Monday, October 20, 2008

Methadone maintenance as palliative care

David Clark sticks his neck out on MMT:
As I have said many times before, I have nothing against methadone substitution therapy per se, but I feel strongly about it being used with clients being offered no, or only minimal other, support. I have written:

'Due to the approach adopted by much of the UK treatment system, this generally leads people from one addiction to another without providing a realistic opportunity to attain recovery.

Whilst methadone (and Subutex) have an important role to play in helping people take the chaos out of a heroin-using lifestyle, they should not be prescribed in isolation or with minimal other support.

The majority of heroin users actually want to get off drugs completely, not be “left” long-term on methadone or other substitute drugs. They must be provided with the choice of, and help in, finding a path to recovery, rather than just being helped to live with addiction. Much of the treatment system shows a shocking paucity of ambition for its clients. If cancer patients were only offered what amounts to a form of palliative care, it would be seen as a scandal.'
This issue of palliative care gets to the very crux of the issue doesn't it?

From Wikipedia:
The term "palliative care" may be used generally to refer to any care that alleviates symptoms, whether or not there is hope of a cure by other means;
It really comes down to whether once believes addiction is a treatable illness doesn't it?

I'd add that it might be possible for a methadone program to have a recovery orientation, rather than a palliative orientation, but it's not what I see.

Once again, I'd welcome a day when addicts are offered recovery oriented treatment of an adequate duration and intensity and have the opportunity to choose for themselves.

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