Category Archives: Medication Assisted Treatment

When Methadone Clients Get Stuck

Posted on March 26, 2013 | Comments Off on When Methadone Clients Get Stuck

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Clients across the country in methadone clinics and suboxone treatment programs are required to receive counseling while taking methadone or suboxone medication. Opioid replacement therapy specifically treats the painful opiate withdrawal, but counseling addresses the thinking, behaviors, and lifestyle that fed the addiction or that made individuals more vulnerable to developing addiction-related problems.

While in early recovery from opioid addiction, individuals begin to look at themselves and their lives through the process of counseling. It is during this time that clients face the truth about themselves and the effects that their addiction may have had on family and friends, finances, personal reputation, employment, and a host of other real world considerations.

It is easy to understand how some people can feel overwhelmed as they take their first sober look at the consequences of their recent addiction-based lives. However, change does occur … and change is a choice. A very personal and deliberate choice.

Many addicted individuals come to understand that one must face recovery one step at a time. No matter how much one wants to erase or repair past damage, there is only so much that he or she can do on any given day to start anew. What is required in this early phase of recovery is the simple desire to stay drug free and to try and make better decisions one-by-one with each new day. This sounds simplistic, but is a profound & powerful personal philosophy that leads the recovering person down a road to success. ACTION is a must. Action … is not optional.

Many suffering addicts are tired from fighting their addiction, but they also have an innate desire to move forward and to address their addiction problem. So many people become stuck in an active opioid addiction, spinning round and round, sometimes for years. They wonder if things will ever change. As the addiction becomes a familiar foe, addicts grow weary of the fight and settle for feeding the monster just to get through the day.

If you are opioid addicted, you do not have to be "stuck" in this addiction. You do not have to settle for a life of perpetual worry. It is important that you take action. You must take action. You must not wait for someone to come along and drop a miracle at your doorstep. Get into treatment immediately. Connect yourself with an addiction counseling center or detox or inpatient rehab. There is hope there. There are answers. There is support. There is real recovery going on everyday all over this country, and it is happening to people just like you. Believe that … because it is true! There are recovering people who have made the journey. There are treatment professionals with decades of experience. They have a clear road map and can offer you a new direction.

You can become unstuck! Methadone or suboxone treatment may be a part of the new solution for you. Or perhaps a medically supervised detox where they ease your withdrawal symptoms using safe medications. And you then follow that up with admission to an intensive outpatient counseling program (IOP) to learn the new coping tools you'll need in order to avoid relapse.

Maybe your first step is to go to a 12 Step meeting and ask for help, or a friend, or a pastor, or walk into the local mental health clinic and ask for a referral. Being "stuck" is a result of inaction, or taking the wrong action over and over. If you're serious about a new life and finally facing this opioid addiction, take the right action for yourself. So much is possible. You can do this. It can be done.

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Posted in Addiction Counseling, Addiction Recovery, Drug Treatment, Medication Assisted Treatment, Methadone, Methadone Clinics, Methadone Maintenance, Methadone Programs, Methadone Success, Methadone Treatment, Opiate Addiction, Opiate Treatment, Recovery, Relapse Prevention

Balancing Methadone Client Rights With Accountability

Posted on November 4, 2012 | Comments Off on Balancing Methadone Client Rights With Accountability

methadone-clinic-13Methadone “take home” medication (also referred to as “take outs”) is a true convenience for those enrolled in a methadone clinic. Typically, clients who demonstrate that they are drug free and progressing in their substance abuse treatment can earn the privilege to receive take home medication.

Receiving take home methadone requires that the prescribing physician (and clinic) have safety and accountability measures in place to help reduce the chance of methadone or suboxone getting into the wrong hands. When clients take medication home, it is critical that the opioid replacement medication be kept secure and out of the reach of children. Overdoses can occur with individuals that have no developed tolerance to opioid replacement medication.

Receiving take home methadone is a privilege, not a “right”. This decision to award take home medication is usually a collective decision made among the clinical and medical staff in a treatment program. They base a client’s readiness to receive take home medication on that person’s level of recovery stability, absence of active psychiatric symptoms, and the safety & security of their immediate home environment.

Methadone and suboxone have considerable “street value” and can be resold or misdirected. Therefore, clinic staff want to be as assured as possible that any particular client receiving methadone is sincere, stable, and appropriately focused on his or her own recovery.

Methadone and suboxone patient rights are of course always very important. Clinics and physicians sometimes walk a fine line between accommodating the patient and requiring accountability measures that are perceived by the patient as a hassle. For example, methadone clinics are required to perform random “call backs” in which a client is contacted and required to bring their methadone medication back to the clinic within 24 hours for a recount. This helps the clinic insure that the patient is not over-taking their medication or misdirecting (selling) their medication. While not a guarantee of good behavior, it does encourage patients to treat their take home medication responsibly and with substantial care.

