Misunderstanding Methadone: The Stigmatization of a Life-Saving Drug
Mary Jeanne Kreek and her colleagues at Rockefeller University developed methadone 50 years ago. Methadone was the first pharmacological treatment for opiate addiction.
Today methadone is used in treatment programs all over the world. It has saved countless lives and helped millions of heroin addicts reintegrate into society. However, it is still not used widely enough to prevent an epidemic of opiate related deaths in the U.S. which gets worse every year.
Even though deaths from heroin-related overdoses have risen to expose a massive public health crisis in the United States, the drug’s use has remained limited. Kreek’s six-decade career has not only resulted in medical therapies for numerous addiction illnesses, but it has also taught us a lot about the molecular and genetic roots of drug cravings. She has also advocated for the introduction of drug treatment programs all across the world.
“Addictions are diseases, they are diseases of the brain. They are not criminal behaviors, and they are not weaknesses. They however do respond to treatments—and it’s unfortunate that we have tools available to treat opiate addiction, but we’re not using them.”Jeanne Kreek
Methadone was first used as a painkiller for combat casualties. At first a few clinics used methadone as a short term detox regimen, but it had not been studied extensively for use as a opiate detox or opiate maintenance medication.
Kreek and her colleagues began conducting clinical research to establish a methadone-based heroin treatment in 1966 and published findings a year later. Kreek discovered that methadone soothed users’ cravings and prevented withdrawal symptoms. The studies also revealed that methadone, while being chemically identical to heroin, did not elicit a euphoria like heroin.
Even more hopeful, methadone patients who attempted to inject heroin, did not feel a “high.” (It is important to note that methadone does not completely prevent this feeling like suboxone does, but it does make the feeling less enjoyable.
Kreek invented the first analytical procedures for quantifying methadone and other related substances in blood and tissues in the early 1970s. She ascertained that methadone stayed in the body long enough for patients to only need one dose per day. She also planned long-term prospective investigations of methadone maintenance’s physiological effects and medical safety.
These findings gave the FDA enough support to approve methadone for opiate use disorder in 1973.
“I am sick of going to funerals.”
Recently, I came across a Vox article that really spoke to me because the person interviewed had the same revelation I did about methadone treatment. Even when I was using heroin, (as much as an 8-ball a day, which is enough to kill most people) I judged people who went to the methadone clinic. Even those who stayed clean while on it. Based on what society had brainwashed me into thinking, these people were just replacing one drug for another. Years later and I relate much more to interviewee Hansen in the excerpt below.
Vox Methadone Article
Here is the excerpt from Vox:
“I’m sick of going to funerals.”
If you ask Jordan Hansen why he changed his mind on medication-assisted treatment for opioid addiction, this is the bottom line.
Several years ago, Hansen was against the form of treatment. If asked back then what he thought about it, he would have told you that it’s ineffective — and even harmful — for people who use drugs. Like other critics, to Hansen, medication-assisted treatment was nothing more than substituting one drug (say, heroin) with another (methadone).
Today, not only does Hansen think this form of treatment is effective, but he readily argues — as the scientific evidence overwhelmingly shows — that it’s the best form of treatment for opioid addiction. He believes this so strongly, in fact, that he now often leads training sessions for medication-assisted treatment across the country.
“It almost hurts to say it out loud now, but it’s the truth,” Hansen told me, describing his previous beliefs. “I was kind of absorbing the collective fear and ignorance from the culture at large within the recovery community.”
To put it simply, I too am sick and tired of going to funerals and I do not want to be the next one put in the ground.
It is so sad to me how many have died without considering methadone as an option. All of this death because parents and communities decided to stigmatize methadone treatment.
I can safely say methadone saved my life.
I will not pretend I stayed clean the whole time I have been on methadone. However, if I kept going the way I was before I started methadone, I know I would be dead. I certainly would not be here today to write this article.
Hopefully someone struggling will read this.
Someone who is out of options.
Someone who has tried everything else.
I am here to tell you, stop listening to the mainstream opinion on methadone.
Go to a clinic and ask questions for yourself.
Pretend it is a new treatment that society never had the chance to take a dump on.
You may realize what you thought you knew was all wrong. A pleasant surprise in this case.
ALL the Science Supports Methadone Treatment
The science is there and the numbers do not lie. Methadone treatment is effective.
Mainstream, abstinence-based, treatment programs are doing more harm than good in a lot of cases.
We are Killing People with Our Current Approach
Getting someone off of opiates completely, without a bit of a crutch, is the number one cause of overdose in this country.
The majority of my friends that have overdosed and died were fresh out of rehab or jail, clean from opiates for a week, six months, even a year. On a low dose of methadone, my friends’ lives may have been spared. In fact, the relapses may have been avoided completely.
Related Article: Heroin Addiction Treatment Programs – What are my Options?
The “But He Was Doing So Well” Phenomenon
If you are not familiar with this phenomenon, let me explain. Isn’t is odd that after someone overdoses and dies, it is common to hear their families and friends say things like, “She was doing so well though” or “He had been clean for 8 months?”
Well, just wait a second.
Sometimes you hear, “We all thought she was clean, but maybe we were wrong.”
Stop right there.
Most likely, you were not wrong.
The statistics actually support that the deceased was most likely clean, just like her family believed.
There is a very simple explanation for what seems like such an unfair phenomenon. The trend that users who are getting their life back together seem to be the ones who die is not as mystical and unfair as one may believe. There is a simple explanation. The only unfair part is that the deceased had not been offered a treatment program with a crutch, like methadone, to fall back on, before deciding to use again and ultimately die.
The majority of overdoses happen when a person has been clean off opiates for a short period. This happens because their tolerance level have rapidly decreased. Even a small portion of what they did in the past could be a death sentence.
This is increasingly true with the fentanyl epidemic plaguing opiate users as of late.
WILLPOWER was NEVER the Problem
The cravings a freshly clean user experiences were never a willpower problem.
As Kreek explained years ago, using opiates actually changes the way a user’s brain functions. These cravings are a direct result of a chemical change that has actually changed the landscape of a user’s neuropathways within the brain.
With a bit of methadone, the cravings may not be so intense and the freshly clean user may never feel the urge to relapse, and unintentionally overdose.
Related Article: Heroin Withdrawal Symptoms-Timeline: A User’s Personal Experience of Opiate Withdrawal
Stop Contributing to the Problem
I beg of you. If you are a person who has carried on this stigma of methadone treatment as evil, please just keep your mouth shut.
You may be the reason someone who was thinking about trying methadone treatment, decides not to. ]
As a result, you may indirectly contribute to that person’s death. Yes this sounds harsh. (Yes, I am directly this towards people who got clean in NA or AA type programs and choose to discourage opiate users from trying methadone maintenance programs. What works for alcoholics does not work for narcotics users, so this is not a good model anyway.)
If interested in more user experiences or facts about methadone maintenance, please let me know in the comments below. I have not updated this site in a while but will if I know it is helping people!