Methadone and morality

[treadhead]

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.

I’ve know of people being on methadone for many many years. I don’t like it.

For my friend, as of now, it is probably the best solution, at least for now. I’ve been praying for her repeatedly, and I know these prayers will be answered. I’ve already seen a change in her. She spends more time staying with and caring for her elderly mother instead of running the streets – that’s a good sign.

Back in 2001, she successfully detoxed off of methadone and remained clean for almost 2 years, which is a record for her. I’m hoping that she can do it again when she’s ready.

She needs a reason to live and stay clean – and I believe that with prayer, that can happen. Abstinence would be the ideal solution – but for now, methadone seemed the best short term solution.

 

[ac_claire]

I’ve know of people being on methadone for many many years. I don’t like it.

For my friend, as of now, it is probably the best solution, at least for now. I’ve been praying for her repeatedly, and I know these prayers will be answered. I’ve already seen a change in her. She spends more time staying with and caring for her elderly mother instead of running the streets – that’s a good sign.

Back in 2001, she successfully detoxed off of methadone and remained clean for almost 2 years, which is a record for her. I’m hoping that she can do it again when she’s ready.

She needs a reason to live and stay clean – and I believe that with prayer, that can happen. Abstinence would be the ideal solution – but for now, methadone seemed the best short term solution.

Sounds like it. I hope it’s short-term for her, or as long as she wants it for. The worst is when you are ready to quit but can’t.

 

[GaryTaylor]

With methadone I could tell you this. Today our society is much to quick to refer a patient to Meth Maint. When you see young adults at the age 17-25 on a high dose and Meth Maint. This is in reality a lack of patience and a inabilty to effectively deal with the issues of a young adult. Meth Maint for us has always been reserved as a LAST RESORT. And for those who have already been in the revolving door syndrome of the Dept of Corrections, have been to multiple in-patient detoxe facilitys. And have usally tried LONG term abuse facilitys [such as Daytop] a “few” times. When at wits end we would recommend meth. maint. But “never” when its not the choice of the individual to stop trying. And I firmly suggest you never stop trying. You will overcome this if its your hearts desire and you follow the proven path and pray the rosary. I guarentee it and I guarentee a 100% success rate for those who follow the path. But ya whan all else fails Then implimenting a recovery outpatient program along with the Meth Maint.would be the direction at that point. So by combining (name removed by moderator)atient and out-patient the process of building a positive support system could take place.

Meth Maint. under the above circumstances for someone with a true desire not to commit slow suicide. And a true desire not continue a life of crime. Could be a very good alternative. And in many case’s I have also seen patients slowly change their life and ultimatly live a drug free positive lifestyle. Then ultimatly walk off the Meth maint program regardless of the time table, dose, etc. But it will not happen by dosing yourself daily and paying no attention to the recovery process. At best, you’ll stay out of prison, be able to work and have a family. But you’ll never walk aay from drugs if that drug line is your only motivation.

But today I see [including Yale] programs start patients at 90mgs [which is insane]. And through manipulation residents easily could reach dose’s exceding 130-140mgs. Often the same residents manipulating the system are also prescribed benzo’s such as Valuim Xanax etc for psychological issues. And these issues could vary from Bi-Polar, to Anxiety etc. But my point being is this is one of MOST dangerous combinations of drugs you could possible take. One wrong dose will shut down your respiratory system and kill you.

But anyway my point is this. Each individual case is different and has to determined on its own merits. But I firmly believe this way, to many souls are being lost and these are “not” all bad evil people. Many are simpled shuffled into the system or have a issue not effectively or mistakenly being dealt with. Unfortunatly I’ve seen many individuals come to terms with their issues on their own. And ultimatly walk away from meth. And to take it a step farther. The REAL SAD part of this? Is that if they have a decent insurance policy. The Meth programs are VERY reluctant to let them off the methadone.

But those in the age bracket of 17-25, I could almost say with certainty that they are simply being given up on and thus directed to a easy solution. They are NOT correctly being worked with. You have to realize that many issues confront an addict. First and foremost is denial. Many addicts simply believe they have no problem, and they are doing this “because they LIKE how they are feeling”. Once the level or realization is reached that you know you have an issue? Then you can begin to work with the “real issues” Which could be a variety of things. Behavior being the easiest to deal with. Drugs are not the problem is what I’m saying. They are a symtom of the problem.

