I love Bill and have enormous respect for him. This is not the first time I've heard him express these opinions and I respect where he's coming from, but it's just not been my 18 years experience in Southeastern and central Michigan. Just last week I admitted another 19 year old who had been going to a dosing clinic, getting no real counseling, no real recovery and little help when he asked to be detoxed so that he could pursue drug-free recovery. These are the kinds of stories I hear without exception. I recognize that my contact might be limited to a non-representative sample, but I've never even heard someone say something like, "Other people were doing well on it, but it wasn't for me." or "The people there really cared and treated me well, but I decided I needed something else." I've yet to meet a person on methadone at a professional conference as a success story. I've interviewed countless professionals seeking to leave methadone clinics--including people who don't have any connection to 12 step recovery. Methadone seems to be the dominant approach in the U.K. and it appears to be wrought with the same kinds of problems I see locally and the same pessimism about the capacity of opiate addicts to recover.
It's a crime if there are all sorts of great methadone recovery stories and stigma is preventing them from being heard, but I'm skeptical.
Bill has a history of doing a great job of delivering difficult messages to drug-free treatment providers. Methadone providers need to be challenged in the same manner. If drug-assisted treatment is ever to have a place in a recovery-oriented system of care, it seems to me that the providers in my area need a dramatic culture change.
UPDATE: Just to be sure that my position is understood. I'm not advocating the abolition of methadone.
Here's something I wrote in a previous post: "All I want is a day when addicts are offered recovery oriented treatment of an adequate duration and intensity. I have no problem with drug-assisted treatment being offered. Give the client accurate information and let them choose."
Another: "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."
It's also worth noting that there is a link between AA and methadone.
It's a crime if there are all sorts of great methadone recovery stories and stigma is preventing them from being heard, but I'm skeptical.
Bill has a history of doing a great job of delivering difficult messages to drug-free treatment providers. Methadone providers need to be challenged in the same manner. If drug-assisted treatment is ever to have a place in a recovery-oriented system of care, it seems to me that the providers in my area need a dramatic culture change.
UPDATE: Just to be sure that my position is understood. I'm not advocating the abolition of methadone.
Here's something I wrote in a previous post: "All I want is a day when addicts are offered recovery oriented treatment of an adequate duration and intensity. I have no problem with drug-assisted treatment being offered. Give the client accurate information and let them choose."
Another: "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."
It's also worth noting that there is a link between AA and methadone.
16 comments:
I need to say that your experience is my experience albeit four thousand miles distant. Our methadone maintained clients in recovery (full lives, contributing, working or in education etc.) are few and far between. Our harm-reduced (and probable public health sucesses) are many.
I'm tired of clients telling me when they come to our abstinence focussed service that they've tried for ages unsuccessfully to get a reduction in their methadone.
Mind you, here in the UK, many workers have never seen an addict in recovery. I think you have the edge on us there. Self-fulfilling or what?
Thank goodness there is a wind of change around.
yep jason i have to agree with peapod, and i am a little surprised to hear it is the same on the other side of the pond, bill white i think is perhaps more exposed to meth recovery stories than wee have been and perhaps is advocating rather than witnessing. It is very rare to see anyone in my area who is on a script to well functioning anywhere near "normal" but hey thats just my anecdotal and experiential opinion, if you know what i mean, perhaps they are out there quietly recovering and getting on with their life.?
yep jason i have to agree with peapod, and i am a little surprised to hear it is the same on the other side of the pond, bill white i think is perhaps more exposed to meth recovery stories than wee have been and perhaps is advocating rather than witnessing. It is very rare to see anyone in my area who is on a script to well functioning anywhere near "normal" but hey thats just my anecdotal and experiential opinion, if you know what i mean, perhaps they are out there quietly recovering and getting on with their life.?
