sessionidval

I think its a “PLUS” in the treatment of opiate addiction.

Reduction of crime.

Reduction in the spread of HIV/AIDS.

Reduction of criminal behaviors.

Costs less to administer than to incarcerate, and the receiver is still able to function productively and work toward full recovery.

Additionally…for every 1 Dollar spent on Methadone treatments, there is a 4 to 5 Dollar savings realized on other health-care costs incurred due to the opiate abuse.

One interesting benefit…is that a pregnant woman can take methadone with no apparent deleterious effects.

Makes sense to me…and its use serves not only the good of the person its prescribed to, but all the greater good of society.

Hi Rob, thanks for replying. A lot of what you’ve written can’t be argued with. The facts are the facts, I guess the differences are in how you see things. You may live a somewhat normal life, but methadone is still a regular opiate, like heroin, like percocet, etc. Taking methadone for addiction is drug-replacement therapy. You’re still addicted to opiates but you’re taking it under legal, harm-reduction guidelines. You haven’t beat through the withdrawl, you’ve just put yourself in a holding pattern. You still have to pay the piper and face the withdrawl unless you plan to stay on the methadone indefinitely.

I have a few people in my family who’ve gone this route. Two for addiction treatment, one (my dad) for both addiction treatment and long-term pain management (he has a messed up/mangled leg from an accident 28 years ago). His situation is what inspired me to start this thread in the first place. Several months later, I think a bit differently than I did when starting this topic. In his case, I think he is probably better off on the methadone because of his pain issues and the amount of time he’s been taking it, which is about 30-40 years on and off.

 

[treadhead]

What would you say if a person gets on methadone for that purpose- to get off heroin-- but then they can’t seem to get off methadone…?

I guess the moral question comes in when I think about the specific addict in my life who this applies to. Staying clean, avoiding temptation, etc. --none of that is a problem. It’s the actual getting off in the first place that he can’t go through. Heroin detox is in a category by itself. It’s not even the most physically dangerous of withdrawls, but the physical and psychological toll it can take on a person is just unimaginable unless you’ve gone through it…And it can take weeks just to kick. This person has tried, and tried, and tried. He’s been in rehab, medically asisted detox, cold-turkey at home…you name it, he’s tried it. He’s so brave and strong, if he could just get past the worst part of the withdrawl, he might be able to get clean on his own. But he can’t do it. He’ll go as long as a week and half sometimes, but then caves. With methadone, it keeps him from ever having to go through it. It puts your body in a holding pattern as long as you’re on it.

I understand what you are saying.

I have a dear friend who’s in that very same predicament. She’s been a heroin user for quite some time. She’s gone through detox several times. She’ll be clean for awhile then relapse again and again.

She’s recently gotten on methadone, and is doing better.

The thing about methadone is that it takes away the cravings for heroin without producing the high that heroin produces. With heroin, in order to stay well, the user will have to keep upping their habit – and that’s not to feel the euphoria – that is just to keep from being sick.

Methadone users (or patients) – if they are keeping free from illegal opiates – can maintain the same dose for quite some time. And when they are ready, they can be gradually titraded off the stuff with very little discomfort (but it may take months of gradually reducing the dose)

The other dangers of heroin include infections from the needle injection site. Heroin is basically garbage injected into human flesh, and abscesses normally develop. I know of one girl who died from such a wound. At least with methadone, there is no use of needles.

Personally, I don’t like methadone. I prefer to see my friend abstain. But for her, at least for now, that is not an option. I am hoping that the methadone treatment will draw her mind from the street-mindset and draw her close to her family. Once the physical problems are taken care of (ie drug use), she can start working on the mental and spiritual.

My ultimate hope for this woman is a conversion of the soul. She was born Catholic, and I pray that one day she will come to love and appreciate what it means to be a part of Holy Mother Church…

 

[ac_claire]

Treadhead, I think you’re right about the benefits of methadone in your friend’s case especially. Only danger I can see is AFTER she achieves a period of stasis and is stable mentally and physically, etc., that she’s able to taper off the methadone if she wants to, within a reasonable amount of time. I’ve seen people get on methadone “just to detox” or just to help with a taper, or for “6 months tops”, etc., and then because it does work SO WELL they’re still on it 4 or 5 or more years later. That’s the bad thing about methadone. But it does have it’s good uses, as you described.

 

[GaryTaylor]

Being born into a family where addiction is passed down? Is part of the suffering you are doing on earth for pentance. No different than the new-born being born Crack addicted.

Using Methadone to detoxe Heroin sounds like a Plan. But remaining on methadone is a choice to remain addicted to another drug. And to continue addiction and the battle with Satan. You sure thats what you want to do? Liquid Handcuffs? Pray the Rosary daily and I’m sure you’ll find the strength you need. MOF I KNOW you will. Doesn’t that sound like a better plan?

Listen you can continue to GO UP on your Methadone Dose. Untill what? The infused supernatural spirit of Faith you recieved at Baptism is so numbed you no longer feel it. Or you can stop at the dose where you don’t crave Heroin. Then once your life has stabilized? Being a VERY SLOW decline OFF of Methadone. 5mgs a mth. How painfull do you honestly think that would be? If it was a BLIND detoxe you wouldn’t even know when you off methadone…serious. But you want to get that clarity of Mind back don’t you where God flows full force through your being. Good Luck bro

 

[ac_claire]

Being born into a family where addiction is passed down? Is part of the suffering you are doing on earth for pentance. No different than the new-born being born Crack addicted.

Using Methadone to detoxe Heroin sounds like a Plan. But remaining on methadone is a choice to remain addicted to another drug. And to continue addiction and the battle with Satan. You sure thats what you want to do? Liquid Handcuffs? Pray the Rosary daily and I’m sure you’ll find the strength you need. MOF I KNOW you will. Doesn’t that sound like a better plan?

Listen you can continue to GO UP on your Methadone Dose. Untill what? The infused supernatural spirit of Faith you recieved at Baptism is so numbed you no longer feel it. Or you can stop at the dose where you don’t crave Heroin. Then once your life has stabilized? Being a VERY SLOW decline OFF of Methadone. 5mgs a mth. How painfull do you honestly think that would be? If it was a BLIND detoxe you wouldn’t even know when you off methadone…serious. But you want to get that clarity of Mind back don’t you where God flows full force through your being. Good Luck bro

Liquid handcuffs is exactly what it is. The problem is, once you’re on it for years and years, you’re already seduced and you’re already party gone. It’s your “normal” and getting off will require wrenching a part of yourself away, it’s a death of sorts. Which is always hard and painful.

The clinic system is no help. Most clinics have the party line that some addicts “need” to be on methadone indefinitely due to an endorphine deficiency…brought on either by the original opiate addiction or by genetics. There is no science to back this up, but it’s still the line they use. And they’re always encouraging you to increase your dose. Having trouble sleeping? Raise your dose. Leg cramps, depression? Increase your dose.