Recovery is often a series of relapse’s which continue to cycle untill the individual comes to terms with their issues. But to simply give up and thus condemn yourself to a life of numbness? Not the solution. At Daytopn many many Heroin addicts would come in. We couldn’t refer these people to detoxe facilitys because we would lose more than half of them. We would admit them and immedialty put them on a 30-day blind methadone detoxe. So the resident would never know their dose and never know when they off the detoxe. The final 3-4 days they were taking flavored water not methadone. And believe me you would be shocked to see just how much of the physical addiction is you head. NOt to downplay how severe the physical addiction is. Because it is a long. severe, physical detoxe which isn’t pretty to see. At Daytop we would work with individuals for 18-36mths. If after twice through the program the individual still hasn’t seen the light? Then and only then, “MAYBE” methadone would be discussed, “discussed” now I mind not proposed as law.

When an individual is correctly dosed on the meth program. And brought up to 60mg at most. [40mg is the blocking dose]. You won’t crave heroin at 40mg, if heroin is the issue. If your taking 100mg of street meth in pill form? This is another issue. But at 40-60 the client will adjust quickly. They will not sit and nod all day long. And their body will reach a normal level or a level where a normal living could be achieved. Once at this point, through a effort to maintain a productive lifestyle. Your support system will slowly begin to evolve and take place. Through church, family. friends, AA. work…you will gravitate to those living drug free. BTW AA is NOT the only way. Its merely a support system like so many others including Church, Family etc. Once time and GOD has taken its effect and your life has ultimatly changed? You could begin the process of slowly coming down off the methadone.

But I’ve witnessed people on methadone for 10-years detoxe and successfully walk away from that lifestyle. Its not as rare as you think. It has to be done slowly, and I mean slowly. And it could take a year or two. I’m not saying this is a 30-day detoxe at this point.

Do not underestimate the power of praying the Rosary daily either.

GOD BLESS YOU!

 

[Rence]

hmm, thats a contradiction in terms. Just because someone is dependant on pain medication dosen’t make them a junkie, it makes them physically dependant. A junkie only looks for the high off the drug. A person with chronic pain just wants the pain to go away so they can function in life. Thats what I take it for. So I can goto work, be with my wife, and eventually be able to take care of our future children(were trying )

I have fibromyalgia which causes severe pain, earlier my doctors thought I had Chrones Disease, but it is under control now. It has effected my life horribly and has kept be bedridden for so many years. My mother was born with many autoimmune diseases and she also has Colitis, Meneere’s disease, migraines, and IBS.

Sadly, this is a common misconception. Drug addicts addicted to drugs to get high, are looking for just that: to get high. People who are in chronic pain just want pain relief. There is a VERY big difference between a drug seeker and someone who wants relief from chronic pain. This is a concept that is hard to understand if you don’t experience, or don’t know, someone in severe chronic pain.

 

[Jonny87]

PLEASE READ MAY HELP

Methadone is Heroin SUBSTITUTE.

The terrible addiction forcing side effect of Heroin is reffered to as being “Dope Sick”

Coming down off a high from this drug can be painful it includes vomiting, extreme head and stomach aches, body pain and cramping, chills, sweats, and sinus congestion.

In order to get “better” addicts must wait for the opiates to leave their system or do more drugs.

The purpose of methadone is to control the sickness without getting them high. Methadone helps addicts to start putting their life back together and remember what it’s like to not be high all the time and rediscover their sense of purpose and true happiness

 

[ac_claire]

PLEASE READ MAY HELP
The purpose of methadone is to control the sickness without getting them high. Methadone helps addicts to start putting their life back together and remember what it’s like to not be high all the time and rediscover their sense of purpose and true happiness

Well…this can be one purpose of methadone, for some people and in some situations. But if you put it out there as THE purpose then unfortunately you’re using the same propaganda that the for-profit clinics use. The same clinics who could really care less about an addict’s true recovery or happiness. Read the rest of the the thread; there’s a very dark side to methadone maintenance. And I’m someone who’s been very intimately acquainted with the stuff and the system for a number of years, so I’m not just showing an anti- harm reduction bias…

 

[zenith15]

As someone who has had their life given back to them through methadone treatment, I must disagree.