Subject: METHADONE MADNESS
DEAR SIR
I'M WRITING THIS LETTER OUT OF CONCERN FOR THE MADNESS THAT EXISTS REGARDING THE METHADONE PROGRAM TODAY NOT ONLY HERE IN VANCOUVER BUT ESPECIALLY IN SURREY AND SURROUNDING AREAS. I MYSELF HAVE A MEN'S RECOVERY HOUSE HERE IN EAST VANCOUVER NONE OF THE MEN THAT STAY HERE ARE ON METHADONE. I HAVE FIVE VERY CLOSE FRIENDS WHO HAVE RECOVERY HOUSES IN SURREY, ONE FRIEND IN PARTICULAR SHARED A FEW RECENT STORIES THAT I THINK WOULD BE OF INTEREST TO THE PRESS. THE SO CALLED KICKBACKS THAT EXIST THE MAINTENANCE OR TAPER PROGRAM THAT WAS THE ORIGINAL REASON FOR THE INTRODUCTION OF THIS PROGRAM HAS GONE OUT THE WINDOW ALONG WITH THE MANY VICTIMS WHO ARE CURSED WITH THIS DRUG.
HE TOLD ME AND IS WILLING TO TELL ANY REPORTER WHO IS INTERESTED FIRST HAND STORIES ABOUT THE ABUSE THAT'S TAKING PLACE, NOT ONLY IN THE CLINICS BUT THE PHARMACIES AND EVEN IN THE DOCTOR'S OFFICE AS WELL. HE HAS A MEN'S HOUSE AND HAS STARTED A TAPER PROGRAM FOR ANY NEW CLIENT'S THE RESPONSE HE HAS BEEN GETTING FROM DOCTOR'S PHARMACY'S ETC. IN UNBELIEVABLE ONE OF HIS CLIENT'S WAS APPROACHED WHO LIVES IN HIS HOUSE AND WAS ASKED IF HE WOULD BE WILLING TO OPEN A HOUSE OF HIS OWN THE PHARMACY WOULD SUPPLY THE CLIENT'S THE HOUSE' PAY HIM TO LIVE THERE AND ANYTHING ELSE HE WOULD NEED .MY FRIEND WHO HAS THE TAPER PROGRAM WAS GIVEN A CHECK FROM A PHARMACY FOR 2700 DOLLARS FOR FOUR PEOPLE IN HIS HOUSE FOR ONE MONTH .
THIS IS THE TIP OF THE ICEBERG WE SAT AND TALKED FOR OVER AN HOUR AND HE SHARED ONE STORY AFTER ANOTHER WITH ME HE SAID HE WOULD LOVE TO SHARE THESE STORY WITH THE PRESS. WHY? , BECAUSE HE IS THE ONLY RECOVERY HOUSE AS FAR AS HE KNOWS IN SURREY THAT HAS A MANDATORY METHADONE TAPER PROGRAM AND HE'S SEEN FIRST HAND THE RESISTANCE FROM THE SO CALLED MEDICAL PROFESSIONALS. IF YOU WOULD BE INTERESTED YOU CAN CONTACT ME AND I WOULD BE HAPPY TO SET IT UP. ON ANOTHER NOTE IF YOU HAVE THE TIME TAKE A LOOK AT MY WEBSITE IF YOU WOULD LIKE A LITTLE BACKGROUND ON ME. THE NAME OF THE WEBSITE IS 2010homelesschampions.ca YOU WILL FIND THIS SITE HAS WHAT I BELIEVE TO BE THE MOST ACCURATE PORTRAYAL OF THE CURRENT CONDITIONS AS THEY EXISTS IN THE DTES OF OUR CITY THERE ARE OVER 30 VIDEOS THAT I HAVE PERSONALLY TAKEN WE ALSO HAVE A SECTION ON METHADONE AND ANYTHING ELSE THAT IS CURRENT TODAY
THANK YOU YOURS TRULY SEAN EDITOR@2010homelesschampions
Supporting Terminal Addiction Is Alive And Well In Vancouver And I.M Sick Of It.
