Chris Kelly, Director of Advocates of Recovery through Medicine, questions the therapeutic doses of methadone being given to patients trying to kick cocaine and heroin addiction. No patients were given doses that exceed 100 mg. She has witnessed patients being able to stop illicit alcohol and drug abuse when given adequate amounts of methadone. Adequate for some users is more than the 100 mg dose provided. According to Kelly, the success rate drops to one percent when the dosage is too low. This is the letter she wrote to the Journal of the American Medical Association.
Another study done has been conducted by participants from such entities as Albert Einstein College of Medicine, Yale University School of Medicine, and the New York State Psychiatric Institute. That study confirmed the importance of high-dose methadone for heroin abstinence. The participants saw the need for further study of the association between heroin and cocaine use.
Methadone User Relationships
Instead of living a life addicted to illicit drugs, using methadone is a good thing. The right dose for an extended amount of time is required. Sometimes problems such as loss of sex drive, depression, or irritability occur. Methadone is often seen as the culprit by the patient’s significant other. The problem is likely caused by lower hormone levels that are exaggerated by methadone. Methadone, taken correctly, helps people function close to a normal baseline. Partners need to consider other quality of life and health factors before jumping to the conclusion that methadone is to blame. This article tells of a problematic relationship that occurred because of a partner’s attitude and misconceptions about methadone treatment.
Ultra-Rapid Opiate Detoxification
Prior to 1980 detoxification techniques were usually unsuccessful and painful. Ultra Rapid Detox was developed. Patients are put under general anesthesia and given Naltrexone to flush brain receptors of the opiate. Patients typically feel terrible following the procedure and some risk is involved. A ratio of one to between 500 and 1000 patients die of unknown causes. The risk, the discomfort, and the cost have caused the Coleman Institute to discontinue using the procedure.
The Institute is recommending an Accelerated Detox Technique. Patients are stabilized before flushing the brain receptors. Patients adjust more comfortably. Risks are lowered by avoiding general anesthesia. Inpatient care is not needed, so costs are reduced. While this may work for some individuals, those who used the UROD procedure would likely advice against the approach and suggest methadone maintenance treatment. Here are two links describing what two UROD users experienced.
There are some police officers who either don’t know about methadone treatment for opiate addiction or don’t care. Police cruisers have pulled patients over after leaving methadone clinics. They give reasons such as making a wide turn. Sobriety tests are administered. Some are arrested for the presence of methadone in their system, even though it causes no driving impairment. The take-home doses of methadone have been dumped by officers frustrated because patients pass the sobriety test. Sandy shared her harassment story on this website.
It is an infrequent occurrence for methadone clinics to report harassment. Forty percent of New York methadone patients have been stopped and frisked by officers outside a clinic. Seventy percent have witnessed someone else from a clinic being harassed.
Twelve Step Programs
Those who diligently go through the 12-step process may see life change. Anyone, who has used the program and succeeded, deserves a well-earned pat on the back. The statistics for the success rate are not very promising. The success rate is not any better than the rate of success by people who underwent no treatment at all. Amy Cortney shares experiences she had with AA and NA on this website.
Believers of the anonymous groups use the help of parole officers, judges, counselors, and therapists to push the agenda. Bad advice and misinformation about addiction and recovery is spread. Others believe what sounds so good, and repeat what they have heard. The explanation given for the cause of dependency seems to be immorality. If that cause is true, addiction would be a behavior problem rather than a disease.
Extended Use of Methadone
It is believed that long-time heroin use causes a permanent metabolic deficiency of the nervous system. A regular opiate administration is required to correct the deficiency. Maintenance and retention are the goals of treatment. Similar to diabetes mellitus, there is an ongoing and indefinite dosing need. Methadone is a daily substitute opiate, having a long half-life that replaces the short-acting heroin.
Goals in terms of what can be achieved by those dependent on opiates have to be realistic. Sometimes total abstinence is unattainable. Individuals in drug-free programs are likely to use illicit drugs at least occasionally.
