ARM-ME BLOG

JAMA — A 50-Year-Old Woman Addicted to Heroin: Review of Treatment of Heroin Addiction, July 16, 2008, O’Brien 300 (3): 314.

Truly wonderful review of heroin addiction and methadone treatment.  ALSO, many great resources (look at bibliographical information at bottom of this report for links) and great opinions from the JOURNAL OF AMERICAN MEDICINE.  This article has great information for writing Letters to the Editor and when debating the use of medication in addiction with ANYONE.

My favorite quote, from the Author is:

When I was on the American Psychiatric Association DSM III-R [Diagnostic and Statistical Manual of Mental Disorders (Third Edition Revised)] committee, the problem that we had when we were designing a diagnostic classification scheme was that we were trying to come up with a scheme that applied to all drugs of abuse. So that meant nicotine, alcohol, cocaine, heroin, and so forth. People who work primarily with alcoholics don’t like to use the word “addiction” regarding alcohol. But it absolutely fits. All of the drugs of abuse activate the reward system, but through different mechanisms. The reward activation produces learning, which results in long-term behavioral effects that increase the probability of relapse. The major problem with terminology is the tendency to stigmatize. However, as more public figures have admitted to addiction problems, we see that it can happen to anyone. I think it is better if addiction is dealt with as an illness instead of as something that implies bad character. Addiction is just another medical problem. I think the stigma is a holdover from the time when addiction was thought of as weakness of will or bad character or criminal activity. Addiction is a chronic disease of the brain with strong heredity components, and it ought to be approached as a medical illness.⁵³

http://www.latimes.com/news/printedition/front/la-me-drugs18-2008may18,0,2949274.story?page=1

Every day in my inbox I receive GOOGLE ALERT after GOOGLE ALERT about the “rising tide of methadone deaths”…it never fails, in these articles, that methadone treatment clinics will be brought into the forefront of the article and therefore to the forefront of this epidemic and falsely linking them to the problem in peoples minds.

The stories always note that the amount of methadone prescribed for pain has increased about two hundred fold….and that Doctors mostly have NO IDEA how to prescribe it and patients have no idea how to take it.   These articles also note (as the link above shows) the rising tide of prescription opiate drug use and abuse-from rural Maine (where this epidemic started with the rise of OXYCONTIN) to the celebrity of hollywood (HEATH LEDGER) and back again.  They also usually state that our government has already done a lot of work to figure out how these deaths are happening and that methadone clinics are NOT the problem.  But the damage is done.  People read: methadone is bad.  They “know” addicts are bad.  These clinics actually have BOTH addicts and methadone….BOOM!  In the readers mind death and clinics are forever linked.

YES, methadone is handed out to the hugely growing number of opiate addicts addicted to prescription drugs and Heroin, but methadone treatment is a big part of the fix not the”broke”  The reporters writing these articles probably don’t even understand the implications  of doing this (the more pessimistic advocates like me believe they know exactly what they are doing, though)…….they probably don’t even realize that by mentioning the clinics in the middle of all these horrible stats about death of our young and the evil that is addiction,  they are irrevocably changing the way society looks at methadone treatment.  Even sadder still, is that these reporters don’t even realize that they are stigmatizing one of the only ways an opiate addict MAY find his way out of addiction hell.  These reporters probably also don’t even know that by bringing methadone treatment into an article about what is wrong with methadone, they are making sure that even fewer people who need it will benefit from what is truly REMARKABLE about methadone TREATMENT….and by doing that they are doing the exact opposite of their original intent: they are letting more people die from opioid overdoses.

Lets look at the plain FACTS…..We want to save lives right?  The people we are trying to save are mostly addicts that are abusing prescription drugs and heroin in an illicit and addictive way, right?  They are people who are so miserable without these drugs that life seems not worth living to them without them, right?  They are people who are so sick they can’t help themselves anymore and we need to help them help themselves RIGHT? OK then here comes the reality:  an opiate addict using illicitly has a 14 out 1000 chance of dying while actively using………that same opiate addict IN METHADONE TREATMENT reduces his chance of dying to 0.66 in 1000….it doesn’t matter the reasons why methadone works (there are many) what matters is IT DOES WORK.  The point of any medical treatment is to save lives and give back quality of life and methadone treatment hits those marks with flying colors.  It really doesn’t matter if you agree with methadone treatment or not, denying that it saves lives is like denying the earth is round despite satellite pictures of it from space.

The truth about methadone treatment is actually so basic, simple and straightforward that only a completely irrational person couldn’t “get it”… but these stories are borne of irrational fears…..and nothing about prejudice, stigma and ignorance IS rational, now is it?

KEH

ps: if your one of those holier than thou fools who think saving an addicts life is pointless because they are immoral, selfish or stupid-fine.  You shouldn’t really care about this debate one way or the other if thats the case…..and if thats the case I don’t even know why your bothering to read this so don’t leave a comment about it? I will just say that kharma is wonderful thing, and someday, somehow you WILL figure out why being an addict has nothing to do with the previously mentioned states of mind.