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Monique Manna
Southbridge Sustainability Committee
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Getting Involved: Methadone is a KILLER drug
Thanks for posting the video. It was good to see it. I am really more involved as a methadone maintenance advocate, but the pain situations are of interest to me as well.
I am aware of the tragedy of addiction and the misuse of pain prescriptions and the need for the careful prescribing of methadone at all levels.
It is sad to think that the simple words:
"Take this medication only as prescribed and keep it safe." are not always heeded by either side of a drug transaction outside of a doctors office or clinic. Nor are they heeded by some pain patients.
It comes down tragically to that point of sale or prescription and the drugs' subsequent use outside of the intended prescription, be it ignored or with full knowledge of the potential consequence.
Why that transaction should reflect on the patients who take their medication as prescribed and keep it safe, or on the Clinic doctors and the pain MD's who prescribe the medication properly is beyond me.
Just as I believe that the disease of addiction is framed by an all too much ignored innocence. Just as innocent as the dance of greed or the gift of a friend to an addict is ignored. Too often, addiction is mistaken for a moral deficiency rather than a treatable disease.
The reflections of such actions towards the methadone medical community - including the pain doctors, maintenance doctors, and their patients - has been taking it's measure as though, some how, the doctors, the medication and the patients are morally responsible for the actions of a dealer and an addict or a pain patient who goes beyond the prescription. Clinics take great care in this matter. Where does the blame fall? Should it fall on them all? Should it fall on the addict in treatment? Should it fall on anyone? Are the laws correct in their applications? Who holds the responsibility of someone becoming an addict? Who holds the responsibility for someone just taking too much against the prescription warnings? Who holds the responsibility when their hand curls around a pill they should not be taking?
Shoukld it be the methadone clinic doctor or the pain doctor who did their job correctly? I do not think so.
Some of us are now more tragically aware than before of those who who sell & misuse medications and who are not following the intended prescription at all. How can we make the pain sufferer follow a proper prescription as written? How can we stop the dealer from selling?
Now, all we have to do is figure out how to help the addict and the dealer or the gifting friend.
Well, that is where methadone and buprenorphine come in.
How can we help the pain patient..
Methadone has good analegesic properties and is very inexpensive.
It helps with pain and it helps the addict providing they:
Take this medication only as prescribed and keep it safe.
George
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Thank you for for your comment. As I agree, the "Take as Perscribed" should be followed, when abusing medication this warning means nothing and sometimes the decision one makes is one of tragedy.
I also believe that Doctors too should be held accountable because there are those who do "heed" the warning and die from taking this medication.
Drug addiction is a very sad thing and it is hard sometimes to understand. I have been touched by this disease too many times and the only thing I can do now is pray....I have learned that one can not help themselves unless they want to truly be helped.
Thank you again for your comment.
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Hi George,
I meant to say "One can not help someone unless they truly want the help themselves"
Thanks!
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PART 2
Now we come to a very sad part of this… Before I start, I wish to say that I honor what everyone is going through when a family member or friend is lost to drugs and/or alcohol. This disease is very powerful.
Death by methadone or death by valium, alcohol and methadone – etc.?
METHADONE DRUG INTERACTIONS
http://www.harmd.org/Drug_Interactions.pdf
Interactions with Alcohol and Drugs of Abuse
Methadone may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression. Deaths associated with illicit use of methadone frequently have involved concomitant benzodiazepine abuse.
Source above: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=4369
The combined effects of benzodiazepines and alcohol or other CNS depressants (drugs that slow the central nervous system) can be very dangerous, leading to unconsciousness or, rarely, even death. Anyone taking benzodiazepines should not drink alcohol and should check with his or her physician before using any CNS depressants. Taking an overdose of benzodiazepines can also cause unconsciousness and possibly death. Anyone who shows signs of an overdose or of the effects of combining benzodiazepines with alcohol or other drugs should get immediate emergency help. Warning signs include slurred speech or confusion, severe drowsiness, staggering, and profound weakness.
Source above: http://www.faqs.org/health/topics/37/Benzodiazepines.html
It would seem to me that the saddest part of this is the fact that addicts choose to mix other drugs and alcohol with methadone. Sometimes, this is called a “cocktail”.
When a parent tragically loses a loved one, the other drugs present in the mix may not be mentioned because of the focus against methadone. This is expected by advocates like me because the Stigma against methadone and methadone clinics is very strong.
