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
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.
In New York City, opioid addiction treatment is sharply segregated by income, according to addiction experts and an analysis of demographic data provided by the city health department. More affluent patients can avoid the methadone clinic entirely, receiving a new treatment directly from a doctor’s office. Many poorer Hispanic and black individuals struggling with drug addiction must rely on these highly regulated clinics, which they must visit daily to receive their plastic cup of methadone.
Despite a national drumbeat for more science-based treatment for people addicted to prescription painkillers, heroin and other illicit opioids, the expansion of methadone clinics has mostly gone unheralded.
Unlike buprenorphine, which can be prescribed by specially licensed practitioners and taken orally at home, or injectable Vivitrol, which can be administered by any doctor, methadone must be doled out daily at highly regulated and often very visible clinics.
But unlike pills and heroin, methadone lingers for a long time in the body, helping to alleviate cravings and compulsive drug-seeking—the need to fill the hole. At the right dose, it doesn't produce a high; it's meant to give people the brain space they need to stabilize their lives and focus on therapy. A regimen of therapy plus methadone—or one of two other Food and Drug Administration-approved medications, buprenorphine and naltrexone—is considered the gold standard for opioid addiction treatment. Studies show that, compared to getting no medicines, methadone and buprenorphine keep people in treatment for longer and reduce how much they cheat with illicit opioids. The medicines also save lives: Compared to getting no treatment, methadone can cut death rates by 75 percent.
''The safety and efficacy of methadone in the treatment of narcotic addiction have been documented more extensively than any other medication in the pharmacopeia,'' said Dr. Robert G. Newman, president of Beth Israel Medical Center.
Medication-assisted treatment is often called the gold standard of addiction care. But much of the country has resisted it.
Leaving a jail or prison is a particularly risky time for opioid users, due to lower tolerance and the increased prevalence of fentanyl.
VICE News obtained statistics that reveal soaring numbers of methadone patients in recent years, and provide a glimpse into how much health ministries are being billed for it.
Methadone maintenance has been used in the United States for approximately 50 years as an effective treatment for opioid addiction. Yet many myths about its use persist, discouraging patients from using methadone, and leading family members to pressure patients using the treatment to stop.
Despite an escalating opioid-addiction epidemic, methadone clinics still meet stiff opposition from many state and local governments.
Despite the nation’s decadelong surge in opioid addiction, large swaths of the U.S. still lack specialized opioid treatment centers that can dispense methadone, one of three medications available to treat addiction to heroin and prescription pain pills.
The other two medications, buprenorphine (approved by the Food and Drug Administration in 2002) and Vivitrol (approved in 2010), can be prescribed by doctors. But for some patients, particularly those who have built up a high tolerance for opioids through prolonged use or high doses, methadone can be the only addiction medication that works.
This post is part of a collaborative narrative series composed of my writing and Chris Arnade’s photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx.
Ask the old hands what they think about the methadone maintenance program in Australia 40 years in and you’ll hear a good deal of pragmatism. “It’s like the electricity bill. You want light at the flick of a switch, you’ve got to sign up and pay for it. Simple as.”
First, it’s true: some people use methadone to get high. It’s a synthetic opioid with mild sedative and euphoric properties similar to other opioids. But those properties are far less intense than in common opioids of abuse such as Oxycontin, Fentanyl, or heroin. There’s a black market for methadone. People buy, sell, and use methadone illegally. This activity occurs outside the purview methadone clinics regulated by the Drug Enforcement Agency (DEA), the Food and Drug Administration (FDA), and other local and federal agencies.
No one disputes that.
Brand has become a high-profile advocate for the need to treat addicts through rehabilitation programmes, with the ultimate aim of making them drug-free.
Methadone treatment is one of the most frequently evaluated interventions in medicine. The World Health Organisation and other UN bodies with a major responsibility for illicit drugs policy have endorsed the treatment.
You may be wondering that if methadone is an MOPR agonist why is it a treatment for another MOPR agonist like heroin? Isn’t this just replacing one drug for another? The answer is an emphatic: NO!
Methadone is long-lasting MOPR agonist. What this means is that is binds to the MOPR, activates it fully, but then sits there on the receptor for a full day.
The American Association for the Treatment of Opioid Dependence (AATOD) was founded in 1984 to enhance the quality of patient care in treatment programs by promoting the growth and development of comprehensive opioid treatment services throughout the United States.
NAMA is an organization composed of methadone patients and health care professionals that are supporters of quality opiate agonist treatment.
Methadone is a misunderstood, underprescribed, medication for chronic pain. Even doctors do not understand its potential for improving chronic pain sufferers lives.
Methadone is a narcotic pain reliever, similar to morphine. Methadone also reduces withdrawal symptoms in people addicted to heroin or other narcotic drugs without causing the "high" associated with the drug addiction.
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Methadone is a long-acting opioid; it has an effect for up to 36 hours (if you are using methadone you will not withdraw for this period) and can remain in your body for several days.
you stop taking heroin, methadone can prevent or reduce the unpleasant withdrawal symptoms. Many people stay on methadone long-term, but some people gradually reduce the dose and come off drugs altogether.
Methadone and Suboxone are opioids that have been well-studied and widely used to minimize withdrawal symptoms and cravings in opiate addicts. By removing addicts from the junkie lifestyle, these medications have been marketed as a solution to a life of crime, sickness, unemployment and poverty, with minimal side effects and a more affordable price tag than rehab.
Why the Controversy: Once believed to be a “cure” for opiate addiction, the drawbacks to these medications have become clear over time.