The American Medical Association, clearly defines addiction as a disease, NOT a socially deviant behavior, as it was previously known as.
However, much like many other diseases, whose symptoms are primarily behavioral, theories abound, from heredity, and or chemical imbalances, to childhood trauma, and on it goes.
The definition that I subscribe to, is that "Addiction is a process by which a person continually repeats a behavior, despite negative and or harmful effects to them, physically, emotionally and/or spiritually." We may never truly know, why we are addicts, and in the end game, what matters most, is how do we get well and stay well?

Methadone is a powerfully addictive drug, and the choice to use it, especially as a maintenance regime, should not be made lightly. Traditionally, it is, and should be, the last option, after standard treatment programs, have repeatedly failed.

Sadly, we live in world where money dictates the lay of the land, and because insurance companies, feel that money is ill spent, on 30 and 60 day in house detox programs, most no longer exist, as a treatment option. For the person addicted to Opiates, a bare bones 5 to 7 day detox, is all that is available, to them, other than programs like Methadone , Suboxone, or rapid recovery regimes

The tragedy here, is while most people will not succeed the first time, these programs educated one about their addiction, and exposed them to the tools of recovery, such as 12 step programs,that they would not likely choose to access while actively using.

IT IS SAID, THAT ADDICTION WILL LEAD YOU TO THREE PLACES, JAIL, INSTITUTIONS AND DEATH. I can attest to that, at least for the first two. When all other treatment modalities have failed, it is time to consider methadone.

Methadone detox, should be used with people who have a relatively short history of addiction, and who have not had success, with other treatment regimes. The client receives a daily dose which is titrated slowly down, until it is no longer required. Often times, if the person is on a dose of methadone that is under 30mg, but does not want to be on maintenance, and is not comfortable being totally off everything, a less addictive, and easier to detox from drug, Suboxone, may be introduced. Suboxone, is a combination drug, consisting of A) Bupranorphine, which is drug with similar properties as Methadone, and Naloxone which is a narcotic antagonist. Narcotic antagonists are used primarily in emergency rooms, for narcotic overdoses, as it binds to narcotics, and neutralizes their effects. In Suboxone, it is added to the Bupranorphine, to reduce the potential for abuse of the drug, by reducing any "high" one would otherwise get, from using just the bupranorphine

METHADONE MAINTENANCE
Methadone maintenance is used when all else fails. It is a wonderful program, which when used correctly, can be like a breath of air to a drowning person
If I were asked, what I thought the most important thing that methadone does for an addict, I would say this:
METHADONE GIVES YOU A CHOICE.
Opiate addiction is EXTREMELY compelling, and sadly recovery rates statistically are not good. When an addict is in the throes of active addiction, They HAVE NO CHOICE about whether they will use or not. Withdrawal is agonizing physically and mentally, and comes to be greatly feared by the active user. Ones life becomes a grotesque cycle of hustling money, getting and using the drug,and then starting all over, while not sick, to get more and keep the withdrawal demon at bay.
THE PROPER DOSE OF METHADONE, TAKEN DAILY, GREATLY REDUCES THE URGE TO USE.
This is the first and most important step on the road to recovery, having the choice to use or not.

Time is a healer. Methadone maintenance can give you the time you need to relearn how to live again.
Naturally, one needs counseling,often medical attention, and quality activities, to fill idle time, which is not a good thing for newly recovering addicts, along with the methadone. This applies of course, to any treatment program.
SIDE EFFECTS
Fortunately, studies have shown that there are relatively few side effects of methadone. The most commonly encountered ones are:
a) SEDATION- This is largely dose related, and can usually be remedied by adjusting the dosage. This can take some time, for people with severe liver damage, HIV, or other conditions that affect the body's ability to absorb and utilize the medication effectively.
b). WEIGHT GAIN- People who are begin Methadone maintenance often gain weight. This is largely due to the lifestyle change, and eating regularly. This most often levels out after a while as they adjust.
c.) CONSTIPATION- long term narcotic use, can lead to chronic constipation, which can lead to some serious conditions such as rectal prolapse. The ability of the intestines, to propel waste material through and out is reduced, which results in the constipation. If constipation is a problem, early management is essential, to avoid complications down the road. Increasing water consumption, staying active, and eating fiber in your diet can help. Fiber adding laxatives such as Metamucil can be used in moderation as well.

