I was an Addictions Counselor at a Methadone Clinic.

First of all, I neither approve or disapprove of a person's choice of methadone treatment. Because of this I do not disapprove of the treatment clinics can offer.

The following check list I'm commenting on is from this link--

[link to www.druginfo.adf.org.au]

Interesting that this article mainly mentions heroin. Far more of the clinics patients were addicted to prescription opiates than they were to heroin. Because of this I do believe that the entire medical profession needs to get their shit together regarding the dispensation of prescription opiates, especially regarding long term pain relief treatment.

...you haven't seen-it-all until you've done intake on a 17 year old addict in withdrawal. It's heartbreaking and enough to make you physically sick. This youngun' got her pills on the street, as did a number of patients. Even patients that had prescriptions from doctors still bought more on the street when their scripts ran out. This means that some people are written scripts for opiates whose need for them does not exceed their need for money. And, for one truly in pain, much less addicted, NOTHING is rarely any more important than dosing to stop pain; whether it's pain from injury or withdrawal, or both.

Wherein "all roads lead to Rome," methadone treatment and clinics are not at the heart of the body of issues. The medical profession and medical insurance shortcomings are "godheads" with regard to the body of the issue.

And then there are the addicts, themselves, the true center of the heart of the issue. Whether or not an addict becomes drug free is ultimately reliant on exactly what quality of life it is they're prepared to accept...be it good, bad, or ugly. Some people are just unable to give up the ghost of addiction.

Some comments regarding the following--


* people are less likely to use heroin that may be contaminated with other substances;

* methadone is taken orally, which makes it cleaner and safer than injecting heroin. This reduces the risks of sharing equipment and becoming infected with blood-borne viruses such as hepatitis B , hepatitis C (which may lead to long-term liver problems) and HIV - the virus causing AIDS;


Of course, these are indeed some pros of methadone treatment.


* the routine involved in methadone treatment encourages people to lead a balanced and stable lifestyle - including improved diet and sleep;


Such encouragement was the main focus of being a counselor. It was this part of the job I so loved. Not all patients cared about an enhanced quality of life, but those who did? It was a joy to work with them.


* people are less stressed, as they do not have to worry about where their next 'hit' of heroin is coming from;

* methadone lasts longer in the body than heroin, so it only has to be taken once a day;


While including script opiates, these two points were excitedly commented on by new patients.

Drug seeking behavior can be, as you might imagine, more than just a little inter-personally degrading. For some, their behavior while using was one of the largest hurdles to overcome. Their shame could be deep and wide in scope.

Given they had daily treatment that actually lasted the full day they were freed up from the cage that is drug seeking behavior.

THIS is a huge step toward recovery counseling having a snowballs chance in hell to work.



* it allows people to handle the withdrawal process with less discomfort;


Once the correct dose is achieved and psychological and social issues are addressed during maintenance, then a incremental dose reduction is initiated. Where I worked this never started before a three months maintenance period, and most often not before a six month period. The dose reductions are in extremely small increments, with frequency of reduction likely no more than monthly if a patient isn't to feel some kind of physical withdrawal symptom...and even then, there's still some fright or fight discomfort, bio-emotional issues wherein the patient is just plain ole scared they'll fall prey to their own bodies, and fail. This is a classic anxiety response from a patient.


* criminal activities conducted to obtain illegal drugs are reduced;


I haven't seen stats on how much methadone treatment reduces criminal activity, but I fully doubt it's remarkable within the scope of drug related crime.


* it helps people cut their connections with the drug scene;


And this made me laugh, sardonically. There's only a smidgen of value in this statement. The only thing that does this is the person, themselves. It was like attempting to pull teeth out of a clenched jaw trying to get patients to see the necessitate value in changing their social group.


* it's cheaper - although there is usually a dispensing fee with methadone, this is relatively cheap compared to the cost of illicit drug use (the recommended dosage fee at the time of writing this information was $7.50, although this amount may vary between dispensers); and

* under certain conditions, take-away doses of methadone are also available, which help clients return to a more stable lifestyle. To be eligible, clients must meet the criteria as outlined by the state/territory health department as well as those of the methadone prescriber. Some of these criteria include family commitments, illness and travelling long distances.


Street drugs and abused prescriptions are far more expensive than methadone, and in more ways than one - the ways of mind, body, and spirit.

Also, there were many patients who had take home doses and didn't have to come to the clinic every single day. Granted, they had to have a good history with their recovery program in order to do so, but they could. Maybe it's not all clinics policy to allow for this, but it was in the one where I worked.

And although I didn't work there long I learned a lot while there. I quit because it was an extremely hostile environment; not only some of the patients, it was my fellow counselors, too. I was the only one who had no personal opiate addiction history and this made me kind of like a mark. I was considered not only as a "marshmallow," but they also thought that my lack of experience made me ineffectual as a counselor.

At the end of my time there--within four days I had a chair thrown at me by a patient who had too many dirty UAs and was being taken off the program, had found a letter on my desk from a patient with organic brain damage (she not very stable) detailing 10 different ways she was going to kill me, and got told "little girl, you don't know what you're talking about" by one of my peer counselors in a patient review about one of my patients (the 17 year old). The later was the straw that broke the camels back, and I quit.

Ahem, methadone clinics are living, breathing, soap operas. Seriously. It's terribly ridiculous, and I've never seen anything like it in my life.

Even so, even for the myriad of complications that can arise, there are some who are helped. I witnessed some wonderful breakthroughs that patients had because they had this alternative treatment.

Methadone is not a cure nor cure-all for addiction, but it can be an effective and affective stepping stone in one's recovery from opiate addiction.

The only cure for addiction comes from within a person.

While considering all opiates as an "evil," proper application of methadone treatment and addictions counseling is a lesser of the many stigmatic evils. This I personally believe to be true.

It's not for all and the success rate is not remarkably high, but for those it does work for - after a lot of hard work - they do have a new lease on life.