Monthly Archives: December 2013

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.