A GRATEFUL ADDICTS VIEWPOINT

Most addicts I know, and have known, and I'm talking about any addition, from alcohol to gambling, and everything in between. describes addiction as being "uncomfortable in my own skin" or "having a great big hole in me, that can't be filled" .
The essence I think, from these kinds of statements, is that all addicts recognize, at some level, that they are somehow different than everyone else. These feelings of being "different" can start at a young age, and are often intensified during puberty. Sadly, feelings of isolation, being misunderstood and unsure of ones self, and ones place in he world, often result in unhappy and lonely memories of youth. Somewhere along the line, alcohol, and/or drugs, are discovered to be the magic bullet, that "fills the hole" and makes you feel confident, and just plain normal

THE DOUBLE-EDGED SWORD
I believe very strongly, that addiction is a disease that is present, long before the first drink or drug is taken. The offending substance is a double edged sword, that cures you, but ultimately will kill you.

I believe that sobriety is a state of well being, which is sustainable,WITHOUT THE USE OF ILLICIT DRUGS. Many people think that people on methadone are not sober, but I beg to differ. If addiction is viewed as a disease by definition, and not viewed as a moral issue as is often the case, then being on methadone in and of itself, does not "disqualify" one for the title of sobriety.

WE ARE DIFFERENT! Yes we are. However, we are not the weak, undisciplined, selfish, and lazy people we are often portrayed to be.
I think that addiction affects the emotions most of all, especially the way they are assimilated. Negative emotions are easily overwhelming to us,and we tend to "chew" on things, like a tape, that plays over, and over again in ones mind, that can't be shut off. This can be exhausting,and is described in 12 step groups, as "stinking thinking". This kind of thinking is often the precursor to a relapse. Conversely, some of the most talented, empathetic, and giving people that I have known, have been addicts in recovery. They have learned that their sensitivity need not be a curse. With the proper insight, understanding, and tools to maintain quality sobriety,it is a gift, that can greatly enrich ones relationship, with the world around them. Why am I a grateful addict you ask? I know that the horror I experienced, gave me the insight, empathy, and appreciation in life that I have today. After all, how could can we define beauty, without ugly?

I DRANK, I DRUGGED, AND I LOST.

I was a "maintenance drinker' in my 20's, and used alcohol to feel normal, and not so anxious. I avoided getting drunk, but needed my steady stream of it, to maintain. I went through many detox programs, but never was able to maintain sobriety for more than a few months. I have experienced addictions to cocaine, valium and other drugs, but Heroin is the drug that brought me to my knees. I used daily, for many years, and at the end, was homeless, and emotionally, physically and spiritually bankrupt. Detoxes were useless, and my life was pretty much over, until I discovered Methadone.
My new life began then.............

I MAY HAVE TO LIVE WITH ADDICTION, BUT I DON'T HAVE TO DIE FROM IT.
When my boyfriend(who had been my dealer)and I started Methadone, our new life began. We began the process of learning how to live without using illicit drugs.
One must remember, that as well as the drug itself, one gets addicted to the whole scenario, the needle, or the pipe, or the glass.
Step one was simply staying out of harms way, while we adjusted to things.
IDLE TIME IS NOT GOOD. They say that if you hang out in a barber shop, you will eventually get a hair cut! So it stands to reason that you don't want to hang around the bar drinking cokes, or in the neighborhood you used to score in. We were fortunate to live near a park, where there was a flock of wild ducks that people fed.
We fed those ducks for years! In the early part of our sobriety, (the first two years) the only thing we were capable of doing, was not using. We needed time to get healthy physically again, and to develop a normal routine, which had become a distant memory for us, at the end. Things like paying bills, working, and just doing things that "normal" people do, still seemed like an fantasy for us. It took time, to change our old thinking patterns, and we were fortunate to have been able to live with a parent, while doing this.

