Monday 26 May 2008

Methadone time limit??

One of Scotland's leading authorities on drug treatment, released a statement yesterday calling for a time limit on substitute methadone prescribing for heroin addicts. Neil McKeganey, Professor of Drugs Misuse Research at Glasgow University, said that methadone treatment should only be available for a short time, suggesting that 2 years is long enough for anyone to overcome their addiction problems before becoming drug free.

He said: "There is no question that methadone has a role to play in assisting addicts to become drug-free but we have far too many addicts on it for far too long, many of whom are continuing to use illegal drugs alongside their methadone," he said.

"I am not saying we should not have methadone but what I am saying is people should be on it for a modest period of time and moved on to a drug-free programme. If it's not time limited, they remain on it for far too long and I do not think we should have addicts on methadone for more than two years."
In my opinion, it is a vast generalisation to say that everyone with an addiction problem should be drug free within 2 years. It should be treated on a case by case basis, some may need methadone or another kind of substitute treatment (yes there is more than one kind) for a lot longer than the next man/women.

In my personal experience of treatment and recovery, I eventually realised that it was essential I be in control of my treatment, in both increasing and decreasing the dosage and also the time scale, (I'll be talking more about this in the near future). I was certainly a lot more successful in my recovery when I was given responsibility in making my own decisions, with medical guidance of course, than when it was forced upon me.

In a previous posting, I've talked about how I've experienced methadone being used in the wrong way, but implementing a blanket ruling such as a time limit is totally the wrong way of addressing this problem. There isn't a quick fix (no pun intended!) for solving the issue of addiction and recovery in our society. It's going to take a whole new treatment/recovery ethos, with 'client led' at the top of the list.

3 comments:

Anonymous said...

Couldn't agree more! Methadone, like any drug, CAN be misused and CAN be dangerous. However, it has helped more people than any other treatment for opiate addiction, and limiting the time one can be on it is ludicrous. What other drug anywhere is time limited by the government? This should be between a patient and his/her physician ONLY.

Anonymous said...

As long as the brain is exposed to opiates in more than normal quantities it does not restore the neural pathways to their normal state. Addiction is caused by an increase in the number of opiate receptors in the presence of abnormally high levels of opiates. These receptors then beg for stimulation when opiate levels are reduced, creating the symptoms we know (boy, do we!) as withdrawal.

Methadone is an opiate. Physical recovery does not begin until it, along with any other opiate drugs, is removed from the system, or at least reduced to the base level of the natural opiates -- the endorphins.

The most effective treatment at present is detox in a medical facility with substances that block the withdrawal symptoms while allowing the blood and brain to become free of the drug in a fairly short time. Then, over a longer period, the extra receptors deactivate and we are able to function without external supplementation.

The problem with methadone is simply that the craving doesn't go away because the overabundance of receptors remain activated by the methadone. Addicts are, almost by definition, people who believe it isn't OK not to feel OK. They are the last people who should be in charge of stimulating (or, in this case, not stimulating) their own brains.

Been there, done that.

David Clark said...

Bill is quite simply wrong in stating:
'The most effective treatment at present is detox in a medical facility with substances that block the withdrawal symptoms while allowing the blood and brain to become free of the drug in a fairly short time.'
Addiction is far more complicated that what goes on a set of receptors. I say this as someone who has expertise in addiction and brain receptors. Reading any expert text will tell you that getting someone off opiates involves far more than detox.
This is naive speak and sadly somewhat dangerous speak! :