Methadone

Heroin addicts who have experienced Methadone have strong opinions. Some call it Goverment Wine, others compare it to Orange Government Handcuffs, or some even call it Tang. Methadone is so addictive, that many addicts are never capable of leaving that few block radius from the Methadone Clinic, out of fear of running out. The best tool for an addict to get clean is another clean addict - Unknown

Methadone

image by: Pinnacle Treatment Centers
     

 

The scientific evidence supporting the usage of methadone is indisputable and has been for years. So why is it not being used more often when there are millions of opioid addicts that need treatment? This problem can be summed up in a single word: STIGMA.

Methadone clinics have been associated in the mind of the public with criminal activity and other deviant behavior. This is because addicts themselves have been viewed as suffering from a “moral failing” and they view the clinic as just another way for these moral deviants to get their “fix”.

This view is, of course, grossly incorrect. Methadone is a treatment and for a chronic medical condition. Addicts attending a methadone clinic are receiving a life-saving treatment that relieves the constant, compulsive craving for heroin, prevents addicts from resorting to multiple heroin injections a day and the extreme dangers associated with heroin injection, and allows these people a chance to live a normal life.

Stigma Causes Legal Bans Of Methadone Clinics

But because of the stigma around methadone, many cities pass ordinances to ban methadone clinics or restrict them to certain neighborhoods. Indeed, some people need to drive 20 miles (or even more) just to receive their daily dosage, which makes it incredibly inconvenient to attain treatment and is a reason for some patients to drop out of MMT. It’s truly a tragedy that false public attitudes can prevent or impede people from seeking and receiving treatment. This type of situation would never be tolerated for treatments to other diseases like diabetes or HIV.

Stigma Alters The Way Patients See Themselves

Beyond accessibility to methadone, stigma can also hurt the patient’s self-esteem or the perception of the treatment to themselves and their friends and family. Studies have shown that stigmatization of methadone actually reduces treatment outcomes and is a reason why some patients drop out of MMT. And the data are very clear, if a patient ceases MMT they are extremely likely to relapse to heroin use. Stigma hurts addicts seeking treatment in multiple ways and a change in attitudes is essential so that policy and regulations can change.

Stigma Promotes “Abstinence Only” Ideas

Also, because of the stigma around treating addiction with medications, many patients are forced into expensive rehabilitation or detoxification clinics that only promote abstinence-only therapy. I even found one clinic that actually discourages its patients from even seeking out methadone treatment!

The problem with abstinence or “detox” is that a patient may be opioid-free while in the rehab facility, but once released, the addict will inevitably start using again. This is because detox or abstinence does not actually address the underlying biology of opioid addiction and does not prevent the powerful psychological craving for the drug, which is practically irreversible.

As described above, the Cochrane study concluded that only methadone is effective at helping the patient to remain off of heroin. A change needs to be made in how addictions are treated: abstinence and behavioral therapies without medications don’t work but methadone does.

What Can Be Done To Increase Availability Of Methadone?

Before political action can be taken to reduce overly strict regulations on methadone, public attitudes need to change. The public needs to realize heroin addiction is medical disease and that taking methadone is a treatment that needs to be taken everyday in order to fight the disease. A diabetic needs to take an insulin shot every day in order to live yet no one criticizes a diabetic for taking this treatment (an insulin shot is not a cure either). The same thing goes for a HIV patient who needs to take his or her anti-retroviral medication every day in order to fight the virus.

Patients suffering from opioid addiction take methadone for the same reason as the diabetic taking insulin or the HIV patient taking anti-retrovirals: it gives them a chance to live a normal life. Methadone is a treatment for a devastating disease, opioid and heroin addiction, and needs to be taken daily in order to keep the disease at bay.

Methadone Is Too Strictly Regulated

Despite its efficacy and safety, methadone is extremely tightly regulated. Ironically, it is much easier to get a prescription for oxycodone, which can lead to addiction, than methadone, which is the treatment for that very addiction! A recent review of state laws and regulatory policies on addiction concluded that prescribing law “has not kept pace with advancements in medical scientific knowledge about the interface between pain management and addictive diseases.”

Current regulations limit distribution of methadone to clinics so that dosing can properly be controlled and random urine tests can be done to test for heroin. However, a patient must be compliant for two years at a methadone clinic before the patient is allowed to receive their dose at home. Imagine if you needed to drive over 20 miles a day to the doctor’s office for two years just to receive the medication that you need before the doctor agreed to just write you a prescription!

While it is important that methadone administration must be initially supervised for dosage, risk of possible respiratory depression during first use, and to assure retention in treatment but two years is excessive. Furthermore, reduced regulations on how methadone is administered might help to combat resistance from communities that don’t want a clinic in the first place.

Source: Derek Simon PhD, Excerpt from Is methadone an effective treatment for heroin addiction? YES! AddictionBlog.org, March 9, 2016.

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Last Updated : Wednesday, October 23, 2019