We looked for sources of bread, cut it up into little pieces for the ducks, and we used up a lot of idle time that way. Caring for those ducks, and observing them, was very theraputic for us, and taught us responsibility, commitment and empathy.
After two years on methadone, we took the next step, and a scary one at that, and got jobs. The next 8 years, we worked, got our own apartment, as we had been living with his Mom, and began to acquire things. We had never had anything before, because it would get sold to buy heroin.
Over time, we regained the important things, such as, OUR INTEGRITY, SELF-RESPECT, AND SELF CONFIDENCE

We started methadone in 1994, and have been on it successfully FOR ALMOST 14 YEARS.

Four years ago, we decided we wanted to live in the country, away from a city that was rife with drug activity.(Remember the haircut?) However, we could not afford the rents in the nicer areas.

My sister, also from Mass, had bought two really nice commercial buildings, in Eastport Maine, the most easterly city in the US. It is a small island community, in Down east Maine, in an area, that is pristine, and beautiful, but very depressed economically, with few jobs. She encouraged us to move there, as rents and real estate is cheap, and offered to let me supply a gift shop she was going to put in one of her buildings with my art.

Because Maine is so big, the few clinics There are huge distances apart. They were going to open a new one, near Eastport, and I spoke with the director for many months before moving.
Naturally we were reluctant to move to the sticks, with the clinic not officially open, but she gave the clinic I was in, an official open date, transferred our paper work, and assured us over and over, to move up, as they WOULD BE OPEN.

Can you guess the rest? The opening date was Dec 13,2004. They opened APRIL 5th!!! We came up, Dec 5th, our methadone ran out, and noone would help us. It was the worst thing that ever happened to me!! We were so sick, and so alone, not knowing anyone, or where anything was. The nearest clinic was three and a half hours away, and we were too sick to make that trip. I KNEW, THAT SOMETHING BAD WAS GOING TO HAPPEN IF WE DIDN'T DO SOMETHING.

We ended up, looking for street methadone or heroin, and ended up with Oxycontin, which we had never used, but was prevalent up here. It is amazing that we even found anyone, as we were totally unfamiliar with the area. The price was unreal, at 50-100 dollars a pill, and for what we needed to stay un-sick, we were spending 500 dollars a day.

We had tried to convince the clinic that was further away to give us an emergency admission, so we wouldn't have to use, but they simply told us to come in on open admission day, on Wednesday, and take our chances that we would get in. Here we were with 10 years of sobriety, and we were given no consideration for that. Detox mentality again
They agreed to take us finally,after my sister started lining up her lawyers, and we ended up using for about a week and a half while we waited. Then we had to make the 7 hour a day drive for a month and a half, until they finally gave us take out status.

Did we relapse? I do not consider what we did as a relapse. Sadly, we were forced to resort to what we did, because a drug that was prescribed legally to us, could not be made available, because of out dated regulations, "detox mentality" and incompetence. We lost most of the money we had worked so hard for, that we had hoped to use for a down payment on a modest home, and it created some major trust issues for me, that took a long time to come to terms with.

WE TOOK THE ONLY VIABLE OPTION AVAILABLE. We survived, and had no desire to use, when we got our methadone back. Lesson learned? You betcha. The good news is, we went on, are making our products as a team, and enjoying life, as we are all meant to!

