Methadone 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.
Many 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.
Florida 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.
I 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!
The 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.