Firstly, as to the “evil” clinics–people make many false assumptions about them. People assume that they “keep people hooked” for the money, and that they should be encouraging everyone to get off methadone. Here are the facts:

1. Most methadone clinics have long waiting lists–and even those that do not have no problem whatsoever immediately replacing someone who tapers off and leaves treatment, due to the large and ever growing number of opioid addicts. They have no financial need to hold onto someone who does not wish to stay. They are licensed for only so many people.
2. 90% of methadone patients who leave treatment relapse within one year. This is not a guess–it’s a statistical fact. Urging patients to leave treatment, knowing full well there is a 90% possibility of relapse, is unethical. No doctor would urge a stable schizophrenic or bipolar patient to stop taking the medication that made them stable, just so they could be “drug free”. This is the same thing. It is a brain chemistry disorder, which methadone treats by replacing the missing endorphins no longer produced by the patient’s brain.

Not everyone needs long term MMT–but most do. Very often, the chemical disruption produced by opioid addiction is permanent, and requires more than just counseling and groups–it requires medication to restabilize. Will power alone cannot fix a “broken” brain.

Are there some patients who divert their medication, or who continue to use drugs? Yes–however, it’s important to note that methadone ONLY treats opioid addiction. Patients who are dually addicted often are not getting treatment for their other addictions, because most (name removed by moderator)atient facilities will not accept methadone patients. It is a real problem.

Also, though all methods have their failures, methadone is far and away the most successful method of treatment available for opioid addiction, with a success rate of about 65% free of illicit drugs and alcohol, as opposed to about a 10% success rate for the same patient population in abstinence based rehabs. It is supported as the best treatment option by the World Health Organization, NIDA, the NIH and the White House ONDCP, among others.

People make many false assumptions about who MMT patients are. About 75% of today’s clinic patients are there for addiction to Rx painkillers, not heroin. They come from all walks of life.

Lastly, stable, compliant methadone patients do not meet the definition of being “addicted” to methadone. They are physically dependent, yes–but addiction involves not just physical dependence, but also a set of behaviors, such as continued use despite harm, escalating use, lying and manipulating to get more, etc that are not present in stable MMT patients.

MMT patients are not “high”–they can work, drive, etc without cognitive impairment due to their tolerance and the unique characteristics of methadone.

 

[zenith15]

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.

As I noted in the above post, this is not the case. Methadone does not cause the intense high of other opiates due to it’s extremely long half life and very slow crossing of the blood-brain barrier, which is why it is used. Yes, people who have no tolerance to opiates will feel some sedation from it, but not the rush that most addicts seek, and stable patients feel nothing whatsoever. If a methadone patient you know appears high, nods out, etc you can be sure there is more going on than just a regular dose of methadone.

Also, it is not the same as being in active addiction, as I explained in my previous post.

As for “beating through withdrawal”, I have done that 13 times before I got on MMT. Each time, I relapsed. Getting through the physical withdrawals does not “cure” the bran chemistry imbalance that occurs in opioid addiction.

Many, if not most methadone patients WILL require life long treatment. However, some can taper off and do well, and as long as they taper slowly and carefully, they need not suffer withdrawals at all. Most people simply become impatient and rush through the process, making themselves ill. It can take months or years to safely taper off a high dose. However, methadone, unlike many other opioids, does not cover ALL the opiate receptors in the brain, leaving about 30% open to encourage the production of natural endorphins, if the brain is still able to produce them. This means that the brain can begin healing–again, if able–even while the patient is still on methadone.

 

[zenith15]

Well…this can be one purpose of methadone, for some people and in some situations. But if you put it out there as THE purpose then unfortunately you’re using the same propaganda that the for-profit clinics use. The same clinics who could really care less about an addict’s true recovery or happiness. Read the rest of the the thread; there’s a very dark side to methadone maintenance. And I’m someone who’s been very intimately acquainted with the stuff and the system for a number of years, so I’m not just showing an anti- harm reduction bias…

If you go by this logic, then the for profit abstinence based rehabs must not care about the patients either–they certainly count on repeaters to come back through those revolving door spin dry rehabs that offer no real evidence based treatment.

Just because a medical practice makes a profit, does that make it unethical somehow? Its really ironic that with MMT, if the clinic is for profit, they are villified as being evil and uncaring, and if they are government run non profits, they are villified for taking tax dollars and giving addicts a “legal fix on my money”.

Would you accuse your regular doctor of being evil and greedy for making a profit? Would you suspect he was keeping you on that insulin or blood pressure pill to keep your money rolling in?

The ACTUAL purpose of methadone treatment is to stabilize the brain chemistry of the opioid addict–to treat the imbalance in the brain chemistry that is causing the repeated relapses.