Another safety measure is random urinalysis. It is not safe for patients to receive take home medication if they are using other unapproved drugs. If a random drug test shows the recent use of illicit substances, then this requires the clinic to suspend take home privileges for some period of time, at least until it can be established that the patient is back on track and testing drug free again.

If a patient feels that their rights have been unfairly compromised, then they have access to the clinic’s internal review process and/or the state’s methadone board who hear and investigate client grievances. In the end, the patient and the methadone clinic should be in a cooperative partnership. This is the working ideal in any health care relationship one has with their treating physician. Clinics exist to treat and serve patients, and opioid addicted patients need the services of opioid treatment providers. This relationship is extremely valuable and should be nurtured by both parties both at initial intake and ongoing for the duration of the treatment process.

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Posted in Medication Assisted Treatment, Methadone, Methadone Clinics, Methadone Maintenance, Methadone Safety, Methadone Take Home, Methadone Treatment, Suboxone

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Anti-Methadone Sentiment Not Rooted in Reality

Posted on August 29, 2012 | Comments Off on Anti-Methadone Sentiment Not Rooted in Reality

methadone52In browsing articles on current methadone treatment, I came across a brief one in the United Kingdom’s Daily Record specifically from the Scottish news section. The article contained a number of derogatory quotes (in regard to methadone) from Scotland’s Maxie Richards. Ms. Richards runs a foundation for addicted people in recovery.

One quote from Ms. Richards pertaining to methadone included: “To me it represents a hopeless road, a road to nowhere.” Another comment was “I think it is such a waste to let young people spend years on methadone because we don’t think there’s any hope for them.” Ms. Richards is openly critical of the government’s support of methadone treatment programs.

Her words “a hopeless road” are not a fitting description of the life enhancing benefits of methadone in treating addiction. To the contrary, methadone is often the single most beneficial intervention for someone struggling with opioid addiction. In my experience, any addiction professional who is categorically against methadone is revealing a lack of education on evidence-based treatments, and is merely expressing an unsubstantiated personal bias that is easily refuted.

Today, a former client made a surprise visit to our clinic. She had been in methadone treatment with our agency for a little over 4 years and had come off of methadone one year ago. Today, standing in our lobby, she was full of life, smiling, and enthusiastically talking about how well things were going in her life. She said that methadone had been instrumental in saving her life. Since leaving treatment, she had remained completely drug free, was full-time employed, enjoying positive relationships with her family. And she looked wonderful, very healthy, and had a beautiful complexion.

Was her methadone treatment a “hopeless road’? Absolutely not! She, and we, knew that it was a bridge to a better life. She had originally arrived at our clinic beat down, lost in addiction, hopeless, and desperate for an answer after having tried everything she knew of to get clean and sober. Choosing methadone and counseling worked for her. I wonder what Ms. Richards might think if she had the chance to see and to speak with our former client today? Results speak for themselves. Methadone programs save lives and provide a deeply desired new opportunity. True, not all methadone programs are the same. Some are better than others.

Hope … is what many addicted people find when they begin dosing with methadone. Relief … from painful opioid withdrawal symptoms is what they feel. Gratitude … is what they express for a new start in life. And eventually happiness. Which is what our former client had come to share with us on this day.

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Posted in Addiction Recovery, Medication Assisted Treatment, Methadone, Methadone Benefits, Methadone Clinics, Methadone Maintenance, Methadone Safety, Methadone Success, Methadone Treatment, NIMBY, Opiate Treatment, Recovery

Prescriptions for Opiates

Posted on May 11, 2012 | Comments Off on Prescriptions for Opiates

opiatesThere are many legitimate and appropriate uses for opioid medications. Opioids are excellent at managing acute or chronic pain for back injuries, post-surgical recovery, dental work, and other medical conditions that generate unbearable pain.

For those who may become physically dependent upon opioids, their difficult journey often does not begin with a chase for euphoria or a “drug high”, but with a short-term prescription from their physician for a pain killer … in order to minimize the pain and discomfort from a recent surgery or injury.

How the brain & body respond to opiates varies from one person to the next. Some individuals have a very high tolerance for pain and may need relatively less pain relief medication than someone who possesses a high sensitivity to pain.

