Category Archives: Opiate Treatment

Working As A Methadone Program Counselor

methadone-jobsWorking as a methadone program counselor is both a fulfilling and challenging professional job position. Personal fulfillment comes from forming a therapeutic relationship with people in recovery and enjoying the opportunity to see them move upward and onward in rebuilding a quality life. Fulfillment also comes from one’s role within an organization or agency and being able to contribute meaningfully to that methadone program’s expansion and continual improvement.

The challenging aspects of working as a methadone counselor stem from several areas. The first is caseload size. Most methadone programs require that counselors serve sizable caseloads which results in counselors striving to meet the many varied needs of patients while having numerous other demands made on their time.

Closely related to serving patients is the extensive documentation requirements that must be met when a counselor provides any type of direct counseling service or case management assistance to an active patient. In today’s healthcare environment, documenting one’s professional activities is an extensive drain on time, energy, and productivity. This is particularly true with state and federally supported programs that draw on public funding to run the methadone program. Good computer skills are generally a must have.

Effective methadone counselors become time management experts and develop a high level ability to work quickly under pressure, to shift priorities, and to multitask while maintaining an appropriate focus on their professional development.

Quality methadone counselors also bring to their work a dedication to patient welfare and a spirit of enthusiasm, hope, and positivity to co-workers and the patients that are relying upon them for guidance and support.

Methadone.US provides an extensive employment section that lists numerous methadone treatment jobs across the country. Those interested in working in the opioid treatment field can browse our job section for recent methadone program openings. This includes nursing positions, physician positions, counselor openings as well as support positions like receptionist and billing or finance specialist.

Working as a methadone counselor offers many rewards. Appropriate supervision and professional development are very important when undertaking any counseling position. Knowledge, skill, and experience must be actively developed, and are ideally supported by any reputable methadone treatment employer.

Couples in Opioid Treatment Together

womens-recoveryIt is good news when an addicted couple find their way into treatment. Opioid addiction is a very lonely journey, and alienating friends and family comes with the territory when one is deep into a drug addiction.

With severe addiction, it is not uncommon for both members of a couple to be struggling with an opiate dependency. While this bond is certainly not a healthy one, it is one that makes sense for the couple, who often find themselves feeling like it’s “us against the world”. As they plow through addiction, sometimes one hour at a time for years, a bond is formed … like two friends going through a war together each watching the other’s back in a never ending fight to stay alive.

At some point, one member of the couple will have the good thought about entering treatment and may push their partner to seek treatment together. Sometimes this works out and sometimes not. When it does work, the couple will begin dosing with methadone or suboxone and hopefully attempt to re-orient themselves to a sober way of living. This is a beautiful experience to behold when two people are ready, and they encourage each other to make better choices.

In 12 Step recovery circles, recovering couples are strongly encouraged to seek their own individual recovery apart from their partner. Couples often resist this suggestion, but it is a very wise approach. It is so easy to relapse when one’s partner goes back to using. So, having one’s own circle of support outside of this relationship can be critical in helping a person to remain drug free when their partner has relapsed. It actually helps the relapsed partner too when he or she sees their spouse not compromising on recovery principles and continuing to make appropriate choices.

With stable couples who have methadone take homes or who receive the same psychotropic medication, there can be the occasional temptation to swap each other’s medications. When they were actively using, they shared works, pills, anything and everything. Now that they’re stable, it may not seem like a big deal to to take a partner’s medication if one has run out or misplaced their own. However, it is a big deal and should be always avoided. Successful recovery is not easy. It requires personal discipline and a strong commitment to do what is right, even when doing the right thing is challenging and difficult.

While couples in treatment can be a complicated affair, it can work and does work everyday around the country. It is important to note that a couple may not progress at the same rate. While one partner stabilizes quickly on methadone and discovers their cravings & withdrawal disappear, the other partner may have uncomfortable withdrawal symptoms and struggle with urges to use illicit drugs for a period of time.

Good methadone programs will strive to support the couple’s mutual effort to be drug free together, but they will also work with each patient separately. This will include being in separate treatment groups and having separate individual counseling sessions.