 

[ac_claire]

Hi Zenith…

I understand what you’re saying. I know a lot of people the same way and I feel, personally, the same way about methadone in a lot a ways as far as the effects it has on me, etc. (since I wrote this OP years ago I have since “come out” as being one of the “other family members” I was talking about who is on methadone.) I have been on it for quite awhile now. If you want to PM me, I’ll tell you how long. My dad has been on it for most of his adult life. A lot of the morality issues I was referring to are my own issues, and questions I was/am wrestling with myself.

I understand that methadone can be used, functionally and in addition to pain control, almost as an antidepressant, as you describe. I have experienced this myself. I am still on methadone, but I don’t want to be. I don’t want to be tied to the clinic system anymore, and I don’t like being dependent on anything. And it had some consequences for my baby daughter that I’d rather not ever repeat. But I do know what you’re saying and I have been there myself. I’m just not there anymore.

Zenith, I believe I recognize your name from some other methadone support boards…unless it’s just a huge coincidence. I used to live in Austin and went to the MARS clinic before moving to Kansas. If you’re the person I’m thinking of…I’m not sure if we ever met in person, but I have spoken to you on some of the other forums. Small world, huh?

 

[zenith15]

Hi Claire, yes, that’s me. I administer those sites now. One former admin passed on and the other stepped down, so I took them over. It is indeed a small world.

I certainly understand your frustration with the clinic system–many feel the same way. I also attend MARS and love it–I think it’s one of the best clinics in the country–but many others are not. Unfortunately, if you need the medication to live a normal life, you gotta do what you gotta do—but if you don’t, that’s great. I just hate to see people believing it’s all a matter of willpower, or of “working the steps right” or whatever when in fact it has a good bit to do with brain chemistry and is in some ways out of our ability to control at this point.

As for being tied down–I only attend the clinic once a month. I see people stopping off every day at the store for coffee and cigarettes on the way to work–they seem more tied down to me, lol! I have a colleague at the clinic who travels extensively to all kinds of foreign countries, etc and he has no problem. We are all “ties down” to some extent, I think–to our jobs, our families, our obligations here and there, our health constraints, etc. To me, this allows me to live a much fuller life than I otherwise could, and for that I am grateful.

 

[ac_claire]

Hi Claire, yes, that’s me. I administer those sites now. One former admin passed on and the other stepped down, so I took them over. It is indeed a small world.

I certainly understand your frustration with the clinic system–many feel the same way. I also attend MARS and love it–I think it’s one of the best clinics in the country–but many others are not. Unfortunately, if you need the medication to live a normal life, you gotta do what you gotta do—but if you don’t, that’s great. I just hate to see people believing it’s all a matter of willpower, or of “working the steps right” or whatever when in fact it has a good bit to do with brain chemistry and is in some ways out of our ability to control at this point.

As for being tied down–I only attend the clinic once a month. I see people stopping off every day at the store for coffee and cigarettes on the way to work–they seem more tied down to me, lol! I have a colleague at the clinic who travels extensively to all kinds of foreign countries, etc and he has no problem. We are all “ties down” to some extent, I think–to our jobs, our families, our obligations here and there, our health constraints, etc. To me, this allows me to live a much fuller life than I otherwise could, and for that I am grateful.

Yeah, I get what you’re saying. It’s sort of like the economics of need-- the one thing I learned in my econ classes at college lol. Basically, if something is “expensive” in any way (money wise or time-wise, or…being tied to a clinic, etc…) it’s not necessarily too expensive. The element of need factors in- how much you need the product or service or medication…those factors mitigate the cost.

Right now, and also in Austin, I only went to the clinic twice a month and that certainly is better than having to go daily. I’m like you in a lot of ways…methadone just makes me feel normal at this point. And if I go too long between doses, I feel it. I feel tired and scatterbrained and completely overwhelmed physically and emotionally. I take my methadone and I’m fine. My two big issues— the two big mitigating factors against methadone-- are a.) my fears about what would happen if there was a national or natural disaster or something (also on a related note, I don’t have a car and have to depend on my brother to drive me the hour trip to the clinic twice a month), and b.) the effect it had on my baby daughter. Or, the effect that me being on mrthadone had on the hospital staff and the consequences of that being I couldn’t take my daughter home till she was a month old. Those two things are the big ones, Especially since we want more kids and we want to start trying again ASAP. But my taper is very slow going. Slower than we ever thought it’d be.

