Monthly Archives: March 2011

Effective Medical Treatment for Opiate Addiction

nihMethadone treatment has been in existence in the United States since the 1960’s, and it became fairly well-established in the 1970’s particularly in the larger metropolitan cities where heroin addiction was more pervasive. In the 1980’s, methadone clinics continued to emerge across the country since they successfully helped opioid addicted individuals experience dramatic improvement in their lives.

During the 1990’s, this expansion continued and the efficacy of methadone treatment became further substantiated through research. Eventually, full endorsement occurred by the U.S. National Institutes of Health (NIH). In November of 1997, the NIH converged to make a formal, consensus statement for this purpose:

To provide health care providers, patients, and the general public with a reasonable assessment of the effective approaches for treating opiate dependence.

A 12 member panel, assisted by 25 experts, had coordinated a study. Various professional fields were represented including psychology, psychiatry, family medicine, behavioral medicine, epidemiology, plus participants from the general public. This group shared with the world their conclusions in a single, definitive, all-encompassing statement, which read:

Opiate dependence is a brain-related medical disorder that can be effectively treated with significant benefits for the patient and society, and society must make a commitment to offer effective treatment for opiate dependence to all who need it. All opiate-dependent persons under legal supervision should have access to methadone maintenance therapy, and the U.S. Office of National Drug Control Policy and the U.S. Department of Justice should take the necessary steps to implement this recommendation. There is a need for improved training for physicians and other health care professionals and in medical schools in the diagnosis and treatment of opiate dependence. The unnecessary regulations of methadone maintenance therapy and other long-acting opiate agonist treatment programs should be reduced, and coverage for these programs should be a required benefit in public and private insurance programs.

This endorsement further validated what many addiction professionals had known for years, that methadone maintenance was an extremely beneficial therapeutic intervention. As time rolled forward into the new millennium, 2000 and beyond, methadone clinics continued to be established in areas where no opioid treatment had previously existed, including America’s smaller rural areas and modest-sized towns.

Today, methadone and buprenorphine (suboxone) treatment are more readily available than ever. A major focus of many opioid treatment programs is to now treat a client’s co-occurring disorder(s) either within the OTP clinic itself or though a local referral to another mental health provider/specialist. A substantial number of addicted individuals suffer from depression, bipolar disorder, generalized anxiety or panic attacks, attention deficit hyperactivity disorder (ADHD), or other psychiatric illnesses which can be successfully managed once properly diagnosed.

While some communities are reluctant to embrace methadone treatment & methadone clinics, this can change with education & time. Treatment changes lives for the better, and allows addicted individuals to become more responsible and more productive. It was highly beneficial that the NIH publicly recognized the validity of methadone maintenance. This was a positive, and justified, large step forward in advancing help for opioid addicted people everywhere.

Why Self Administered Home Detox Rarely Works

methadone-patientMany opioid addicted people have discovered that trying to detox off of opioids “at home” does not work and leaves them feeling miserable. There are some individuals that have “kicked the habit” without medication-assistance or a medically supervised detoxification. However, these success stories are somewhat rare, and usually pertain to people with a comparatively milder opioid addiction or an addiction of relatively shorter duration.

Somewhat compounding the challenge of addiction recovery are outspoken critics who wrongly assume that every drug addiction is the same, and that an addict should just pull themselves up by their bootstraps and tough it out. Individuals who hold such views are typically uneducated on the physiological characteristics of opioid addiction and the underlying brain neurochemistry that has been radically altered once opioid addiction sets in.

I have spoken to many suffering opioid addicts who have attempted home-based detoxes. The story is almost always the same: “It didn’t work. I just couldn’t make it. It was a horrible experience.” And they return to active drug use in order to cope with a myriad of sudden & protracted withdrawal symptoms, and to regain some momentary ability to function again.

Unfortunately, even some addiction professionals are poorly schooled on opioid addiction, and consequently may hold a bias against opioid replacement therapy (methadone, buprenorphine) until someone comes along to properly educate them.

Acute withdrawal from opioids results in a plethora of extremely uncomfortable physical symptoms and psychological stress that builds for days. With a home based detox, users try to self-administer decreasing amounts of opioids only to find the process overwhelming. Even a seven day detox in a medically-supervised setting using suboxone (and other medications) often leaves users with discomfort and protracted symptoms that are difficult to deal with.

In either scenario (home or hospital detox), individuals typically must deal with PAW (Post Acute Withdrawal). PAW for opioid addiction can last for months and results in lingering feelings of depression, tiredness, physical ache/pain, powerful cravings, inability to concentrate, insomnia, etc. Scientists have suggested that chronic opioid use/abuse affects the body’s metabolism and may temporarily (possibly even permanently) shut down the body’s ability to manufacture natural endorphins. This leaves the person feeling not normal. Obviously, the possibility of opioid relapse is greatly increased as a result of this post acute withdrawal process.

PAW (Post Acute Withdrawal) is greatly magnified as opioid addicts go from using daily fast-acting opiates to nothing at all. Alternatively, tapering down gradually off of methadone or suboxone introduces much less stress and allows a patient’s neurochemistry to adapt slowly to medication reduction. It also allows for much better preparation, planning, stability, and support-building as patients pursue a gradual medication taper. Tapering gradually off of an opioid replacement (methadone, suboxone) is often a much more comfortable experience than a short-term detox at home or in a hospital. Importantly, it must be said that a “social setting” or hospital-based detox is far superior to attempting a detox at home.