I have been on Methadone long enough, to have heard it all. Here is a list of common misconceptions I often hear:

1) Methadone is just a free high for junkies
2) you can always spot someone on the clinic, they are always out of it
3) a methadone clinic will bring junkies to our neighborhood.
4) people on methadone, don't have the willpower to quit doing drugs
5) methadone maintenance is just trading one addiction for another.
6) methadone is evil

I WILL ATTEMPT TO ADDRESS THESE, BASED ON MY OWN EXPERIENCE, AND WHAT I HAVE LEARNED:

1)METHADONE IS JUST A FREE HIGH FOR JUNKIES

I have NEVER, I repeat NEVER, gotten high on methadone. methadone a) eliminates withdrawal, and
b)accordingly stabilizes mood somewhat.
Even while using heroin, getting high, is primarily in what I refer to as the "honeymoon" phase of addiction, when one first gets a habit. Once the body is adjusted to heroin, the addict chases it to keep from being sick. Getting "high" was a rarity indeed for me at the end.
The sedating effects of methadone are dose related, and can be adjusted, based on weight, and physical condition. The usual starting dose is 30 mg. and is raised 10 mg a day, until the optimum dose for that person is reached. ie: no withdrawal symptoms,and lack of intense cravings.
As for it being free, METHADONE CLINICS ARE FOR PROFIT COMPANIES, and I have seen weekly costs for methadone maintenance range from $90 TO $190 !!!!
People are forced to get assistance, to be able to get their medicine. I have been a private pay before, and we had to live with my mother in law, because we only had ten dollars a month to live on after we payed for our methadone. So is it free? not really.

2) YOU CAN ALWAYS TELL, WHEN SOMEONE IS ON METHADONE, BECAUSE THEY ARE OUT OF IT.

This is just ignorance, rearing it's ugly head
Someone who appears overly sedated, could be suffering from any number of things, and caring "Are you OK?" would be a more sensible, and certainly a more gracious thing to do, than making uninformed assumptions.

3) A CLINIC WILL BRING JUNKIES TO OUR NEIGHBORHOOD
Chances are, there probably are plenty of addicts in your neighborhood already.
Opiate addicts who are receiving help by means of a Methadone clinic, are not going to be driven by withdrawal, to steal, or break into your home to secure money for their habit. It has been proven, and I believe NYC tried this, with disastrous results. Methadone is still a greatly misunderstood drug. When a person on it, displays socially unacceptable behavior, You will often see the methadone blamed for it, without knowing if that person was drinking, or using other drugs as well.

4) PEOPLE TAKING METHADONE, JUST DON'T HAVE THE WILLPOWER TO QUIT.
What is willpower? People do not choose to do things that they know will cause them heartache and pain. 12 step programs will teach you that willpower has nothing to do with it, as many an alcoholic will attest to, as well as any other addict. The disease is insidious, and powerful!

5)TAKING METHADONE IS TRADING ONE ADDICTION FOR ANOTHER.
This is true. However, methadone, if used properly, is an addiction you can live with. You don't have to take it as often, you don't have to do things you don't want to, to get money for it, and you know what you are getting when you take it. Most importantly for addicts, you will not be sick. One can always go off of it, in a slow, safe manner, with support, if one chooses, also. Again, it is all about choices.

6) METHADONE IS EVIL
This kind of idea is just ignorant, and the result of narrow minded, uninformed thinking.

IF WE LIVED IN A PERFECT WORLD, DRUGS LIKE METHADONE WOULD NOT BE NEEDED. However, this is not the case. Young people are faced with more challenges, and fewer certainties, than ever. I have seen this reflected in the rise of younger clients in the clinic. Methadone is just one of the tools available to people, who have run out of options. Fewer options, can be blamed on insurance companies, who like all of our other service providers, want more and more, money for increasingly fewer services.