And also, for me, there is a moral element as well, which I went into in some of the earlier posts in the thread…

 

[zenith15]

The natural disaster thing gets mentioned a lot. But in all honestly, lots of people are cut off from medical necessities during natural disasters, but that doesn’t mean they should do without them during the rest of their lives. I personally would not be willing to feel miserable every day of my life out of fear that there might possibly one day be a disaster that might cause me to be deprived of my medication for a day or two and cause me to be sick. That just never really struck me as a good rationale for getting off a medication that is benefitting someone greatly.

Now, if someone is planning to have children and they are ABLE to get off ANY medication, that is always best of course. But, if you need the medication in order to be stable, then you have to weigh that against the possibility of the baby requiring a short period of time in the hospital afterwards. These babies almost always do very well, and can be kept very comfortable as long as the hospital knows how to treat them. While it IS hard not to be able to take the baby right home, ultimately, it’s much better than mom remain stable and able to take care of and raise the baby, and if she needs medication to do that, then she does. Moms have babies every day while battling medical conditions that require medication–diabetes, epilepsy, depression, etc.

 

[GaryTaylor]

One of the oldest and most sucessful programs in the states was started by a Catholic Priest in 1957 here in the Tri-State area to help addicts. All long term theraputic communities today are modeled after Daytop. Many are ran by either ex-residents or those who worked in some capacity at Daytop. Its still helping addicts today.

When you look at social issues today in the US and elsewhere, its very rare that you won’t find either the Catholic Church or its members involved on the front lines helping.

Methadone isn’t a cure, its a substitution that replaces an illegal drug with a legal drug and is then closely observed. The problem in essense is not going away by doing this. Somewhere real treatment will still be needed to address the real issue which is not the drug.

When you get sick and tired of being sick and tired? Contact them and they will help you either directly or refer you to the right facility. Its not an insurance country club though and is not an easy program. Many of the insurance programs simply will get you straight and send you home. Thus correcting the drug problem but not the real problem. So its a profit oriented business to a large degree. A shortcut in other words won’t resolve the issue.

 

[zenith15]

Gary I am very familiar with Daytop, whose techniques are modeled on the now discredited cult Synanon, because I went through a similar TC myself. Shaming and humiliation and sleep deprivation do not cure brain chemistry disorders, unfortunately.

No, methadone is NOT a cure–because there IS NO CURE for endorphin deficiency. The public perception of methadone is just as you stated–a legal drug to replace an illegal drug–but this is NOT the case.

As I have already stated, people often begin using opioids due to a natural deficiency in endorphin production, as a means of self medicating. In addition, those who did have normal endorphin production to begin with cause a disruption in this production by using opioid drugs over long periods of time. In a small percentage of patients, with a period of abstinence they are able to begin producing endorphins again, and will not require ongoing medical treatment. But for many, the dysfunction is permanent. This leaves them struggling with severe, unrelenting depression, anhedonia (inability to feel pleasure or happiness in any way), anxiety, physical exhaustion, and extreme irritability. These symptoms cannot be treated with counseling, shaming techniques, job training, etc–it must be addressed medically.

Methadone replaces NOT the drug of abuse, as so many think, but rather, the missing endorphins no longer being made by the brain. It does this without causing any high or euphoria in stable patients. It can be taken long term without damage to the body. Just as with other diseases of the brain chemistry–schizophrenia, major depression, bipolar disorder, etc–medication, in conjunction with other therapy, has the best outcome.

The “real problem” in my case was not a bad childhood, or unresolved trauma, or a poor upbringing, or any of those things. I went through 13 of these supposedly wonderful abstinence based rehabs, attended thousands of step meetings and did all they told me, went to dozens of therapists, counselors, psychologists, doctors, etc–without any lasting effect. This went on for almost twenty years and resulted in the loss of just about everything that was important to me.

However, when I was finally appropriately treated for my brain chemistry imbalance, I immediately was able to stop using illicit drugs and turn my entire life around, and to return to the life I had been raised to live. I don’t steal, lie, manipulate, cheat, etc. I don’t need job training or courses in basic hygeine or AIDS prevention or smoking cessation, such as are commonly offered at abstinence based facilities. I don’t need to beat an empty chair with a nerf bat while yelling at my deceased mother. I don’t need to color pictures of flowers and rainbows in “art therapy”, or say positive affirmations about what a swell person I am every day.