The Methadone Program Is As We Speak Creating A Whole New Generation Of Opiate Dependency The Government Junkies Slash Methadone Zombies Are Just Starting To Amass The Support Of This Form Of Terminal Addiction Is The Worst Of Its Kind The Overall Program Is Corrupt The Kickbacks ,The Pharmacies Themselves Can Do What They Want!
help
I just came ba back from a professional conference where there were many many methadone patients doing extremely well, speaking at the conference lecturing to other attendees, giving professional presentations, etc. Not only that but I have personally, as have others I know, told our stories of MMT recovery to you on many occasions, so for you to claim you have heard no such stories is untrue--the fact is that these stories don't jibe with what you WANT to be true (i.e., the only way to recovery is through the 12 steps), so you ignore them. You say you hear only negative MMT stories "without exception". Perhapos you might try the Addiction Treatment Watchdog website, or We Speak Methadone, or Methadone Supoort.org. These sites are chock full of people whose lives have been saved by MMT--not a "higher power" and the 12 steps, but MMT and evidence based medical treatment. If you close your ears and yeys tightly enough though I am sure you can continue to avoid these "troubling" stories and pretend that only bad bad things come from treating a medical illness and disorder of the brain chemistry with actual medication.
"Not only that but I have personally, as have others I know, told our stories of MMT recovery to you on many occasions, so for you to claim you have heard no such stories is untrue--the fact is that these stories don't jibe with what you WANT to be true (i.e., the only way to recovery is through the 12 steps), so you ignore them."
I don't know who you are and it's difficult to respond directly when you report direct contact with me but don't identify yourself. My bias is pretty plain to any reader of this blog (As is yours with your dismissive reference to 12 step recovery.) but I'm reporting my experience truthfully, and I was careful to insert all sorts of qualifiers about my experience and my region. If you're someone who's commented here before, that's hardly grounds to accuse me of bad faith.
I have a suggestion for you. Michigan's state conference of addiction treatment is in September and I think that they are still looking for presenters. Why don't you offer a panel of methadone success stories? I'd go and write a post about it here.
http://www.thepetitionsite.com/takeaction/360731625
At the website above you will find THOUSANDS of positive testimonials from methadone patients speaking to its efficacy and "life-saving" positive impacts on countless lives. Addicts in your part of the universe are no different than those elsewhere. Your experiences speak more to your own prejudices than to reality on the ground. Anon. also suggests other sources for additional positive methadone patient stories. These are the places where you can find that which you've successfully overlooked in the past.
Views such as yours fly in the face of the voluminous scientific brain research that gives credence to this enormous body of anecdotal evidence on methadone maintenance treatment's efficacy. Views such as this also do nothing to solve the problem of addiction, and only exacerbate prejudice and stigma.
Bill White has been big enough to recant his earlier opposition to methadone treatment. Do you have the courrage to examine your own views? You've been presented with the sources you state you lack.
Kind regards,
J.R. Neuberger
NAMA-Recovery
Wilmington, Delaware
Of course this is the type of experience you encounter from patients "without exception" YOU WORK AT A DETOX FACILITY! I work at a hospital, the people I encounter are always SICK....you work at a detox facility the people you encounter are always going to be folks that are not happy with their current "recovery"!
I hear similar remarks from nurses who work in jails....of course they are going to have encounter the people who are doing POORLY on methadone...they work in the JAIL FOR GODS SAKE!
How 'bout this? I won't judge your theory on recovery based on the fact that a mere 10% of the people who come to you for help, actually find "recovery"....and you can admit you know absolutely nothing about medication assisted recovery based on your very LIMITED interaction with patients on it?
Sounds like a deal to me!
First, I visited your blog. Good luck on your upcoming test. I'm glad you've found a path to recovery that worked for you. I wish you nothing but the best.
I'm not sure where to begin, your comments don't really follow my post or comments.
"...the people you encounter are always going to be folks that are not happy with their current "recovery"!"
First, I don't work at a detox facility. Our agency offers detox, among other services. Second, of course our clients are unhappy with their current circumstances, but they have a lot of different things to say about previous treatment providers of all kinds--some good, some bad.
I'll make the same suggestion that I made earlier. Michigan's state conference of addiction treatment is in September and I think that they are still looking for presenters. Why don't you offer a panel of methadone success stories? I'd go and write a post about it here. I see that you're in Maine, but you might be able to use your network to get people in Michigan.
I don't know where you got the 10% number. It isn't true. If you're so skeptical of recovery among our clients, you're welcome to come visit our programs and see for yourself.
J.R.--I've addressed methadone research in other blog posts.
