A Daily Dose of Death
What Methadone is really doing to addicts who seek recovery.
Methadone does not stop addiction. It stops illegal activity in the addict who previously aimed to get high and medicates a world of internal dilemmas, rather than lifting the addict out of the addict mindset and life.
The door slams, loudly. Repeatedly. They go in and they go out and then in and then out and in and out…and in and out.
I sit in the parking lot at the local “recovery” clinic that maintenance doses my son and hundreds of other would-be-recovering opioid addicts each morning.
I watch each one stumble, sway, or swagger in…all appearing to be high, 99% appearing unkempt, most with disjointed bodily movements, and all smoking outside the clinic before going in and after coming out.
They ALL appear to be zoned out, barely there-zombies.
I hear them yell at one another from across the parking lot. I hear the way they gruffly and angrily speak to one another and to themselves...or to no one in particular. I see such shame in their eyes as they pass by my car, as they look at me or don’t, as they leave the clinic with their heads down.
Others hold their heads exaggeratively high, chin way up over their shoulders, carrying their medboxes, trying to retain their dignity.
And I realize they are unfortunately and realistically in supervised active addiction.
They all look like they just strolled over from a street corner or from under a bridge. But, they didn’t. Other parents, friends, family members wait in their cars for their person to come back to the car.
I view this scene as a mother…not as a nurse and I am absolutely appalled that these people are being dosed, but are not being “treated.”
I am appalled that the healthcare professionals and the entities who provide this assistance to the addict community do not appear to notice or address the continued addict demeanor, dress, and overall poor mental health of these individuals in congruence with their taking of Methadone.
It’s not something any observer would miss. They do not look well.
That is not living. That is not treatment.
Treatment yields results…improvement. You are supposed to get better and your life is supposed to improve. Effective treatment improves self-esteem, self-worth, and increases the desire to move forward in life, but these patients are noticeably stuck in the same thinking and behavior patterns and habits from which they are trying to escape from via “treatment”…but, from my perspective, and the perspective of many a Methadone patient, they are in a desperate, swirling sinkhole.
One Example of Our Experience with Ignorance/Prejudice in the Medical Community
Most of these patients at this local South Austin clinic are given Methadone to treat their heroin addiction.
After challenging the under-educated and over-arrogant intern student doctor who manages the treatment, dosing and the chosen method of medication at this clinic, my own son was put on Buprenorphine, instead of the intern’s odd demands for and an obvious preference for Methadone.
In his initial evaluation for treatment at this clinic, Landon had insisted on being placed on Suboxone, (a combination of Buprenorphine and Narcan) which he had taken effectively and successfully before coming to this clinic.
My son did not want his “treatment” to make him feel like he was high, and did not want to be placed on maintenance medication that does not allow his brain to heal from the heroin addiction.
There is consensus in the maintenance and recovery community that Methadone, and the substitutes used to “treat” opioid addictions, do not get a patient high. This is not true for many, many Methadone/Buprenorphine users. High doses of either WILL create a high.
Dosing regulation is meant to reduce or eliminate that issue, but the action of the drug in the body is what it is. Just because a person gets used to the effect of the drug on their body, does not mean they are not medically high or that they are having no ill effects.
Quite the opposite happens.
This intern defiantly defended his persistent push to place my son on the cheaper form of treatment…Methadone.
My son again insisted that he did not want to be high or feel like he was actually on heroin and so refused to take Methadone…which made this intern very angry.
The intern could not answer to or knowledgeably comment on either my son’s questions or my son’s wealth of information regarding the intimate details of the effects of Methadone on the brain/body vs the effects of Suboxone and Buprenorphine on the brain/body.
Instead, the intern has since forced my son to continue on daily visits to the clinic to dose his med for 3 months longer than the clinic’s policy of placing new patients on weekly-then-monthly doses after 30 days of successful administration of maintenance medication of any kind.
This intern has also forced my son to take twice his normal safe dose of Buprenorphine at one time, in the AM, by continually denying him weekly dosing for which Landon could have a reduced morning dose in lieu of taking a night dose at home.
A Repetitive Dilemma for the Addict
The clinic administers both the morning and evening doses of prescribed medications, specifically Methadone, at the same time each morning to the patients. No evening dose is made available, except on weekends, and so both doses are given at once.