Modern medical science has determined that addiction is a brain disease–not a moral failing–and as such it often requires medical treatment. Methadone is not given to these patients to provide a “legal high”–it is given to stabilize their brain chemistry and allow them to return to normal functioning. In no way am I “sick and tired”–my life is full and happy now, finally.

 

[ac_claire]

Zenith, I get what you’re saying…to my own personal fears re: natural disaters, having children, etc., you’re comparing being on methadone to any other sickness/condition that requires constant medication. I totally get the point you’re making. The differences for me, though, are this:

a.) Methadone is expensive. Unlike most other conditions, insurance can’t cover it. At least not for the vast majority of methadone patients and almost all (if not all) clinic patients. My new clinic here in KC actually piloted a program where they were accepting Medicaid. I am on Medicaid because of my baby, so I signed up. Apparently our clinic was the only one in the country that was doing this successfully, and they had to fight for the right to do it. Unfortunately though, a couple weeks after I was approved the program was dismantled. Nobody knows exactly what happened…it happened at the corporate level, with the company that owns our clinic. All we knew was that we were SOL and it was back to nearly $300/month for ALL PATIENTS. My own family is currently on welfare and foodstamps…if it weren’t for the clinic fees, we’d probably be able to go off welfare and we might even be able to afford a car.

b.) most other conditions, such as, say, diabetes…are something that the patient can control and make better, but ultimately can’t cure themselves of. I do believe that addiction is a disease and all that, and I’m not sure that I can cure myself of anything at this point…but I DO know that I have a choice to stay on methadone and deal with the consequences or get off methadone and deal with *those *consequences. That’s where I am now. I also know, from personal experience, that going to the ER in a semi-emergency type situation to get your methadone is not the same as a diabetic or epilectic going to the ER forthe same reason. You will not be treated the same, unfortunately. Depending on the doctor you get, you might not get treated at all. The stigma is real, and it sucks.

People like you and me…I do think we definitely help matters. We only go once or twice a month so obviously we’re not using illicit drugs. We have jobs and/or families. Nobody would be able to pick us out of a crowd and say, “there, that’s a junkie!” But again…unfortunately that stigma still exists.

Another example of the stigma and how it can hurt people: I think that was a big part of the reason why the NICU kept my daughter for month after she was born. They didn’t wait the normal 3-5 days to see if she would present symptoms. They didn’t wait at all, they planned her medications before she was born and then medicated her when she was 12 hours old. She presented no symptoms. But once she was medicated, well then we had to wait for her to be weaned off the meds that THEY gave her…not the methadone dependecy she was possibly born with. Even when they first started her on the meds, on tiny amounts to “see where she’s at”, she presented ZERO withdrawal symptoms. They tested her blood and she didn’t even show up positive for methadone, even though I was taking a dose of up to 85 mgs. daily for the entire pregnancy. The entire time she was in the NICU, as they tapered her from their meds, she didn’t show even the slightest hint of NAS. It was insane. I believe that in her case, the stigma was the culprit again. The staff (both in L&D and in the NICU) wasn’t familiar with methadone babies and totally overreacted, and then over-medicated her.

c.) I’m not sure yet if I believe in the endorphin deficiency argument. I have read about it, but I’ve also read things that discredit it, so… Not sure what to think. I’m not a doctor.

I do know that after all these years, methadone makes me feel “normal”…like I can face the day, face life. Last week actually I got up early with the baby, fed her, went and made coffee, got online to check on some forums, paid some bills…And after a few hours, I just felt tired in my bones. I felt overwhelmed by my short little to-do list. I felt overwhelmed by my baby. I didn’t know what to do first, everything got kind of confused in my head. I felt overwhelmed, dull and tired. Was starting to get depressed and achey, too. Then I realized…I ran to the bathroom and counted my bottles and yep-- I had forgotten to take my methadone! Scared me a little, because here I am trying to taper and I got another reminder of how much I need this medicine to function.

 

[ac_claire]

Gary, thanks for your post. I think places like you’re describing are geared more towards people who are actively using illicit drugs. Myself and my dad-- our “drug of choice” is actually methadone. He had a severe addiction to heroin, pills, etc. for most of his life due to some pain issues, and that led him to methadone.

A much more minor pain issue and some pain pills led me to methadone. I was not an ideal candidate for methadone and never should have got on it in the first place. I never had any addiction pre-methadone that even touched the strength of the hold that methadone has on me.

 

[GaryTaylor]

Well I will give it to you I haven’t worked in the field for years now. Though I did leave the state here to work at Daytop for several years.