My final point is this. Don’t judge individuals struggling with an opioid addiction. And do not condemn them when they fail to successfully detox at home, or even in a hospital setting. Getting well, and succeeding in recovery, is a process that takes time and which may vary in procedure from one individual to the next.

We like to think that “all addicts are the same.” But, they are not. And treating them all the same is antiquated, and a failure in approach. Let’s stop to consider that medicine, science, and recovery are evolving through the years. Medication-assistance is not a cop-out or some negative compromise. It is today’s best practice approach in helping people live much improved lives. Medication-assistance is evidenced-based, and has been proven (not just theorized), but proven … to be effective.

Thanks for visiting Methadone.US, today! For more on opioid dependency, click here.

Florida Methadone Clinics Serve Many

florida-methadone-3Florida currently hosts opioid treatment clinics in about 30 of its largest and most popular cities. The state is ranked 4th nationally in population with an estimated 18.6 million people residing in The Sunshine State. As is typically the case, the number of suboxone-approved physicians considerably outnumber actual “clinics” that dispense methadone or suboxone. The Miami area, for example, has about 60 such suboxone-approved doctors treating opioid addicted persons.

Florida is one of the most visited states in America as a vacation destination, and attracts millions of visitors annually from all around the world. For opioid treatment clients traveling to Florida, guest dosing is a common occurrence and relatively easy to set-up. This is usually accomplished by speaking to one’s primary counselor (or possibly the dispensing nurse) at one’s home clinic.

The staff at the home clinic must fax a request for guest dosing to the travel destination clinic. Bear in mind that many clinics require at least 72 hours advance notice to arrange for guest dosing, and a client must always produce a picture idea at the travel clinic verifying their identity in order to receive medication. Guest clinics typically charge a little more than normal dosing fees due to the administrative time & expense involved in setting up a visitor’s guest dosing.

For a complete listing of Methadone.US Florida cities, visit our Methadone Clinics By State page. There, you will find a number of Florida hot spots with methadone clinics and Suboxone (buprenorphine) providers listed near the bottom of each city page. Also see the page, Florida Methadone Clinics.

Methadone is Not Meth or Methamphetamine

methadone-medicationI was speaking with someone the other day about methadone and they asked me if methadone was the same thing as “meth”. They had heard about “meth labs” on the news and people being arrested for manufacturing “meth” in their homes to sell illegally on the street. This individual was wondering if “meth” and methadone were the same thing. They are not!

“Meth” is a slang term often used in print and TV media to refer to the illegal drug crystal methamphetamine. Crystal meth is a highly addictive stimulant drug that can lead to devastating effects for its users (paranoia, hallucinations, heart attack, stroke, and death). Addiction often develops rapidly, and users are left with severe depression and fatigue as they crash following use of the drug. Crystal methamphetamine wreaks havoc on the brain’s neurotransmitters, and it is estimated that around 20% of those who abuse it develop psychotic symptoms similar in appearance to schizophrenia.

Unfortunately, crystal methamphetamine can be manufactured relatively easily. Consequently, it has sprung up around the country as small home operations began to make and sell the drug for easy profit.

It is easy to see how the general public could confuse methadone and “meth”, not realizing they are completely different substances. It is important that people understand the two have no connection, and that “meth labs” are referring specifically to the illegal production of crystal methamphetamine, not methadone.

Methadone is a leading medication-of-choice in the treatment of opioid addiction. As stated on this site numerous times, methadone is one of the most well-researched medications in history with a proven track record of efficacy in helping opioid dependent individuals avoid illicit opiate use and live productive lives.

Methadone Plus Counseling Equals Treatment

methadonetruthThe two primary components of opioid addiction treatment are opioid replacement therapy (methadone or suboxone) and behavioral health counseling. Each of these therapeutic interventions address very different aspects of one’s addiction. And one intervention, without the other, is generally not sufficient to promote lasting recovery from opioid addiction. Both must work in unison to produce meaningful, lasting change.

When entering treatment, most clients are initially very focused on their physiological dependency to opioids and the associated withdrawal symptoms that emerge when their drug supply runs out. Recurrent opioid withdrawal takes priority over most all other considerations. Consequently, addicted people place much emphasis on their methadone dose due to its ability to provide relief from painful opioid withdrawal. There is such a clear connection between methadone dosing and symptom relief that clients often assume that dosing alone is the complete answer to their addiction problem.

However, this is a false & inaccurate conclusion. Real recovery involves not just the absence of withdrawal symptoms, but deliberate changes in thinking, attitude, and behavior. Without improvements in these areas, a majority of clients will relapse again and again, and consequently be unable to sustain progress over time.

There is an old saying in the recovery field that goes “You can’t go back to being the same person you were … because that person became addicted.” What is meant by this is that one cannot afford to remain stuck with the same old ways of thinking and living. It was those old ways that led down the addiction path. In order to experience lasting quality recovery, one must adopt new approaches to living and coping with life. It is the development of these new approaches, skills, and tools that will allow a person to deal with life using healthy methods … instead of drugs.

Counseling not only teaches key skills for managing life, but aids clients in developing inner resources that will empower them to achieve new things that were previously not attainable. Many clients dedicated to personal recovery become much more complete people, more capable, and ultimately more satisfied. Addiction sucks the life out of individuals day by day, but recovery brings people back in contact with life & opportunity, and opens doors that were previously shut tight. Counseling is an extremely important piece of the recovery puzzle. Counseling facilitates positive change and positive results.

Use counseling to learn more about yourself. It will allow you to become better educated on managing the disease of addiction, and it will strengthen you in numerous ways, if you let it.