Category Archives: Methadone

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.

Suboxone Treatment

suboxone-treatmentSuboxone is the other leading opioid replacement medication and it is becoming increasingly popular as an option for opioid addicted people. Suboxone has historically been too pricey for most patients, but a cheaper generic version is rumored to be on its way to market in the near future.

Suboxone offers some unique advantages in that patients do not have to be observed dosing each day at a treatment clinic, and they can receive up to a two week supply via prescription. Medicaid already pays for suboxone and some states are preparing themselves to help cover the cost of generic suboxone once it is released.

There is excellent science behind the effectiveness of opioid replacement therapy. While methadone is by far the number one treatment alternative for opioid addiction, suboxone is beginning to garner positive acceptance in both the medical community and general public.

The most important issue at hand is that addicted individuals have good treatment choices at their disposal to alleviate opioid withdrawal so that they can once again pursue their hopes and dreams. If you would like to compare methadone, suboxone, and opioid detox, visit our opioid treatment comparison page here at Methadone.US.


Methadone Clinic Transportation

bridgeOne of the chief hurdles clients face in considering methadone treatment is how convenient it will be to get to the methadone clinic for daily dosing. Metropolitan areas traditionally have a timely bus system and access to taxis, but those in rural areas can often find themselves stuck in the country with no way to get to the clinic.

Family members and close friends often become part of the equation providing a daily ride until a client can earn methadone take home privileges. Some clients have their own car, but the cost of gas can be a detrimental factor. Clients with children and limited income, or with a verifiable disability, may be eligible for Medicaid transportation. Any person can apply for Medicaid benefits through their county Department of Social Services.

Attending a clinic session to dose with methadone is a “medical appointment” and generally covered under approved Medicaid services. At our clinic in North Carolina, a number of clients are brought each day to the clinic by Medicaid transportation in order to participate in their treatment.

Another factor to consider in utilizing a methadone clinic is the clinic’s designated dosing time. Some clinics provide a wide window of time in which you can arrive to be dosed. Other smaller clinics may have more restricted hours of operation. Consequently, a person may have to observe time carefully to make sure they arrive before closing time in order to dose. Many clinics will accommodate a late client if that client has a legitimate reason for arriving late and calls ahead before closing time to inform the clinic nurse of their dilemma. However, it is always best to consult first with clinic staff to learn of their policy on arriving late and late dosing.

Interested in more information on methadone? Try our Q & A methadone information page!

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.

Opioid Craving Similar to Food Hunger

Clients tell me that their loved one does not understand why stopping opiate use is so hard. Most non-users think that it is simply a matter of "willpower". While determination is very important in overcoming active addiction, "willpower" alone is usually not enough to overcome one's physical opioid dependence once it has taken hold.

There is a page here on Methadone.US that is dedicated to explaining opioid addiction and the overwhelming compulsion that addicted people feel to keep using these drugs. If you are suffering with an opioid addiction, I recommend that you have your family or friends read this page. It helps to explain (using easily relatable examples) how and why addicted people have such a hard time avoiding opioid use when their withdrawal symptoms and cravings begin to build.

Opioid addicted people are no more able to "just not use" than most people are able to "just not eat". The need to satisfy hunger and the need to avoid opioid withdrawal are similar physiological drives. Both are powerful needs that a person cannot ignore.

Opioid addiction causes profound biochemical changes in the brain. The potential for becoming addicted is always present. Thus, this risk of addiction is something that all physicians should discuss with their patients when they prescribe them opiates for whatever reason.