Pubdate: Mon, 27 Dec 2004
Source: Portland Press Herald (ME)
Copyright: 2004 Blethen Maine Newspapers Inc.
Contact:  http://www.portland.com/
Details: http://www.mapinc.org/media/744
Author: Jeff Toorish
Bookmark: http://www.mapinc.org/find?136 (Methadone)

TAKE-HOME METHADONE SHOULD BE OPTION

A recent editorial in the Maine Sunday Telegram suggesting that
methadone patients should be barred from taking home multi-day
supplies of their medicine was filled with misconceptions and
inaccuracies.

Two years ago, Maine faced a crisis in drug overdose deaths. Some of
the deaths involved methadone combined with other drugs and alcohol.
There was a hue and cry, mostly from law enforcement leaders, to end
methadone take-home programs.

During that time, I was a member of the team that worked to find a
solution to the overdose problem through education of the addicted
community. I will confess, I did not know much about methadone at the
time, but I spent several months educating myself about this drug so I
could better communicate with addicts.

Here is what I learned:

Methadone is not a cure for opiate addiction - it is an opiate
receptor blocker. Thus, it does not replace heroin or OxyContin or any
other opiate. It simply blocks the part of the brain that is addicted,
reducing or eliminating the craving addicts experience.

Methadone does not create a high or euphoria, making it pretty useless
as a recreational drug.

Methadone, in most cases, does not help an addict gradually reduce
dependence on opiates; rather, it is a medicine for lifelong treatment.

Methadone has been tested extensively and has the greatest proven
results in helping addicts stay off opiates.

In interviewing many addicts over several months, I also learned that
without the ability to take home multiple doses of their medicine,
many who were admitting their addiction and trying to put their lives
in order would simply revert to their old drug habits and attendant
criminal behavior.

The communications program we designed and executed dramatically
reduced overdose deaths in Maine. A federal study of the program
called it a "national model" and urged other states with high overdose
death rates to adopt it.

High on the list of priorities was ensuring that methadone patients
retain the privilege of taking home appropriate doses to ensure they
did not return to their drug habits.

It is important to note that methadone clinics (in southern Maine
during that time) dispensed the drug in liquid form. At many overdose
deaths, investigators found methadone in tablet form, meaning it did
not come from a clinic, although the clinics still bore the brunt of
the attack. Some doctors do prescribe methadone in tablet form. It is
also possible that methadone is stolen and smuggled into Maine by
people with the mistaken belief there is a large market for it.

It is also worth noting that not all methadone patients were illicit
drug abusers; many became addicted to OxyContin after accidents or
injury. Their doctors prescribed it and they got hooked. Many doctors,
after the rash of bad publicity about OxyContin, stopped prescribing
it to now-addicted patients. And new methadone patients were born.

The take-home program is not automatic. In some cases it can take
months or years for counselors and doctors to allow a patient to take
home a weekend's worth of medication. Some patients will never be
afforded that privilege. It must be earned and at even the slightest
slip, a patient can lose the privilege.

It is an important step in recovery and to now arbitrarily take it
away from those who have earned it would be cruel.

To suggest that these people must drive, in some cases, hours every
day to receive legal, medically supervised treatment flies in the face
of logic. These are the addicts who have admitted their problem and
are working hard to make amends and move forward.

Remember, the goal of any drug treatment program is to return folks to
productive status in society. It is hard to imagine anyone being very
productive if days are taken up with trips to and from the clinic.

It is clear, upon a closer look at this issue, that allowing methadone
patients to take home a reasonable supply of their medicine is sound
medically and logical from a public policy perspective.
- ---
MAP posted-by: Larry Seguin