If an individual takes pain medication for a long enough period of time, they may run the risk of developing a tolerance to the medication such that only higher doses of it are effective at reducing pain. As the person begins to increase their use of the pain medication, a physical dependency begins to set in resulting in withdrawal symptoms when the opioid relief wears off. The only thing that will eliminate the uncomfortable withdrawal symptoms is taking more of the pain medication. And thus, a vicious cycle sets in.

It is important to consider than no one starts out intending to become addicted. Unfortunately, many prescribing physicians do not explain to their patient the potential for developing an addiction to opioids. In fact, there is general consensus emerging that pain prescriptions are too readily given out. Many admissions to methadone clinics include individuals whose opioid dependency began with a legitimate prescription for pain medication. It is important that both doctors and patients share responsibility in addressing the potential for addiction with opioid medications. We do not want to discourage the appropriate use of pain medications. They are extremely effective at helping people manage their pain and be able to function. But education is critical if we are to help individuals adopt the proper caution & awareness in regard to potential opioid dependency.

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Posted in Medication Assisted Treatment, Methadone, Methadone Programs, Opiate Addiction, Opiate Prescription, Opiate Treatment, Prescription Monitoring

Doctors and Methadone

Posted on May 4, 2012 | Comments Off on Doctors and Methadone

factsHow doctors view methadone is becoming a hot topic. A friend recently informed me that the TV celebrity doctor, commonly known as Dr. Drew, was against methadone and had publicly made negative comments about the medication. I was disappointed to learn of this because Dr. Drew has a fairly large national audience who follow his opinion on medical matters. I then noticed that Dr. Jana Burson (a well-educated and experienced opioid addiction professional) had written on this topic, and herself questioned why Dr. Drew had made derogatory comments in regard to methadone. Dr. Burson knows firsthand how incredibly beneficial methadone is to those suffering with chronic opioid dependency. If a physician deserves a national audience & voice on this topic, it is Dr. Jana Burson, not Dr. Drew Pinsky.

Physicians typically seem to fall into one of two camps: either those who are educated on addiction and modern addiction treatment approaches, or those who are not. This may seem like a simplistic analysis, but is surprisingly accurate. Sadly, in my experience, physician critics of opioid replacement therapies often jump to conclusions that stem from personal bias or opinion based on very limited exposure to methadone and its benefit to the recovering community. Methadone is not “alternative medicine”, or some unproven sideline drug that one must obtain via the black market in a third world country.

Methadone is the leading medically-approved pharmaceutical treatment intervention for opioid addiction in the United States. There is no medical “speculation” on methadone’s success in the treatment of opioid addiction. It is a proven method of saving lives and restoring quality of life for a large subset of those who are addicted to opioids. These are not hyped opinions, but are medical facts that are beyond dispute. That any “physician” would reject methadone as a legitimate treatment for opioid addiction … is professionally irresponsible, and suggestive of medical incompetence in the area of treating drug addiction.

Methadone has been in widespread use in America for over 40 years. The number of addicted individuals whose lives have been saved and/or improved (through the medically supervised use of methadone) is well documented. SAMHSA (the United States Substance Abuse and Mental Health Services Administration) publish evidenced-based Treatment Intervention Protocols (known as TIPS manuals) that are available to treatment centers all across America. They have several such manuals, published and widely distributed, that are specifically dedicated to treating opioid addiction with methadone and buprenorphine (suboxone). SAMHSA also maintain a U.S. government website listing all of the methadone clinics in the USA and U.S. physicians approved to dispense buprenorphine for the treatment of opioid addiction. Why do they list these? So that suffering people can find help for their addictive disorder.

Perhaps Dr. Drew should interview actual patients in methadone treatment programs. Then interview the staff of professionals (including dedicated, knowledgeable physicians) that work in these facilities. Then interview the families of methadone patients that regained their sons, daughters, mothers, and fathers. Then read the evidenced-based literature & research available (through SAMHSA) on the beneficial use of methadone in treating opioid addiction.

That might require Dr. Drew to walk off of the TV production set, out of the celebrity limelight … and into the everyday real world. It’s a place where people like Dr. Jana Burson work for many years, with thousands of opioid addicted people, using medical interventions that are proven and effective. Dr. Drew would do well to have a sit down conversation with professionals like Dr. Jana Burson. This might allow him to replace negative personal bias … with medical fact. Only then, would he be equipped to speak to the public about methadone and opioid addiction. Until then, he is just part of the TV & celebrity noise … where drama, ratings and sensationalism … are cherished over the truth.

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Posted in Addiction Counseling, Addiction Recovery, Drug Rehab Programs, Drug Treatment, Medication Assisted Treatment, Methadone, Methadone Benefits, Methadone Programs, Methadone Success, Methadone Treatment, Opiate Addiction, Opiate Treatment, Recovery, Suboxone