Do you think in fairness that a parent or loved one should include the other drugs that were found in the system besides methadone? Did you know they can kill without the methadone? Do you wonder why methadone is singled out so heavily when it was a “cocktail” of drugs that caused this death. Will you question why methadone is singled out while these other drugs are not?
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Thank you George. Do I think if there are other drugs besides Methadone that has caused a death that a parent should make those drugs known too...yes, I do think it should be known that these other drugs were a causal factor too.
Methadone is such a highly addictive drug...why would a doctor prescribe this to a patient, aren't there alternatives? I know that Valium and Percocet and Percodone, Vicodin etc. all also addictive, but do they stay in a persons system as long as Methadone? I have read that Methadone deposits into the muscles and people do not realize how long the medicine stays in your system and then take another pain killer and this can cause an Overdose. Some people aren't aware that it takes time to feel the affects of methadone so they think it is not working and they take anotehr to soon.
I think it is a Doctors responsibility to educate their patients on this drug. Not just rely on "Take as prescribed". A Doctor when prescribing this medicine should not ask "do you have any questions about this medicine" but as a part of the treatment should tell the patient "This is what could happen if you do not follow the directions" Tell them - then ask questions.
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Off the top: Methadone has a unique character. It's analegesic (for pain) property requires it to be administered several times a day like any other opioid/opiate. The long lasting property is the part that keeps someone from using opiates. Please look over the pdf below.
http://www.atforum.com/pdf/PayteSafetyInstructions.pdf
http://www.hc-sc.gc.ca/hl-vs/pubs/adp-apd/methadone-treatment-traitement/methadone-work-agit-eng.php
Once a patient is on his right methadone dose, there are no cravings for opiates anymore. If there are cravings and other symptoms the need an increase is apparent. I do have an ARM Pamphlet on Dosing too.
I feel that the Pain MDs are getting the information out but I can not tell what they are doing. I have no direct knowledge about how they work. I have some knowledge about how a clinic works. The care taken when starting a new patient is very important. They start off on a very low dose and then work up over a period of time. With methadone, there is no easy conversion tabel for addiction or pain. Heroin, for example is cut and who knows what is in it at all. There are rules for induction. I have attended meetings (Dr. Payte) on induction of both methadone and buprenorphine (audited the Dr's course at Beth Israel) I agree,the patient need to be well cautioned not to take any more than prescribed for pain. They will use a breakthrough narcotic to handle peaks of pain. This is important. Take only as prescribed and keep it safe.
There are a lot of rumors about methadone.
http://hubpages.com/hub/The_Truth_About_Methadone_Myths_Dispelled
Methadone takes about 4 hours or more to get the anllgesic effect. Thus someone who does not know this (but knows he should not take drugs)might well be chasing that by taking another pill..
The doctors and clinics should be doing the proper education. To me, this should be enough:
Take only as prescribed and keep it safe. To me, "as prescribed" includes the warnings and cautions. These, of course, are not evident when the drug is being sold without a prescription.
I my business, every auto policy goes out with 4 pages of information and I do touch on the high points where problems can happen. My back up of what I sent is in every file. That is my boiler plate....my back up. I do not think all agents do this, but I do. Do I have to go this deep.. not at all.
The questions on the application should be enough, but I do emphasize them a lot while we are going over the app and collecting the signatures. I certainly hope that this is being done in clinics and
I have to take a lot of pills for my heart and my prostate. When I go out to look at an over the counter medication... I read the label. I bought some nose spray for a cold, got home and read the label.. There were cautions on that bottle with my ciondition. Gave it to my sister. I remembered what he told me from before and that is what I used.
The way I look at it.. when
Thanks.
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Sorry - not enough space.
The way I look at it, when i say "Take only as prescribed" I do mean that "prescribed" includes the warnings and the cautions. Take the medication only as prescribed and keep it safe.
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METHADONE AND BILL W. AA.
AA (as in Abstinence Advocates who despise medically-supported treatment of addiction)
TAKE NOTE:
Vincent Dole gave a presentation in 1991 to the American Society of Addiction Medicine (reprinted in Clin Exp Res, 1991, 15(5): 749-752), in which he told about being asked in the early 60s to become a "lay" member of the Board of Alcoholics Anonymous - only 7 non-alcoholic trustees are permitted worldwide under the constitution of AA. Vince had just published the initial studies on methadone, demonstrating its unparalleled efficacy in treating heroin dependence, and he couldn't figure out why he was asked to join the board of AA, which had never utilized medication in helping alcoholics.