I’m not sure what changes occured in the DMS IV in referrence to substance abuse.

The behavior modification models of TCs have changed drastically for “physical learning experience’s” etc and basically from the Federal program in Lexington KY.

Anyway if what you are saying is in fact true? What would be the purpose today of support groups such as AA or NA? In essense they’re no different but to deal with a set of behaviors arrived at through attitudes and feelings arrived at from one thought at a time. Know what I’m saying?

Also I do understand where you are coming from to a degree. But not so much with the pure addict. In other words there are no doubt individual case’s where for example bi-polar leads to substance abuse and is then diagnosed as such and dealt with differently.

Also I imagine methadone has changed in many regards. Simply wasn’t used as early as late 90’s early 2000 without a prior narcotic addiction. Matter of fact here we use have what was then called the narcon challenge coupled with urine samples etc. To actually confirm if in fact a potential patient was on narcotics.

Yes as I mention I spent 20-years working with behavior in general not specifically addicts. Though I’m sure about what did happen then, that well may have changed. One fact was certain. We just didn’t know as much about the cause as we would have liked to. And to a large degree we were working on a closer basis with behavior, attitudes and feelings. I know what you are saying about the older TCs. When I was there it was much more civil, and though personal image etc were dealt with. Nothing like the early 60’s. Basically individual and group therapy over a long period of time. And whatever behavior issues came up obviously became dealt with. Yet here in the Tri-State area behavior was in many case’s the main issue. Many grew in ghettos or housing projects and basically didn’t know how to behavior in acceptable social standards.

Interesting how its changed. Stress and burnout were so very common. Which is part of the reason I moved around, till at the end I was running a Homeless Shelter here. And even at that point I was surpized to see just how much addiction was the leading factor in the homeless here. In essense there was no getting away from it but to a degree. But out patient was like a walk in the park at that point.

I would have to actually to re-educate as to what happened the past ten years with the research.

The last decade also gave way not only to the heroin issue’s but to oxycontin, morphine and all the Feel Good Doctors. Still an issue.

Without a doubt I think Methadone is a better alternative to all that. But again how you use it and if in fact its used correctly? Only you know. Then as I’m sure as with today it was not uncommon for individuals to be on 140mg. And I have seen patients on the Bronx NY program and here in CT. Then its just pure chaos. I have also seen many who are responsible and maintain and live a normal life. [whatever normal is or closely as it can be defined]

Personally I am not against it, It is scary when you see individuals on a high does then using benzos or whatever, double dosing. And as far as dope or oxys? The methadone is definately the ticket to detoxe and the process to get straight. Where you go from there, or if in fact theres a problem with chemical imbalance is another issue.

I have seen patients come off methadone and still struggle with a chemical imbalance of the brain for 18-mths to 2-years. But they did finally reach what they described as how they “use to feel”.

Like I said I would seriously have to reseach to say anything from todays perspective though. There may well be a a new theory which is helping. I simply do not know.

But I wouldn’t be in any hurry, and should you want to come off, go so slow your almost at stop. I’ll check back with you guys and you can PM if you want to talk or whatever. My problem is young adults who immediatly jump on methadone at 17-18yo without even giving themselves a change to try other avenues. To me its a last resort for difficult case’s. And even here everyone wouldn’t neatly in that mold or thinking either. Individual case by case I do believe.

Hang in there, God Bless, GT

 

[zenith15]

While it is true that there are some individuals who may, even after many long years of heavy opioid use, get drug free and after a year or who begin to feel better, this is NOT the norm at all. The vast majority of such patients have permanent, long term changes in the brain chemistry, and this is NOT a theory–this is science FACT. We have countless peer reviewed studies and CT scans and much other evidence showing that this IS the case.

AA/NA have been around a long time and have a firm grip on the recovery industry it’s true. People seeking recovery are often told that the 12 steps are the only way to recovery, that no one can ever recover without this method, etc and this just is flatly untrue. AA itself published a self-reported triennial survey of membership showing that of those who began attending AA, only 5% were still there, sober, one year later. The manufacturers who make those keytags and chips given away for clean time make millions of those newcomer and 30 day chips, but very very few of the 15 year, 20 year, etc chips. I am not saying that meetings with others who struggle from addiction are not helpful–I think they are. However, when they were formed, very little was knows about the physical disease of addiction–now we know much more.