I'll repeat the same suggestion that I made a couple of times earlier. Michigan's state conference of addiction treatment is in September and I think that they are still looking for presenters. Why don't you offer a panel of methadone success stories? I'd go and write a post about it here.
I'll throw you one bone. I've tried to be careful to qualify my comments with references to may area. The reason for this is that Bill suggested that MMT is much better on the coasts than it is in Michigan. My qualifying statements have been an attempt to allow for the possibility that SE Michigan is not representative.
BTW - Thanks for the civil tone of your comment. (Seriously. No sarcasm intended.)
The 10% success rate is exclusively for opiate addiction....you'll be hard pressed to find any research that gives detoxed opiate addicts better than a 20% chance of a successful recovery....even more scary is the fact that an opiate addicts chances of overdosing when they first leave detox (or jail) is 8times greater than it is even when they were using before they went to detox.
I think the reason why this issue is so polarizing in the treatment community is because the two groups have absolutely different ideas about what successful recovery IS....it is just my opinion, but I personally feel that for too long, the term "success" (when talking about addiction treatment)has become equated to how many seconds, minutes, hours and days a person has been "clean" and to further complicate the issue, every treatment provider has a different idea of what medications and drugs are ok to take and still call yourself clean. For instance, someone who inhales five packs of cigarettes a day is considered CLEAN, but someone who takes a sleeping pill is NOT.
Personally, for me, I grade my level of success in addiction treatment not by how long it's been since I used a drug...but how longs its been since I was overwhelmed to the point of insanity with the URGE to use drugs. Because for ME, treatment isn't about how well I can cope with the symptoms of my addiction, it's about how few of them I experience. Just like if I were treating depression I would be more concerned with how often I felt overwhelmed by suicidal thoughts, then I would be with how long I had been taking my anti-depressant.
Thank you for the suggestion about the panel....however something tells me it would be similar to going in front of a firing squad...and the problem is these issues aren't debatable. Because people hold their recovery theories in the same light as they do their religous views-it would be like arguing over the existence of GOD. The people that believe will not be swayed by science and the people that do not believe will not be swayed by faith....AND the views of methadone treatment by most 12step followers are irrationally venomous at times, which is impossible to argue with.
Thank you for the good wishes about my test.
ARM-ME,
Thanks for your comments.
One of the first thoughts that comes to mind is that a lot of people have different feelings about methadone clients and methadone programs. The fact that I'm troubled by programs in my area does not mean I harbor ill will toward their clients.
I have a little experience in dealing with criticism and skepticism from people outside of my area of practice. I spent several years defending drug-free treatment programs from accusations that had some truth to them because I thought (and still do think) that they often presented a distorted picture, painted with a broad brush, held biases that facts could never penetrate, and that they had ulterior motives.
Eventually I started acknowledging that much of that skepticism and criticism were well earned. (At one point we did it on a stage in front of 200 people. Talk about a firing squad!) Acknowledging that we made mistakes and fell short created opportunities to change our programs and influence other programs. It also diffused some of the intensity and made it easier to win over the "reasonable center." Some of your advocacy work seems to focus on advocating for clients who are mistreated by clinics.
Zealots will always exist, but every critic is not a zealot. Treating critics as zealots only creates more zealots.
Drug-free treatment does work for opiate addicts. Addicts who receive treatment of adequate duration and intensity with long term recovery support have great outcomes. Impaired Health professionals are a great example and opiate addicts in our programs do just as well as other clients. (Note that I'm not dissing MMT. I'm just saying that drug-free treatment works.)
Best,
Jason
Can you send the info about the Michigan Conference? I had a long conversation with Marilyn Miller, the Michigan State Methadone Authority and Single State Agency director at the AATOD conference and I am sure she would be able to get some Michigan methadone patients to talk at your conference.
Are you familiar with Methadone Today? Its been published by Michigan methadoone patients for over 13 years.
The website is http://macmhb.org/.
Craig Finger is the head of the Substance Abuse Training Project. His contact information is on some of the materials.
Best,
Jason
BTW - I won't be at the conference. I'll be training/entertaining Japanese addiction professionals. If you are able to arrange a panel, I'll send one of our staff and have them write a guest post.
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