The physical health of drug users is hard to measure. Heroin users inject the drug and frequently contract infectious diseases that include HIV, hepatitis, liver disease, STDs, skin diseases, respiratory illnesses, and others. A reduction in injected drug use is beneficial not only to users, but to the broader society. Amy tells how she feels about the possibility of life-long methadone maintenance.
The Drug Market
The FDA has approved a drug similar to suboxone to treat opioid addiction. The pharmaceutical company claims less of the drug than the current opiate drugs being used is needed. An implant designed to treat addiction is also being considered for approval.
One of the problems that arise with these products is the need for cash only payments. Many insurance plans do not cover suboxone prescriptions. Dawn Robinson, from Springfield Ohio, said she spent $1100 in a month on the office visit and prescription. AJ, a heavy heroin user for six years, received the implant from a non-US licensed doctor. He had to have three implants to achieve success. Even with the implants, he expresses the need for a support team, comprised of family and friends, and NA meetings.
Two articles on this website address how the Drug War has become big business, and how being naïve on the subject of drug addiction has merciless consequences.Let’s call on Amy Cortner once more for her opinion on how to measure the success of methadone maintenance treatment.
Who We Are
Addiction Treatment Watchdog is a resource for educating medication-assisted-treatment patients and others about the disease and treatment of opiate addiction. Medications used for treatment of opiate addiction are methadone, Orlaam and Buprenorphine (Suboxone/Subutex). By exposing abuses in the current system, we hope to empower patients and challenge providers to offer quality, individualized treatment for the disease of opiate addiction.
TIPS 40, ‘Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction’ is a new SAMHSA guide for physicians offering buprenorphine treatment.
TIP 40 can be ordered by calling SAMHSA’s clearinghouse at 1-800-729-6686.
On October 8, 2002 the FDA approved Subutex (buprenorphine hydrochloride) and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) for the treatment of opioid dependence. Qualified physicians will be able to treat patients in their offices. Find out more about Buprenorphine and check the Physician Locator -More…
If you have a complaint about your clinic, please see How-To Resolve a Clinic Complaint. A.T. Watchdog would like to hear from patients and providers if they have suggestions about what patients should do when faced with a problem at their clinics.
Family and Friends. Is someone you love a methadone maintenance patient? Or, would you like to find out more about this life-saving treatment? Do you have questions about all this? Please send your questions to A.T. Watchdog and maybe we can help you understand what’s going on with the MMT patient in your life. There are many myths and falsehoods out there; don’t let them destroy your relationship!
Another Watchdog member has given birth and written about her experiences. This is a story that MMT patients that are pregnant, or thinking about becoming pregnant, should take the time to read. We also hope that providers can learn something from it. Read My Baby’s Story.
Please consider sending Watchdog stories about your experiences as a Medication-Assisted-Treatment patient. Your story may be the one that convinces someone MAT could help them. Read A.T. Watchdog Stories.
A group including representatives from various Federal and State agencies, researchers, epidemiologists, pathologists, toxicologists, medical examiners, coroners, pain management specialists, addiction medicine experts, and others conducted an investigation into the increase in methadone-related deaths.
The conclusion of this investigation is that methadone involved in overdose deaths was not and is not coming from Opiate Treatment Programs, but from methadone prescribed for the treatment of pain.
Methadone-Associated Mortality:Report of a National Assessment
If you have a story to tell about yourself or someone else’s experiences withdrawing from methadone while incarcerated, we want to hear it. Denying methadone maintenance patients their medication while incarcerated is a violation of patient rights and something advocates want to change. The stories you send us will help all patients that have the misfortune of being incarcerated and denied medication. Stories should be sent A.T. Watchdog.
The Addiction Treatment Watchdog message board is very active. MMT-related news is posted frequently on the board. If you aren’t already a regular visitor, please take the time to visit.
Friends & Family
The friends and families of MMT patients have requested a place they can call their own. Watchdog receives dozens of email messages from family and friends of MMT patients trying to find information about the disease of opiate addiction. Watchdog is proud to announce the Friends of Watchdog Message Board. Please distribute the link to friends, family members and others that might benefit from this message board. Thanks.