With private self-pay programs, there are instances in which a couple may not have enough money for each person to dose on a particular day. This can pose a stressful dilemma for the couple and there is often no easy answer. One member of the couple may just go without. While there is typically an apprehension that missing a day of dosing will bring about immediate withdrawal sickness, this is often not the case. Since methadone has a long half life and is designed for extended duration, some people discover that they are comfortably maintained even through a missed day of dosing. This is not a recommended practice since missing doses is often correlated with illicit drug use, but it is an interesting and useful piece of information.

In the final analysis, a “couple” can suffer for years with simultaneous opioid addictions and a severely compromised quality of life. Choosing to enter drug treatment, either as a couple or as separate individuals, is a positive decision that should be supported wholeheartedly by family, friends, employers, recovery self-help programs, and the treatment community.

Drug Addiction, Methadone, and Suboxone

suboxone-articleAn article was brought to our attention by Dr. Dana Jane Saltzman, a New York City physician who specializes in the treatment of opioid addiction. Dr. Saltzman uses suboxone in her private practice to help those seeking recovery from a severe opioid habit.

The article was posted in The Village Voice and attempted to depict the duality of opioid replacement therapies. This duality stems from the highly therapeutic & legitimate uses of suboxone (buprenorphine) contrasted against the attempts of some addicts to create a black market cottage industry with the medication selling it illegally online via Craigslist, Facebook, and other social media.

In the world of medicine and addiction treatment, selling suboxone is certainly criminal, and also behavior characteristic of someone who is not grounded in recovery. Many medical & clinical treatment professionals across the country have endeavored for decades to provide safe, effective treatment to suffering addicts. When FDA-approved opioid treatment medications are misdirected and sold on the black market, all varieties of abuse and exploitation occur ending in overdoses and a deepening of damaging social stigma about medications such as suboxone and methadone.

The Village Voice article plays it straight up the middle with perhaps some emphasis on the growing underground market for suboxone targeted to those who want to bypass the cost or inconvenience of signing on with a suboxone-approved physician.

Individuals who attempt to treat their own addiction with opioid replacement therapy are going to fail a high percentage of times. First, most  have no medical basis for understanding the complex nature of opioid addiction in the brain, and they can even deepen their addiction through the inappropriate use of opioid replacements. Addicts often go with what feels right opting for their own intuition as opposed to following proven best practice protocols like those employed in structured treatment programs supervised by suboxone-approved doctors.

Addicts who treat themselves with street suboxone or methadone are also completely missing the counseling component of recovery which addresses the underlying psychological factors that drive addiction. Taking street suboxone without counseling is akin to taking diabetes medication while eating doughnuts. In other words, the individual makes their complicated dilemma even worse.

There are some generic equivalents of suboxone in development which may make opioid replacement therapy more accessible to the larger population. Suboxone and methadone have a definite place in addiction treatment. It is critical however that early recovering addicts receive quality counseling so that they can better understand how to cope with relapse patterns and develop the skills necessary to successfully manage the disease of addiction. Addicts treating themselves with medications acquired on the street will remain stuck in a vicious cycle of addiction.

True recovery requires humility and commitment to higher principles. Chasing shortcuts to recovery creates more pain and wastes valuable time that would be better invested in real solutions.

Zubsolv For Treating Opioid Dependence

zubsolve-methadoneDr. Jana Burson made a recent post about the newly FDA-approved medication for treating opioid dependence called Zubsolv. Zubsolv is manufactured by a Swedish pharmaceutical company, Orexo.

Zubsolv is a new sublingual (tablet dissolved under the tongue) formulation of buprenorphine and naloxone that is taken once daily to eliminate opioid withdrawal symptoms. As an alternative to suboxone or methadone, Zubsolv was approved in July 2013 as a medication which may be prescribed by physicians for the maintenance treatment of dependency on opioids.

The medication is meant to be taken in conjunction with counseling so as to help the patient learn the necessary skills for avoiding opioid relapse. The sublingual tablet is designed to dissolve in about 5 minutes when held under the tongue.

New products such as Zubsolv bring additional choices to those suffering with opioid addiction. As new products enter the market, there is an improved chance that once costly opioid replacement medications may come down in price and become more readily available to individuals who could not afford them.

The primary ingredients in Zubsolv are buprenorphine and naloxone so it is similar to a Suboxone formulation although promoted by the manufacturer as having a better taste, being a smaller tablet, and dissolving more quickly. Note that suboxone is now offered in a thin film formulation that also dissolves more rapidly than the original suboxone tablets.