I saw a show recently about a ball player names Jose Canseco called “Lash Shotl”. In it, he told his story of having abused anabolic steroids for years and how when he stopped using them, he began to experience depression, low libido, low energy and other symptoms. He went to the doctor and was found to have a lowered testosterone production, as a result of his years of steroid abuse–it had shut down his natural ability to produce testosterone. His doctor treated him with a testosterone patch and injections. Jose asked if he would need these replacements for the rest of his life and the doctor replied that it was “quite possible” that he would, as the damage might well be permanent.

Now, this is almost exactly what happens with opioid abuse, endorphin shutdown, and supplementation with methadone, but somehow people villainize that while accepting the need for testosterone therapy without question.

Opioids are not inherently evil. We all have opiate receptors in our brains, we all make natural opiates, they help us to enjoy our lives and be happy. They are God given I don’t think, if a person has been shown medically to have permanent impairment of their ability to produce natural opiates, that prescribing a replacement to improve the quality of that person’s life greatly without causing any high or impairment, is wrong.

Dosage levels vary from person ti person. WIth opioid drugs, whether used for pain management or for addiction treatment, tolerance causes people to require often vastly different dosages, and it never fails to amuse me when people make judgments against others for their dose. Patient “A” will be on 50 mgs, and will assume that someone on 100 mgs must surely be completely wasted–because they know THEY would be. However, patient “B” is on 100mgs, feels perfectly normal, and imagines that patient “C” on 200 mgs, must REALLY be out of his mind!. But of course, patient C is tolerant to hid dose and is no more impaired by it than patient A is by theirs. The average dose today is 80-120mgs, which is much better than the too-low doses given out back in the 1980’s that caused so many people to get sick each evening and to continue using in order to avoid feeling bad. Adequate dosing makes a huge difference in positive outcomes.

 

[ac_claire]

Without a doubt I think Methadone is a better alternative to all that. But again how you use it and if in fact its used correctly? Only you know. Then as I’m sure as with today it was not uncommon for individuals to be on 140mg. And I have seen patients on the Bronx NY program and here in CT. Then its just pure chaos. I have also seen many who are responsible and maintain and live a normal life. [whatever normal is or closely as it can be defined]

I’ve been on methadone in Texas, Seattle and now Kansas. I remember in Seattle for some reason the median doses were crazy high. I didn’t know it then because I had no perpective. I was up to 150mgs. at my highest. I had a good friend who was at, I believe, 220 mgs. I believe that scarcely anyone needs doses like that. My initial dose of 40 mgs. “fixed” me…I should have stayed there if I was going to stay on it at all. But at this clinic, they taught that everyone has this set point in their heads where they will be balanced and normal at, and nobody knows what the point is so you have to fool around with your dose a little to see if you can find it. I was going through a bad break-up at the time and was depressed. The councelors over and over again suggested raising my dose. I didn’t know any better at the time. I thought of it as, these are “the professionals”, they know what’s best.

When I moved to Texas I eventually got down to 20mgs. which was great. Then slowly went back up to 55, and raised a little bit more in the last trimester ofpregnancy because the 'done was burning through my metabolism at that point and I felt like ****. But anyhow-- point being, the way they dose is just silly lol. There’s usually ONE doctor who is connected to the clinic who drops by a few hours a week. Otherwise, the dosing decisions are made by counselors and nurses. The counselors especially can be reeeeaally inexperienced. Zenith, I know you know what I’m talking about there. I’ve had some good, and some not so good.

Personally I am not against it, It is scary when you see individuals on a high does then using benzos or whatever, double dosing. And as far as dope or oxys? The methadone is definately the ticket to detoxe and the process to get straight. Where you go from there, or if in fact theres a problem with chemical imbalance is another issue.

I have seen patients come off methadone and still struggle with a chemical imbalance of the brain for 18-mths to 2-years. But they did finally reach what they described as how they “use to feel”.

Like I said I would seriously have to reseach to say anything from todays perspective though. There may well be a a new theory which is helping. I simply do not know.

Yeah. That’s where I’m at too. I just don’t know, myself.

But I wouldn’t be in any hurry, and should you want to come off, go so slow your almost at stop. I’ll check back with you guys and you can PM if you want to talk or whatever. My problem is young adults who immediatly jump on methadone at 17-18yo without even giving themselves a change to try other avenues. To me its a last resort for difficult case’s.

Yes, exactly. Sometimes nowadays it’s just pushed on anyone who’s played around with pills for a few months. Then they get on methadone and learn what a “real” addiction is like.