That is medically unsound, dangerous and neglectful.
I am currently investigating when, how, and if Methadone dosing at this clinic will ever be split up (except for weekends) in one or more take-home doses.
The idea that Methadone’s “half-life of 8–24 hours,” touted as reasoning for overdosing AM patients and leaving them with no evening dose, is an untruth as the half-life is a sound 4–8 hours only…meaning withdrawal and intense cravings are reported by the Methadone patient much sooner than current documentation states.
What is the “recovering” addict to do for the 15+ hours after the dose has worn off in the early evening to prevent sudden withdrawal?
Well, the obvious answer is: patients who seek an out to their heroin addiction must seek a heroin dose in the evening to prevent that withdrawal due to no night dose being available.
My son literally runs to the car most mornings to prevent being offered a way to get heroin later in the day from other clinic goers that he knows from the heroin addict community.
The random drug testing performed at the clinic to detect misuse or underuse of the Methadone is completely futile in this respect as heroin and Methadone show up as the same drug on a drug test.
The difference is that Methadone provides a constant stable “good feeling,” rather than the short burst of euphoria of heroin. That longer stability then obviously reduces cravings as there is a dramatic decrease or no experience of craving during this period of time.
But, when Methadone wears off…there is the insidious and insatiable craving again and the intolerable withdrawal right behind it.
No healing, no retraction of the drug use and the person from one or the other can or does occur.
No Kind of Consolation
And yet, despite these realities, it with great sadness that I must say…as a mother and a nursing professional…if Methadone keeps our sweet children and our struggling parents and our worn-out elders from dying from an opioid overdose…I have to advocate it, but ONLY for its temporary administration.
A two-year use of opioid agonists/antagonists (Methadone should be weaned and replaced with Suboxone or Buprenorphine for brain healing) in conjunction with intensive therapy is a solid, healthy timeframe in which to assist the addict’s return to a healthy state. (Some patients need less or more time, but suggesting that a decade or more on Methadone is acceptable is absolutely absurd and dangerous.)
A defined healthy state is a state in which there is a much-reduced need for, or the development of alternatives too, self-medication and positive signs of a brain which has been given adequate time to heal, (as evidenced by a lack of cravings and the sense of well-being in sobriety through emotional and mental healing) which only occurs through a weaning of the use of Suboxone or Buprenorphine and proper therapy/counselling.
An opioid addict brain will not heal on Methadone.
Consistent, effective, addict/addiction-related-knowledgeable therapy MUST be in place as part of recovery for every single addict in order for any medication therapy to be completely discontinued over time.
The intensive therapy that lawfully and ethically is to accommodate Methadone/Buprenorphine treatment currently is in NO way managed or actually enforced. The lack of such facilitates the addict in remaining in that same dangerous mindset that propels repeated and fatal overdoses.
Methadone does not stop addiction. It stops illegal activity in the addict aimed at getting high and medicating a world of internal dilemmas, rather than lifting the addict out of the addict mindset and life.
Promoting True Healing
Despite the common allegation that Methadone maintenance is different for everyone and so some have to take it for years or for life…this theory of “treatment” is not acceptable. It is not safe and its effects are not congruent with normalcy.
If you question my observations and theories…go to a Methadone clinic in your area and sit outside anywhere from 6 am to 11 am and observe…or better yet,…go INSIDE the clinic as a passive onlooker and take in the environment as it is.
The call that has rung out since the 1950s aimed at the medical and recovery communities to accept and address the addict’s state as simply human is still far from being heard and implemented.
Understanding the need for the brain to heal completely from addiction…not just be put at bay from the effects of addiction…will facilitate the dire need to actively treat addiction as a medical condition.
The brain CAN heal. Methadone only keeps an addict’s death and healing at bay.
I am all for the longer terms of proper and fully rounded temporary treatment of Suboxone and Buprenorphine in combination with adequate and continual therapy…and the access to this type of treatment void of the ridiculous prices a recovering addict is forced to pay to just to STAY ALIVE if not covered by insurance (which is most addicts.)
