Methadone gets such a bad rap sometimes that I thought we should at least take a look and consider a few scenarios where it *does* actually have a *positive* impact on an individuals’ life, and their ability to recover.
While most treatment centers are staunch in their belief of an abstinence based approach once individuals are back in the community, many of those fighting addiction on the front lines of the public sector will argue the case for harm reduction.
We can consider that Methadone may fall into this category, for someone who has chronic opiate addiction issues, the issue is not considering methadone detox or abstinence as a realistic approach (for many it’s not….yet) but instead recognising Methadone as a realistic alternative to the never ending drain that heroin or other stronger opiates are.
There is a camp which argues that if Methadone is used consistently, as a true alternative to other opiates (and not on top of) then this form of replacement therapy may indeed allow an individual to live a more functional life, and create a greater amount of future opporunities for abstinence that wouldn’t otherwise be possible.
There is no doubt that Methadone maintenance is an approach adopted due to sheer numbers involved in the opiate crisis, and if it doesn’t directly solve the problem, for those who have chronic addiction and no other ways to stabilise their behaviour and propensity towards crime, it can act as a harm reduction mechanism until the individual finds other ways to cope, and straightens out other life issues that for other reasons can’t be addressed in the near term.
As An Alternative To Multi Substance Abuse
Sadly, the reality is that most heroin users got there through other means, and also continue using other substances alongside.
If we’re really honest, *any* possible solution or alternative that keeps an individual from progressing onto other street substances is a good thing, as it avoids the contamination and cross-addiction created by the bevy of dilutants and cutting agents present.
It’s sad, but there is no doubt that certain scenarios arise that we must turn to Methadone as a means to prevent the addiction spiralling, and to counteract the potentially negative effects of the social circle and effect that peer drug users will have on an individual’s likelihood to not ony relapse but extend an active addiction further than the opiates they’re already using.
Although they don’t get the focus in a local authority healthcare setting, there are lots of folks who, stumbled into heroin or opiate use for innocent reasons, and if given the option of Methadone **at a certain stage of their addiction** would gladly take it, and in fact this would dramatically reduce the likelihood of an escalatin pattern beginning.
Of course, there needs to be a willingness there, in the long term to at least move *toward* an abstinence, or a plan that can be carried out to make their way towards abstinence.
Some folks are lucky – they have all the resources they might need to maintain a recovery, and just need a short-term stabilising solution to help them get enought time to implement.
With Emotional Stability Benefits For Dual Diagnosis Or Complex MH Issues
Sometimes, even though the desire and timing to get better are both there, there are still other factors preventing someone moving into addiction recovery and full abstinence that are nothing to do with desire or motivation – but more to do with co-occurring issues.
Many of the professionals label these as co-morbidities – co-occurring chronic mental health issues that, together with addiction issues in the picture, cloud the issue of what came first – the mental health issues or the addiction?
Most of those in active addiction are of course suppressing very real emotional health problems. Whether this is their motivation to use or not, is another matter.
But nevertheless they are themselves working through the fallout of confusing and perplexing issues of self that they don’t have answers for.
Did the self-esteem cause the drug use? Or did the drug use cause the self-esteem issues?
It’d be difficult to argue against the idea that pre-existing mental health issues, can result in a *pre-disposition* towards substance abuse.
Most in active addiction, are seeking nothing more than a coping mechanism, and a way out of the pain they find themselves in, and in most cases, didn’t ask for.
Patterns of usage tend to be exacerbated by the poor conclusions and meanings, those in addiction tend to make, from the events of their lives. By poor, we mean of course, not useful to that individual’s well-being or safety.
With the mental health issues clouding the picture, actions that would otherwise be considered too risky or dangerous, can become rationalised and seem reasonable through the tinted glasses of depression, anxiety, mania, etc.
This can mean that underlying emotional issues become the drivers for a habit that escalates into harder, or more dangerous drug use, and the chaotic behaviours that must inevitably occur to maintain it.
No one is suggesting that mass uptake of Methadone for mental health affected addicts is a realistic long term answer, however, if it does help stabilise usage, that otherwise, mental health issues would have had run out of control, then we must surely consider that a win.
With the opiate epidemic that’s breaking out right now across the globe, esp the US, authorities have had no choice but to turn to methadone as a maintenance method to help opiate addicts desperate to get clean.
Recent changes in the law in some states like Oregon made certain prescription opiates illegal, or at the very least, very difficult to obtain. Hence their prices on street value have risen dramatically, making them unaffordable for most addicts.
An unfortunate side effect of this is that most addicts then turn to the next cheapest substance in order to avoid opiate withdrawal – heroin.
As a result, for those who genuinely want to get clean, detox, and get into recovery, they are inevitably prescribed methadone as one of the only approved ways of dealing with opiate addictions.
Methadone can itself be addictive, and most addicts develop tolerance quickly. When the prescribed level rises so much that medical professionals are unwilling to increase it further, addicts can be left in a place of withdrawal, even though their prescribed levels are already very high.
Detoxing from methadone successfully is difficult, and not many centres offer options for detoxing from higher levels of methadone.
Once detoxed of course, risks become higher of unintentional overdose, should the individual re-use again once clean.
Generally, if considering methadone treatment, it’s advisable to get a professional medical detox that’s overseen by appropriate physicians, to ensure safety and comfort during the process.
It’s important to have supports set up ahead of time, before detoxing from methadone, that will help you maintain abstinence from substance use for the ongoing future.