Category Archives: Suboxone

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.

Methadone Treatment Requires Strong Commitment

methadone-treatmentThe decision to utilize methadone dosing to manage opioid withdrawal is a choice that will require considerable personal commitment. As methadone dispensing for opiate addiction occurs within the structure of a methadone clinic, each patient must travel to the clinic daily to check-in and receive their medication in person under supervision.

In addition to the daily commute, one must also make arrangements for payment of their methadone program fee. A majority of methadone programs across the country are private, self-pay programs. Many of them offer a variety of pay plans with a fair number of patients opting to pay their program fee each day when they arrive. That fee generally ranges from $8.00 to $15.00 per day.

There are a considerable number of State and Federally subsidized methadone programs that are funded though medicaid or state dollars earmarked for mental health & substance abuse services. These programs usually have very low fees and some of them actually have no out-of-pocket cost to the patient. As one might imagine, state supported programs usually have a finite number of available openings whereas medicaid generally does not operate with the same caps and can accommodate many more patients. However, qualifying for medicaid is not necessarily easy with healthy adult males typically not meeting eligibility requirements.

While methadone dosing provides effective relief from withdrawal sickness, it’s the counseling component of methadone programs that helps patients develop improved skills and a realistic plan for long term recovery from addiction.

When committing to methadone treatment, patients are most excited about the benefits of methadone medication and its usefulness in eliminating the sickness of opioid withdrawal. But, it’s the participation in group and individual counseling that make the greatest difference in developing a new & improved view of one’s future and the possibilities that lie ahead. Opiate replacement medications like suboxone and methadone are an important piece of the recovery puzzle, but learning to cope with one’s feelings, thoughts, and life circumstances comes from the unique benefits of the counseling experience.

Commitment to counseling and learning new skills are key elements in your pursuit of a drug free, improved life. Methadone and suboxone help to remove the huge obstacle of daily withdrawal sickness. Once that hurdle has been jumped, then one can truly walk the path of recovery and discover the many good things that await along the road of life.

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.

Suboxone Benefits Overshadowed By Fear and Judgment of Bangor City Council

progressSuboxone is medically approved to treat opioid addiction and withdrawal in the United States, and opioid replacement therapy is a documented, evidence-based best practice. That being said, the city council of Bangor, Maine voted 7-2 against the expansion of opioid treatment services in Bangor that would allow existing treatment programs to offer additional Suboxone (buprenorphine) services to addicted people seeking treatment.

Council members were quoted as saying that Bangor had done more than its fair share of helping the addicted population, referencing the fact that many people travel from outside the area to participate in one of Bangor’s three opioid treatment programs.

This moratorium on expanding Suboxone will leave many to struggle with their severe addictions while viable opioid treatment services could be made available to help them. However, the Council wanted more time to consider whether the expansion of opioid treatment would be a good idea for the city. The temporary ban generated considerable dissension once again showcasing that fear & judgment are still barriers to treating people suffering with addictive disorders.

Progress has most definitely been made over many years with the nationwide adoption of opioid replacement therapy. Nonetheless, people continue to fear and judge those things which they do not understand. Simply put, this is human nature. I reflect on past years in which family members and other non-treatment professionals came to visit our facilities, became acquainted with our staff, and gained a real understanding as to what treatment is about.

Consistently, nearly all of these individuals experienced a change of heart and a new understanding. Some of them never considered that addiction would affect their family. Understanding addiction is something that a majority of individuals may not care to understand … until they have to. This, too, is human nature.

In any event, progress often has a way of moving forward despite impediments and naysayer opposition. If the need is there, then energy will collect and eventually be channeled toward fulfilling that need. Suboxone and methadone are such excellent medications when used appropriately. They meet an important need. It’s sad to say, but sometimes a problem has to “hit home” before a person comes to a new understanding.

The five Bangor Council members that voted against expanding Suboxone may have never faced addiction, or the loss of a loved one, or the desperate fear & pain that an addict lives with after years of being sick. One can’t help but question the motivations and “critical thinking” of people who would vote against modern medicine and saving lives. Progress will continue, but closed minds must first be opened.

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.