Methadone is a powerful, addicting drug. It is not for every addict. For people that are new to it, or contemplating it, my advice is this:
1) keep your dose high enough to eliminate cravings.
2) You may still get high in the beginning, but as you build your new life, you will do this less and less. You can avoid temptation, by avoiding people and places you associate with drugging.Remember the haircut!
3) Really try not to drink or smoke pot, or take other mind altering drugs. Substituting, always leads you back to your drug of choice.
4)Keep busy! Do things that you enjoy, and that make you feel good about yourself. I highly recommend getting involved with your local animal shelter, or somewhere else where you can be around animals. They are very theraputic, and nurturing. It made the difference to me.
5) IT TAKES TIME. you are now free of the horrors of withdrawal, the risk of disease, and overdose, and the brutal cycle of hustling money, looking for drugs, doing them, then starting all over. Take your methadone, don't drink or drug, and empower yourself! by just living life the way "normal" people do. It works if you work it!

WHAT USING A METHADONE CLINIC WILL MEAN TO YOU.

You will need to go there everyday, for your dose. There are take-out programs available,the maximum allowed in Maine is one week, unless one is a private pay, then it is two weeks. If you travel distances to get there, and/or work, this might be an option you choose. However, TAKE-OUTS ARE EARNED. Generally, you get one take-out dose after 90 days, and so on, depending on that clinics policy. You will be asked to give a urine sample, at random times, for a drug screen, and your take-out status will hinge on the results of your urine tests. Also, every client will have a counselor, or be in a group. new people are required to attend more sessions, than people who have a longer period of stability. Make good use of your counselor, they are there for you. You must attend your sessions faithfully to qualify for take-outs, as well as have clean urines. Make sure you read the policy book carefully, and know what the rules are, regarding missed doses, etc. Most clinics are required to be pretty rigid, in regards to their policies, and you don't want to compromise your status there unwittingly, because you don't know the rules.

THE DOWN-SIDE OF CLINICS (IN MY OPINION)

Everything is a trade-off, and being on methadone is no exception. Currently, Physicians can only write a prescription for methadone,if it is for pain. For treatment of addiction, it must be given under the umbrella of a clinic.
This means, that even if you are on methadone for a long time, and have stability, and sobriety, YOU WILL ALWAYS BE TIED TO A CLINIC. If you want to move, take a vacation, work early hours, you will have to do these things around the time you need to be at a clinic.
Encountering the "detox mentality" I have encountered what I call the detox mentality, in the clinics I have been in, to a lesser or greater degree. By this, I mean health care workers(nurses most often) who are not really empathetic to addicts, and many times, don't have a lot of knowledge about opiate addiction. To them you are a patient, not a client, and believe me, you will know who they are. THE BEST PEOPLE TO WORK IN THE FIELD, ARE RECOVERED ADDICTS. Some clinics will only hire people who are in recovery for their staff.
Because of the rigid regulations, most clinic rules, are geared for everyone, and considerations are not made for people who have long term stability. One never "graduates" and after 14 years, I still can only get one week of take- outs, and so on.
You will need to be on assistance to afford your methadone. Why not insulin clinics? or clinics for people who need blood pressure medication? Clinics that provide methadone are, in a nutshell, profiting from the devastating disease of addiction.
My husband and I, would have to pay $100 EACH EVERY WEEK for our medication, if we were private pay. What is wrong with this picture!!! I don't know anyone, who could afford that! Conversely, if we could get it at a pharmacy, we each would PAY ABOUT $40 A MONTH! Most people don't want to be on public assistance, and being on it, is problematic in the sense, that if one wants to strive to do better, it puts them at risk of losing their benefits, ie: their methadone!
I believe from my own experience, and observations, that Methadone is too tightly regulated. There is much more danger from benzodiazipenes, like Valium, Klonapin, Xanax and the like, which are handed out by Doctors like candy.
AT THE VERY LEAST, Physicians should be able to write scripts for methadone for people with a long, documented history of success on methadone. Even most criminals are able to get out of jail SOMEDAY, if they play their cards right! Why not Methadone clients?