At the last meeting he attended with Bill W before the AA founder's death it was explained. "[H]e spoke to me of his deep concern for the alcoholics who are not reached by AA, and for those who enter and drop out and never return. Always the good shepherd, he was thinking about the many sheep who are lost in the dark world of alcoholism. He suggested that in my future research I should look for an analogue of methadone, a medicine that would relieve the alcoholic's sometimes irresistible craving and enable him to continue to progress in AA toward social and emotional recovery..."
Bill W was a wise and compassionate man! Hopefully some day soon an "analogue" to methadone indeed will be found - and when it is, one can only pray it will be embraced by those who are committed to helping those afflicted by alcoholism.
Source: http://opiateaddictionrx.blogspot.com/2008/05/aa-as-in-abstinence-advocates-who.html
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Hi George - I see your passion and I admire that. I do have to disagree though on using Methadone as a treatment. Why would you subsititute one drug for another...an even more addicting drug? Some people remain on this for years. There has to be another way...a more effective way instead of keeping folks addicted to another drug.
I believe in counseling and talking and praying...I truly believe all these things work. If a heroin addicts detoxes from heroin without any medicine then he will feel the pain of the withdrawls...maybe this would be one step in keeping that person off the heroin along with intense counseling and such.
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Hi Monique.
I always liked that faith tale when a person in a flood was waiting on the top of a roof for God to save him and a rowboat showed up.. he said no, I am waiting for God, mistaking that God might work in other ways than he expected and had thus sent him the row boat. (in this case, with a business card for the nearest methadone clinic and maybe an NA meeting schedule too? Maybe not yet.)
The idea of feeling the pain of withdrawals is of interest. Very often, due to a lack of ability to cop, they have felt that pain. This is a chronic relapsing disease that can also be treated by Methadone and Buprenorphine.
A lot of people think the same as you do about substituting one drug for another. It is especially common amoung members of NA. All they have to do is become Methadone Maintenance Friendly MMF and change a few words. That place where it is OK to take mind or mind altering chemicals when prescribed by a doctor...thats cool. They just have to drop the places where they except "Drug Replacement therapy" (Those MD's do not count.)
I should memtion that counseling is done by methadone clinics and that there is a Methadone Anonymous program that does not discriminate against maintenance or taper.
Oddly, in at least one NA group, a methadone person was even asked to chair a meeting.
http://www.facesandvoicesofrecovery.org/resources/in_the_news/2009/2009-01-11_methadone_tool.php
George
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Hi George,
If Methadone wasn't such an addictive drug I may thin differently. How can one think that being on a treatment plan of Methadone for ten to twenty years is right? Aren't people supposed to become drug free? I thought that was the intent of the program.
I respect your views, please don't get me wrong, I just can not see any justification in that type of treatment.
As for the clinics....some say they will provide education...some dismiss it. I believe in intense rehabilitaion....30, 60, 90 day programs under a doctors care....medical care 24/7.
I am not an addict, I know addicts though and I have someone very close to me who is an addict. I chose "tough love" on this person...they have misused everything & every system they have been on.
One will not get help until they are ready.
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I chose "tough love" on this person...they have misused everything & every system they have been on.
Some will do OK with a taper. A lot of them will relapse. There is a problem with relapse after a taper as they do not know that their tolerance has gone down so they will take too much of their selected opiate and overdose.
Some will be on maintenance for a long time.. Maybe the rest of their lives. It depends on what they need. Many who taper will fall due to the fact that this is a chronic relapsing brain disease. This is important to know... They have a brain disease that can be helped with methadone or buprenorphine.
http://www.medicalassistedtreatment.com/548338/550643.html?*session*id*key*=*session*id*val*
Some have it more than others. I urge you to read this by Dr. Payte.
Bad Patients or Bad Treatment?
http://www.europad.org/journal/2004/Payte%206(3)2004.pdf
Of course, they can go to AA or NA while on methadone and get intense rehabilitation. They might not want to mention that they are a methadone or buprenorphine patient. The joy of methadone and buprenorphine is that they do not have to go inpatient. It is generally outpatient. Jobs and life are not put on hold. Repeated opiate relapse is stopped. Other issues and drugs can be helped in many different ways.
