Category Archives: Methadone Treatment

Doctors and Methadone

factsHow doctors view methadone is becoming a hot topic. A friend recently informed me that the TV celebrity doctor, commonly known as Dr. Drew, was against methadone and had publicly made negative comments about the medication. I was disappointed to learn of this because Dr. Drew has a fairly large national audience who follow his opinion on medical matters. I then noticed that Dr. Jana Burson (a well-educated and experienced opioid addiction professional) had written on this topic, and herself questioned why Dr. Drew had made derogatory comments in regard to methadone. Dr. Burson knows firsthand how incredibly beneficial methadone is to those suffering with chronic opioid dependency. If a physician deserves a national audience & voice on this topic, it is Dr. Jana Burson, not Dr. Drew Pinsky.

Physicians typically seem to fall into one of two camps: either those who are educated on addiction and modern addiction treatment approaches, or those who are not. This may seem like a simplistic analysis, but is surprisingly accurate. Sadly, in my experience, physician critics of opioid replacement therapies often jump to conclusions that stem from personal bias or opinion based on very limited exposure to methadone and its benefit to the recovering community. Methadone is not “alternative medicine”, or some unproven sideline drug that one must obtain via the black market in a third world country.

Methadone is the leading medically-approved pharmaceutical treatment intervention for opioid addiction in the United States. There is no medical “speculation” on methadone’s success in the treatment of opioid addiction. It is a proven method of saving lives and restoring quality of life for a large subset of those who are addicted to opioids. These are not hyped opinions, but are medical facts that are beyond dispute. That any “physician” would reject methadone as a legitimate treatment for opioid addiction … is professionally irresponsible, and suggestive of medical incompetence in the area of treating drug addiction.

Methadone has been in widespread use in America for over 40 years. The number of addicted individuals whose lives have been saved and/or improved (through the medically supervised use of methadone) is well documented. SAMHSA (the United States Substance Abuse and Mental Health Services Administration) publish evidenced-based Treatment Intervention Protocols (known as TIPS manuals) that are available to treatment centers all across America. They have several such manuals, published and widely distributed, that are specifically dedicated to treating opioid addiction with methadone and buprenorphine (suboxone). SAMHSA also maintain a U.S. government website listing all of the methadone clinics in the USA and U.S. physicians approved to dispense buprenorphine for the treatment of opioid addiction. Why do they list these? So that suffering people can find help for their addictive disorder.

Perhaps Dr. Drew should interview actual patients in methadone treatment programs. Then interview the staff of professionals (including dedicated, knowledgeable physicians) that work in these facilities. Then interview the families of methadone patients that regained their sons, daughters, mothers, and fathers. Then read the evidenced-based literature & research available (through SAMHSA) on the beneficial use of methadone in treating opioid addiction.

That might require Dr. Drew to walk off of the TV production set, out of the celebrity limelight … and into the everyday real world. It’s a place where people like Dr. Jana Burson work for many years, with thousands of opioid addicted people, using medical interventions that are proven and effective. Dr. Drew would do well to have a sit down conversation with professionals like Dr. Jana Burson. This might allow him to replace negative personal bias … with medical fact. Only then, would he be equipped to speak to the public about methadone and opioid addiction. Until then, he is just part of the TV & celebrity noise … where drama, ratings and sensationalism … are cherished over the truth.

When Methadone Alone is Not Enough

methadone-clinicA methadone clinic where I work has received a surge in calls from prospective clients who are interested in methadone to deal with their opioid addiction. We typically perform a telephone triage when someone calls, which is a sort of mini assessment to determine what services a client may be eligible for. After completing this brief telephone interview, we then offer recommendations which may include potential admission to our clinic for methadone treatment.

Some of these callers are currently in methadone treatment at a competing agency, but are interested in transferring to our clinic. The reasons for requesting a transfer are numerous. Sometimes it is because the client can save money, or they are simply closer to our particular location (less driving time).

I have had some clients report that they receive practically no counseling. In other words, they are basically paying to dose each day with methadone (which obviously eliminates their withdrawal symptoms), but they are receiving very little psychological counseling to help them understand their addiction, or to aid them in developing sound relapse prevention practices. While it is true that some clients desire only dosing, many clients are interested in participating in counseling sessions to help them achieve improved coping skills and a better quality of life. Clients who aim for this type of comprehensive growth stand the best chance of having a real and complete lasting recovery.

This, of course, raises the inevitable question as to whether methadone alone is ever enough. There is a school of thought that methadone alone is much preferable to illicit drug use. I happen to agree that methadone is a much better substitute for illicit opiates, and there is a significant “harm reduction” benefit that is gained when an addicted individual utilizes methadone under the supervision of a reputable clinic.

Another view on this subject is that methadone, in conjunction with counseling, is the superior treatment approach. I fully endorse this viewpoint and know firsthand how recovery is accelerated and enhanced when an addicted individual wants to learn, grow and change through the process of counseling & education.

Perhaps there is value in both approaches. Some individuals who are stabilizing on methadone, but who are not yet invested in counseling, can still be moving in the direction of recovery. Perhaps they are now refraining from injection drug use and illegal behaviors. Perhaps they are feeling better physically and are able to work, or now care for their family with daily withdrawal symptoms being eliminated. If this is the case, who among us can deny that these improvements have value?