I can only condone the temporary use of Methadone if the entity offering it adamantly addresses the core needs of the recovering addict in terms of lab testing, monitoring of the patient’s person (dress, attitude, demeanor, and body language) through the confirmation and implementation of appropriate counseling and the dosing regimen to include a way to night dose sooner than later in recovery.
The effect of the administered Methadone needs to be actually visualized with each dose through a set “wait” time after AM administration and then documented. Evaluating each patient at least weekly for negative symptoms as noted previously in this piece is imperative to their advance to wellness.
It MATTERS that these patients are coming and going looking like pure hell.
In addition, medically speaking, most medication (especially the ones noted), that is administered to or prescribed to any patient is to be monitored with lab testing every 3 months to evaluate kidney and liver changes. This most definitely is not being implemented in much of the medical community as a whole and not in the clinic my son attends with hundreds of other “recovering” addicts.
Some Perspectives and Experiences of Addicts
Russell Brand, a recovering heroin addict, and advocate for abstinence has something to say about Methadone use.
Brand was put on a recovery programme after his agent, John Noel, found him taking heroin in the toilet at an office Christmas party 10 years ago. Brand checked into Focus 12, an independent charity that runs a 12-week rehabilitation programme in Bury St Edmunds, Suffolk, overseen by chief executive Chip Somers, who is himself a former heroin addict.
Somers says: “The beauty of the methadone programme is that it’s really easy. You just dish it out. End of story… It’s a way of shutting up a large population of drug addicts and keeping them out of the way instead of having to engage with people and do things differently.”
I know that not every Methadone patient shares this perspective, but I am presenting the idea that they are themselves being seduced into accepting that Methadone is true “treatment” and potentially is lifelong.
This position does not include the idea of their eventual healing of the need for Methadone, specifically, nor its effects. Addicts are persuaded that Methadone is a be-all-end-all to their addictive suffering which, in exchange for their addiction, has the strong potential to be lifelong. Perhaps they cannot do without it? Sound familiar?
Sounds like Heroin.
This idea of the lifelong need to medicate yourself with the closest thing to the opiate killing you is just not a rational or acceptable one.
The first time my 22-year-old son took that forced double dose of 16 mg, although it was the safer alternative Buprenorphine, he was crying when he came to the car. He was used to staying sober on 8mg of Suboxone twice a day.
“I’m gonna get high, Mom. I can’t get high!”
And so he did.
I think about the founding Project Director of the MARS program, Walter Ginter, who states his expertise in the matter of Methadone “success” (and I have to say…his comments on the subject reiterate the plight of the opioid addict,) is based on his own decades-long use of high doses of Methadone.
What? Clearly, long ago, Walter accepted that he could never be free of his opioid addiction. He soothes it with Methadone to this day. I am not judgemental of that fact at all. I am devastated to think that this man himself, who runs a program that exists fundamentally to assist and save the addict, believes the addict is never free.
The addict’s struggle is commonly longstanding, but they do NOT have to LIVE like an addict.
Shut the addict up with METHADONE and no one has to treat the addiction and its sources.
Barriers and Challenges to the Pursuit of Recovery
I am writing this piece as I want to expose the sordid facets of “sobriety,” and “recovery” that addicts who want to get better must endure achieving safety, security, and a drug-free place in their lives.
The inconsistencies in care, inadequate and lack of access, to treatment, and vile prejudices are serious issues that addicts experience while they are seeking sobriety. Insults to their intelligence and worth within the medical and social communities further damage their frail psyches.
The vulnerable mind frame of the addict and the accompanying low self-worth prevent addicts from standing up for themselves for better or excellent care.
One recent former employer who discovered my son was in recovery, actually called him a loser and told him he did not want “his kind” working for the company and promptly fired him. A recent visit to a new physician who knew my son was in recovery told him that a “spot” on his face was “probably HIV” and proceeded to put the fear of God in him due to his “previous lifestyle.”
The “spot” proved to be a simple skin eruption to be treated with Neosporin.
Medical providers are easily the absolute worst proprietors of the spread of prejudice. They do not understand and seemingly most are not taught, the biochemical workings of addiction and recovery medications.
Most do not respect the opinions and research of addicts who know their drugs and the effects of those drugs in and out…better than medical providers ever will.