Call a nearby clinic and ask what they offer for counseling. Locally, we have live in facility that now will allow Buprenorphine patients. I think this is pretty rare.
There are a lot of Methadone Patients doing well in recovery and they did not do 30-60-90 day programs. I have advocate friends in methadone recovery and if yiou were to talk with them you would never know they are maintenance patients. They are holding down jobs today. They go home to their families, and they are productive members of society.
Buprenorphine is the same way but not for everyone.
One will not get help until they are ready.
I need to thank you for being so frank. More information? Go to: http://www.readybb.com/watchdog/index.php
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PART 4
George wrote on Feb 6, 2009 12:14 PM:
" motheragainstdrugs wrote on Feb 6, 2009 7:09 AM:
" I have not one but two children addicted to drugs of any kind. Methadone is one of their favorites. "
Well, you might be thankful one day because methadone or Buprenorphine, taken and prescribed properly may just be the answer. The mixing of drugs is very dangerous. Perhaps you might suggest a nearby methadone clinic or Buprenorphine MD. as a solution. People opposed to medically assisted treatment can get beyond their personal discrimination and adherence to abstinence based treatment. I am concerned for your children.
http://findtreatment.samhsa.gov/
George "
George wrote on Feb 6, 2009 12:21 PM:
“I remember a friend who was at an abstinence picnic and who had tried several times before to get clean. I, of course suggested he keep coming back. It never would have occurred to me to mention METHADONE MAINTENANCE. The only way to go was abstinence! A day or so after the picnic...he was found dead in a toilet stall with a needle. It still took me many years before I became an advocate for medically assisted treatment. After that, a friend of mine, still in abstinence based recovery came to me and told me he had suggested a methadone clinic for a friend who was having a problem with opiates."
These are personal observations.
Why is maintenance held in such low esteme when it works for so many?
A town as well as its 12 Step Groups could be thankful they have a viable alternative to recommend besides abstinence based recovery for the people who struggle with this chronic relapsing disease.
News flash: UNITED NATIONS http://www.ihrablog.net/2009/02/un-special-rapportuer-on-torture-calls.html
This is about the need for Opioid Substitute Therapy in Jails and Prisons. Something very lacking in North America.
North America Section of the Report: http://www.ihra.net/Assets/585/1/GSHRNorthAmerica.pdf
If this passes, there could be an international human rights violation charge against the USA for not supplying "OST" in our jails and prisons.
Something else MAT advocates are busy trying to change.
It is slow, but....
"The times they are a changin'"
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I respect your views George and it is nice that we can disagree on some things and be civil. Something that seems to be hard to do for some people. I do see some of your points however, and I believe I have mentioned that before.
How long have you been and advocate for this?
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Maybe 10 years. I took a sabattical a few years ago because it had become a war zone trying to help locate a clinic.
A friend of mine who brough me in told me it was not a war zone for her. I told her it was for me. She understood. I was doing a lot of work with a clinic placement in Maine which finally did go through. A paper called village soup was the ground for this work. I remember telling a frind of mine at my local paper about village soup and the interplay. A year or so later, my paper hired someone from there. Now, I can work in many locations, where ever they pop up. I usually start by saying that it would be wise for a town to check into the potential for a law suit from the American's with Disabilities Act. That is to try to help save the town some money. One of the things I have discovered is that some of the discrimination comes from 12 Step members who are very up tight when it comes to methadone. That is why I try to bring in the strange set of values when it is OK to have the same people go to a meeting most anywhere. A clinic is banned from those same locations and often will have distances from homes and schools as well. Other types of abstinance organizations may also be treated different from a methadone clinic. George
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And as one friend just pointed out.. Abstinence is another tool in recovery.
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This is our newest addiction problem.
“Bath salts are one of the newer and more dangerous drugs to arrive on the scene. What does one experience when taking bath salts? Individual responses vary considerably, but there are some common experiences. Because bath salts are a stimulant, they tend to lead to increased pulse and blood pressure. Some users have described the physical sensation as a “panic attack that won’t end”. Individuals who have used bath salts may appear extremely agitated and they may believe that everyone is out to get them (paranoia). They may experience hallucinations (see things that are not there). Of particular concern is that individuals who use bath salts frequently experience suicidal thoughts.”
Go to Drug Rehab Centers and Bath Salt Abuse or goo.gl/8ibSR to read more.”
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