De-Stigmatizing Methadone Treatment

Maureen MurdockAddiction11 Comments

Methadone chemical composition

We are being told that there’s a heroin epidemic in the United States that is killing scores of young people. The Midwest has become one of the hot spots of heroin use where it’s as easy to order it with your cell phone as it is to order pizza. Part of the reason there’s an increase of opiate use is that for years doctors prescribed painkillers such as Percocet, Vicodin and OxyContin thinking they were non-addictive. When they didn’t work to numb pain, people turned to heroin. And heroin is cheaper than prescription drugs.

It’s time to remove the stigma from heroin use and talk about treatment, specifically methadone maintenance.

We are often told that the use of methadone as a substitute for heroin is just “replacing one addiction with another” and that total abstinence is the preferred course of action. Critics of methadone incorrectly conclude that patients who are in methadone maintenance programs are impaired because both methadone and a newer medication called Suboxone can produce a “high.” However, if an individual is taking the same dose of the medication at the same time daily it no longer produces euphoria or impairment. And if calibrated appropriately, taking heroin “on top” of the methadone or Suboxone won’t work.

Maintenance has been proven to reduce crime, stop the spread of disease caused by intravenous drug use and increase employment as long as the medication is continued without interruption.

According to Maia Szalavitz in the NY Times article, “The War on Methadone,” opioid addiction should not be confused with the general concept of physical dependence. “Opioid addiction. . .is not simply needing a substance to function. . .[it] involves compulsive behavior in the face of negative consequences; obsessively pursuing a drug or experience even though it is ruining your life. Maintenance replaces unhealthy behavior with simple dependence, the need to take a drug to avoid withdrawal.”

The Centers for Disease Control, the Institute on Medicine and the World Health Organization have determined that for opioid addiction—heroin, OxyContin and Vicodin—ongoing maintenance is superior to abstinence. Maintenance is the only treatment known to reduce drug-related mortality, which it cuts by more than 70 percent.

According to Kenneth Anderson, “Maintenance treatment with methadone or Suboxone is the gold standard for treating opioid dependence. Patients on the proper dosage of maintenance medications are neither high nor sick—they are normal and functional.”

Drug courts have been instituted to help defendants get treatment and avoid prison time but only a third allow maintenance use of methadone or Suboxone. Gov. Andrew Cuomo of New York and Gov. Chris Christie of New Jersey are both considering whether to sign bills that have passed their State Legislatures to force all courts to allow this treatment. It’s time to increase the conversation and de-stigmatize methadone treatment.

11 Comments on “De-Stigmatizing Methadone Treatment”

  1. murdockbrendan

    Great description of the only real harm reduction there is at this time. Although herion user have alternatives, we still have an almost impossible task regarding user of cocaine, methadrine, myriad amphatimines, molly, and other, cheaper drugs for which there is no alternative but absolute sobriety. Opiod uséis are the least probable canditates for criminal, or harmful acts, at least towards others. The same cannot be said of those that abuse these other drugs. Hopefully, the medical community, pharmaceutical research and development will see the problem concerning a new epidemic of speed use. It is the cheapest drugs out there, it is closely linked to criminal thinking and compulsive action. Thank you for the illumination and researched explaition of a positive, socializing alternative to those addicted to all forms of opiod dependence, illicit,or prescribed through careless pain management. Focused, immediate attention needs to occure with regard to countless other, more dangerous drug dependence. Metadone has been around for at least 70 years, first proven effective in Europe. Countless people have joined the workforce and lived productive Lives. A good number have made a serious commitment to others. Let’s hope for alternatives for the above listed afflictions.

    S

  2. Kim

    Thanks for your valuable information, Maureen. I’ve never really understood how methadone works, but if it helps break the habit for heroin users, it’s a good alternative.

  3. Bill Dial

    This is a great explanation about a treatment option for heroin addiction that actually works. I hope the politicians follow your advice and authorize it in place of the failed abstinence model.

  4. jmccart2013

    Dr. Murdock, Thank you for your research-based, informed online blog postings. Your continuing advocacy on the mentally ill, drug-addiction treatments and prison reform contribute greatly to building an informed, caring and responsive citizenry. I am grateful for the knowledge and lived experiences you share to create a multi-dimensional and humanistic perspective toward the many valued lives existing within the shadows of our ignorance. Thank you!!! J McCart, MFA|MA|PhDc.

    1. Maureen Murdock

      Thanks J, it is always a treat to hear from you!! I’ve really struggled with the whole issue of methadone maintenance and whether it prolongs addiction so I appreciated reading Maia Szalavitz’s article. I’ve heard her present at Harm Reduction conferences and respect her work.

  5. Ackerman Ruth

    it would be fun to discuss this in person. acupuncture detox arose as an alternative specifically to methadone so there is lots of background to discuss. >

    1. maureen

      You’re absolutely right that we need more acupuncture detox and I’d love to hear the background! And there’s not enough acupuncture detox available for free in CA

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