I will never understand why people have such a difficult time accepting Methadone Maintenance as a long term, perhaps lifetime, modality of treatment. I ask you this. If a person has found that they sustain a healthy, productive, happy lifestyle, while at the same time, receiving his or her medication every day, why on Earth, would someone condemn that person?
I have heard countless arguments that Methadone was never designed to be a long term means of staying clean. I couldn’t disagree more.
We all know that the 21 day tapers don’t work for most people. It is proven that the only people who find success with short term Methadone treatment are those who have not been using for a long period of time, have a very strong support system, have some sense of stability in their lives, and have a strong reason for having to get clean. What about the “typical” heroin addict? The person who has been shooting dope for years, has no means of support, engages in a dangerous lifestyle as a means of supporting his or her habit and has nothing to lose. I believe the latter of the two types of people has little to no chance of maintaining any length of recovery.
Stabilization on the medication is mandatory when one is considering tapering their dose and I don’t know ANYONE who was able to stabilize on 30 mgs. for two days and then decrease over a 21 day period. I think I was successful once about 8 years ago when I was snorting a bag or two a day. Though I don’t think that can even be considered success when I immediately started using again after I was off the Methadone.
I believe that most people seek Methadone treatment as a means of offsetting their addiction. Perhaps the sickness and the chase had become much too difficult to maintain and Methadone seemed to be a way that the full-blown sickness could be avoided. As for addicts immediately getting clean upon entering treatment, it doesn’t usually happen right away.
In the beginning, all the person is doing is finding the proper dose to feel normal and, in some cases, block illicit drug use altogether. It takes TIME to gain the desire to get and stay clean. Sure, many people enter treatment real beat up, with their backs against the wall and tails between their legs and claim that they want to stop. However, they don’t want to stop. They want the PAIN to stop. Only after a period of time does the person fully accept that in order for the pain to stop, the using MUST stop as well.
When we find our optimal dose, which could take months, we begin to put our broken lives back together. First and foremost, we stop using. We confront health, financial and social issues that we had long since abandoned. We start getting to the core of our disease and we learn about why we used in the first place. All the while during this process, and it is a process, we can rest assured that we won’t get sick because we are maintaining our endorphin levels with medication. The physical aspect of our disease is handled and only then can we begin to work on the emotional and psychological aspect.
There then comes a time when we may start to wonder if it is time to come off the medication. Perhaps our counselors, families and/or friends are pressuring us to get off. We listen to the comments and criticism. We wonder if there may be any truth in the notion that it is just a “crutch” and a “substitution” for our addictions. We think, “Maybe it is TIME.”
That is where my experience ends. I wondered those things. I asked myself those questions and I am confidant and sure that I made the right decision, all the while remembering that it was MY DECISION TO MAKE. I have no intention of tapering any time in the near future. I have come to a point in my life that I am finally comfortable in my own skin. I know who I am and I know what my limitations are. I have accepted that my brain works differently than a “normal” person. I know how I feel when my brain is screaming for it’s endorphins. I have made an educated decision because I can only know how I *feel*.
All common sense and intellectual reasoning gets shelved when I don’t feel well. That is the ultimate indicator. Why would I ever want to live my life always feeling like something is missing? It sounds almost comical when I describe the feeling. It is as if I am always feeling like I left the stove on or forgot to lock the doors. It is that same feeling multiplied by a thousand. Something just isn’t “right” when I am not receiving the treatment that my brain depends on.
That is just how I see it. Others can argue that they see it entirely differently. See, I just don’t see how this can be argued at all. The decision to stay on Methadone or come off of Methadone is PERSONAL and different for each person. I can’t tell anyone that they shouldn’t taper. That would be like telling somebody that I am qualified to treat them medically. Last time I checked, I didn’t have a medical degree hanging on my wall. So, if someone asks me whether or not I think they should taper, I can only tell them what works for me. If they do decide that coming off is the best option, I will always be here to help them find their keys, turn off the lights, shut off the oven, set the alarm…..