Repairing Life After Opioid Addiction

methadone-recovery-1Addiction is an uphill battle. We have heard this said many times before. Many who found themselves in the midst of a personal opioid addiction were swept along on a nightmarish roller coaster ride with seemingly no brake pedal within reach.

Fortunately, addiction recovery is real, and people do get off of the roller coaster ride to hell. This is accomplished in a variety of ways with one method sometimes being the decision to try opioid replacement therapy such as methadone or suboxone.

Once off the roller coaster, individuals have an opportunity to survey their surroundings, to reflect on what has happened in their lives, and to begin moving along a better, safer path. Inevitably, facing the consequences of one's past becomes part of this gradual recovery process as does repairing the damage that occurred.

It is important to remember that change does not happen overnight, and repairing one's life happens step-by-step a little each day. There is a popular saying in recovery circles that is profound in its wisdom. It's "progress, not perfection". What this means is that no one is perfect, and that chasing perfection is perhaps an unrealistic goal. The goal should be "progress". This … is achievable. In repairing one's life and in living a new life of recovery, pursuing "progress" is enough.

Another insightful saying is this … "A journey of a 1000 miles begins with the first step". Once you have committed to sobriety and living your life in a better way, you have already taken several steps in the right direction on your new journey. You do not have to reach your destination in 24 hours. The journey itself is a huge part of your personal healing & personal growth.

Repairing one's life after opioid addiction will require several things of you. One is to cultivate patience with the world. The world often moves at a different speed than we do, and it is in our best interest to adjust to that rather than to try and control the speed of the world around us. This will require patience. Patience can grow. We can develop patience through mindfulness, prayer, therapy, and in other ways.

Also important to repairing one's life is trying to live with a sense of purpose. We must be committed to something, or someone, in order to live with a sense of purpose. In active addiction, the daily purpose was to get by without becoming sick, and that defined many addicts' focus day after day. Life loses its purpose when one is reduced to chasing drugs to avoid being dope sick.

Recovery offers so much more in terms having a new and improved life purpose. I can't tell you what that should be. But for some, it's being a good son or daughter, or a good spouse or parent. Or regaining a renewed sense of pride in their job, or "giving it away" and helping another addict or person in need, or volunteering to help a child learn to read, or mowing the yard of an elderly neighbor who can't do for themselves as well anymore.

Your purpose may not be known yet. But you can certainly discover what is really important to you once you get off the roller coaster ride of opioid addiction. As always, recovery is a choice. No one can force it on you. But it is there, available to you … when you are ready. Call your local clinic today. Ask a friend to help you find local resources. Choose to take your first step.

Methadone Clinics Have Good Intentions

legaldomains_1A new methadone clinic in North Haven, Connecticut recently opened called APT. Lynn Madden, who is the acting CEO of APT Foundation, has made a concerted effort to connect with the local community in order to help citizens understand that methadone clinics can be operated safely and discreetly with no adverse effects to the surrounding neighborhood.

The clinic currently has about 800 patients. An article by the New Haven Register documents the comments of local residents and businesses who all report that the clinic has been good for local business and has resulted in no problems or increase in crime.

The article goes on to explain how the clinic is actually situated in close proximity to a large community development, but positioned such that neither is really aware of the other. This demonstrates how some clinics are expertly planned and managed.

At Methadone.US, we wrote two years ago about a New York City methadone clinic that is housed in a downtown church and serves many hundreds of clients per day. This clinic there is so private and quiet that local businesses did not even know it was in operation for years just across the street.

This type of well run facility and seamless community integration provides good evidence that the fears and criticisms of methadone naysayers are largely unfounded.

Lynn Madden of APT was quoted as saying that New England has a very high rate of addiction to opioids. We know that this phenomenon is increasing across the country, and consequently will demand more attention, and funding, in the years ahead if we are to adequately address the opioid addiction problem.

APT seem to have a good strategy for dealing with the unfortunate stigma that still exists around methadone. The key is education, outreach, and clinics staffed with professionals who are adept at explaining the benefit of drug treatment to the local community. Treatment solves problems. Treatment saves lives, reduces crime, and restores economic productivity on both a personal/familial level and a community level.