Too many medical providers do not respect addicts as humans, much less as patients, period.
Summarizing a Need for Change in Longterm Methadone “Treatment”
Addiction is a health problem, not a personality/character problem. However, there are major differences in treating traditionally recognized diagnoses with lifelong medications and treating opioid addiction with very longstanding or lifelong doses of Methadone.
Now, medically speaking…when a diabetic begins to use and benefit from insulin, their BS comes down, their weight comes down, their kidney function improves, and their heart attack and stroke risks dramatically decrease, just to name a few of the health benefits of insulin.
Yes, they do need to take Insulin for the rest of their lives, barring a patient’s research into the documentation of the scientific work and research overseas teaching that even Type 1 Diabetes can be a reversible/correctable process. American pharmaco will not allow this information to be spread as truth here in this country.
But opioid addicts’ brains CAN completely heal from the gaping holes in opioid receptors caused by the overuse of opioids which cause the insatiable desire for the drug. Intensive, corrective counselling can and does foster and create the emotional and mental healing needed for the addict to come to terms with their reasons to medicate in the first place.
As a mother who is both an onlooking bystander and a medical professional, and in the opinion of those within my reach who are everyday addicts needing treatment, Methadone is not changing or improving the heroin addict’s demeanor, body function, healing processes nor does it improve the function of any body system or emotional malady.
It is a simple mainstay that has its purpose if used in conjunction with the other aspects that will heal an addict, but that purpose does not and should not be part of a regimen that overdoses the patient each morning, starving them of a night dose, due to lack of staff or funding to offer an evening clinic or especially because stigma still calls for the addict to “toughen up” and “wait it out” for the AM dosing.
My God, does the average medical community read the obituaries? Do they follow their patients’ absences and worry? A heroin addict cannot “wait it out.”
On a positive note, Texas Harm Reduction Alliance and IntegralCare here in Austin, Texas does employ some very dedicated healthcare workers, degreed professionals, who have made it their life’s work to advocate tirelessly for the addict communities. I am so thankful for them.
Today Texas Harm Reduction Alliance returned my call almost instantaneously today when I called to get immediate Suboxone for my son, Landon, as his insurance coverage lapsed yesterday and he cannot go back to his maintenance clinic as of today.
The addicts within my reach and observation who are on Methadone, and those I have had as patients claim and certainly appear to look and feel exactly the same as they do on heroin.
This is unmissable information and a medical urgency for the addiction community.
I have encountered and worked with many genuine healthcare workers who sincerely want to help addicts recover their best life. What constrains the good-hearted efforts of the common man is Big Pharma, the bumbling interference and decisions of confused and unaffected lawmakers, and programs who set the addict up to fail by not follow their own guidelines to promote true healing within addiction treatments methods (requiring but not monitoring intensive treatment, not monitoring systems check labs, not addressing the lack of proper and adequate dosing, etc.)
Real change is needed and in some of areas of the country, addiction treatment is addressing and eliminating the previously held stigma that historically prevented permanent and positive outcomes for addicts.
Drug addictions, specifically heroin and other opioid addictions, are medically sound conditions requiring medical attention and intervention to save countless lives.
Methadone is not what a heroin or other-opioid addict needs to become free of an addiction…that will never occur on Methadone.
Methadone is to be used as a temporary tool; its efficacy and appropriation should be monitored by the outward effect of the drug on the patient and attention should be paid to the tolerance to it that builds up over time in those patients.
My own son, a Buprenorphine/Suboxone patient, will only begin to truly recover from his heroin addiction in a year or two when therapy and the passage of time allow for gradual weaning off the medication…allowing the opioid receptors to shrink.
Because I am in this war with him for good, I will tirelessly advocate for the change in perspective and attitudes towards the addict’s sobriety and recovery, and specifically for improved and effectual treatment for the addict that does not include lifelong dosing of an opiate to treat opioid addiction.
Because death is not acceptable for the addicts we love, addiction to any drug is not acceptable regardless of its widespread existence and use.
Methadone is not acceptable as a long term “treatment” for opioid addiction.
Please help by educating yourselves first, then others and then advocate for real research and changes in addiction treatment, specifically Methadone, that will help an opioid addict, and any addict, separate from addiction for good.