Recovery is a process that involves forward steps. Sometimes, the addicted person has only enough energy to take one forward step. That first step may be the decision to receive methadone instead of injecting heroin or snorting Oxycontin. With time, the addicted person may become ready for more. When they become ready for counseling, we as treatment providers want to be ready to give them what they need. Recovery occurs in stages and plateaus. The recovering individual can achieve as much positive change as their heart desires. Counseling is a powerful medium for this positive change. Methadone plays a very important role as well.

Methadone and the Importance of Safety

safety1Methadone is so very beneficial when used properly and judiciously (as prescribed). However, in the wrong hands, methadone can lead to tragic consequences. Here is a cautionary tale.

Making the news in Gaston County, North Carolina was the recent death of a young man who was a member of his school’s football team. His name was Harry Cohen, and he was 17 years old.

Harry had played in an extraordinary football game on August 26, just days before his death. He is reported to have rushed for 241 yards and passed for 107 yards. A very impressive performance. He is also reported to have taken some hard hits in the game. His family indicated that he was sore from the highly physical contact.

While visiting with his grandmother later (who had a legitimate methadone prescription for pain management), Harry decided to take some of the medication to ease his physical pain. His mother found him the next morning in bed. He had died from a methadone overdose as a result of not having developed a tolerance to the medication.

This story reinforces how important it is that methadone (and all potentially high risk medications) be carefully safeguarded. The Gaston County article had a number of comments and opinions posted by local community members expressing their sorrow over Harry’s death. Fortunately, no one blamed “methadone”.  Most commenters emphasized the importance of treating prescription meds with caution. This is exactly the right sentiment, and a message that bears repeating over and over.

Often, children & teens assume that a medication must be “safe” if it is prescribed by a doctor and sitting out in plain view. Of course, this is not the case in many instances. It is imperative that adults think twice about securing medications, and also educate themselves on the associated safety concerns that come with various medications.

It saddens all people when something tragic like this hits a family and a community. Hopefully, we can draw from this loss an important lesson … that will help to prevent future losses.

What Opioid Addicted Persons Want To Know About Methadone Treatment

methadone89Since launching Methadone.US earlier in the year, I have received daily questions & requests from site visitors in regard to methadone services and methadone treatment referrals. Some inquiries pertain to the benefits of Suboxone (buprenorphine) although the majority pertain to methadone medication specifically.

Listed below are some of the most popular and frequently asked questions by those suffering with an opioid dependency. The answer to each of these questions is already provided here on the site, but I will post the short answer again.

Q1. I live in ‘Anytown USA’ and would like to find a methadone clinic near me. Can you help?

A1. Each city page on Methadone.US lists both methadone clinics & suboxone (buprenorphine) approved physicians for most populated U.S. locations. Just scroll toward the bottom of your city page to view contact information for clinics in your vicinity. If your city is not listed, write me (admin) and I will perform an individualized search for you.

Q2. How much does methadone treatment cost?

A2. Methadone clinics operate independently of one another and each one sets their own fees for services. Some clinics are private (accepting only client self pay), while others receive government or public funding. The best way to learn of a clinic’s fees is to contact that clinic directly and ask them to explain/list their treatment pricing for you over the phone.

Q3. I want to guest dose in (Anytown USA). How do I go about setting that up?

A3. Guest dosing must be coordinated by the staff of your methadone treatment “home clinic”. Contact your primary counselor (or the dispensing nurse) to request assistance with guest dosing arrangements. Many clinics require 72 hours advance notice to set-up guest dosing. The guest clinic will charge a daily fee for guest dosing with them. You cannot guest dose unless you are an active client in a methadone clinic.

Q4. My son, daughter, family member has tried to detox several times, but never been successful. Will methadone really take away the withdrawal symptoms? Can they function if they take methadone?

A4. Yes, methadone is highly effective in eliminating opioid withdrawal. And yes, he or she can live an entirely normal life and be fully functional.

Many other additional questions have been emailed to Methadone.US, but these are the ones that are most often repeated. Also, the Methadone Assessment has been popular with a substantial percentage of assessment takers indicating that they have been dealing with a moderately problematic opioid addiction.

Thanks for visiting Methadone.US. And best of luck with your recovery efforts!

Methadone Treatment Takes Work, Don’t Become Complacent

Often times, new methadone treatment clients experience a renewed sense of hope and vigor. The prospect of no longer feeling sick, or having to spend hours looking for opiates, brings incredible relief. Most clients familiarize themselves with the requirements of treatment and then follow the program as is prescribed. And particularly so if their home clinic is professional, organized, and takes an active role in interacting with their clients on a regular basis.

However, human nature tends to look for the path of least resistance, “the easy way”. This sometimes results in a client beginning to skip individual or group counseling sessions. Or in other cases, procrastinating on completion of their Medicaid renewal forms which results in the sudden termination of Medicaid payments for their methadone treatment. For some clients, old bad habits are hard to break, and they can ease back into complacency & put off important things once the crisis which brought them into treatment has been alleviated.

It is important that treatment clients identify daily priorities, live in accordance with a schedule, and develop the necessary discipline to follow through on important matters. Addiction is a cunning and baffling disease that undermines progress in both subtle and mysterious ways. Every client in recovery (and in methadone treatment) must make a firm personal commitment to put their recovery needs first. This mindset (and the accompanying healthy choices which are made on a daily basis) are essential to long term success.

Admission to an opioid treatment program is an excellent first step, a life saving decision for so many. When clients pursue real growth and try to re-engage with life, then real living can begin. Not being “dope sick” is valuable in itself, but investing in the recovery process and accepting the challenge to change leads to great discoveries, and a much better quality of life. Don’t just stand idle on the sideline. Step onto the field. Life is waiting!