My experience with methadone, has been and continues to be, a positive one. My husband and I had to learn how to live all over again.
Even the simplest things like food shopping, having a phone put in, or paying bills were a challenge for us, in early sobriety. Methadone gave us the choice to do these things.
Integrity, Self-Respect, Gratitude, and Humility, equal EMPOWERMENT. Whatever way you choose to attain sobriety, the desired result, is the same.
I would like to see less restrictions on Methadone, so that people like myself and my husband, don't have to be "hostages" of a clinic, and can get our medication from a pharmacy, like other people.
THIS WILL ONLY HAPPEN WITH MORE EDUCATION, WHICH MEANS LESS STIGMA, AND PREJUDICE.
Of course more treatment options are always desirable, but let's make the ones we DO HAVE, more "user friendly". By that I mean, first and foremost, Make it accessible to people, without them having to get public assistance to pay for it! This would benefit everyone. Secondly, LIGHTEN UP! on the misguided restrictions of it, so that people like myself, can have a life that isn't bound to a clinic.
I HOPE YOU ENJOYED THIS LENS. I WELCOME ANY COMMENTS, OR QUESTIONS!

There are other treatment programs out there, that may or may not be a good choice for you. It is always good to educate yourself about your options.

1) RAPID RECOVERY- Rapid recovery is a process by which the addicted person, enters a hospital, where this procedure is done, and is placed under anesthesia. While in this unconscious state, narcotic antagonists are introduced to put the person into intense withdrawal, and essentially rid the body of all narcotics. THIS IS AN EXTREME PROCEDURE, AND IS VERY STRESSFUL TO THE SYSTEM. While there have been success stories with this method, it is not a good choice for anyone who is debilitated, has a heart condition, or other health issues, that would put them at high risk. I am not sure how many hours, the client is kept under, to complete the procedure, but there is a lot of info on the net about it, and you should research it thoroughly if you are considering it.

2)RATIONAL RECOVERY- This a somewhat underground organization, whose basic premise is that we all have basically two parts of our brain that come into play, with addiction. The aware, reasoning self, that makes decisions, etc. and the "Addictive voice" that operates on pleasure seeking activities, and manipulates us into using. Rational Recovery operates on the idea that once this is recognized, one can make a decision to abstain from using as that is the wish of what they refer to as the "beast" (the primal part of us) and not the true you. They believe that recovery groups, encourage dependence, and that one merely need to decide to quit, truly recognizing the addiction as the enemy, and understanding that any thought, imagery, or feeling associated with addictive behavior, is the "voice of the Beast, or primal self, and should be dismissed immediately as such.

This is certainly, what most would consider a radical approach, and is spoken out against, by 12 step programs everywhere. However, if even one person has found success with this method, I believe it has worth. You can learn more about this at www.rationalrecovery.org

3) 12 step Groups- I am sure that most are familiar with AA, NA, and other 12 step groups, which operate on a recovery program, of 12 steps, that involve admitting, and ACCEPTING ones addiction, being honest with yourself and others about it. Asking for help, from the group, a sponser, and a HIGHER POWER of some kind. getting rid of emotional "baggage", by making amends to people that you have wronged while under the influence, and finally, helping others recover as well. The program revolves around the concept, that with these tools, recovery can be achieved one day at a time, one hour at a time, one minute at a time if necessary. There are 12 step programs for every addiction one could think of, but they all work with the same principles.

Does taking methadone mean you are not sober?
NO, NO, AND AGAIN NO!
Methadone is a prescribed drug, ordered for you, by your doctor. As long as you are not using illicit drugs, that are not prescribed to you, you can consider yourself sober as a judge! I do!

When you are looking for 12 step groups to join, BE A CONSUMER. Look for groups that have members with strong sobriety, that come up to you, and say "welcome", and whose members offer phone numbers and support. I have been to meetings that are very clicky, and ones where old time aa'ers frowned upon drug users being there instead of NA. These are the kind of groups that you should avoid. Look for a group that embraces the true principals of AA. That believe that a drug is a drug, whether you drink it, shoot it, snort it, or eat it. our stories are different, but the FEELINGS ARE THE SAME. THESE KIND GROUPS, WILL HAVE GOOD ROLE MODELS FOR YOU,AND THE KIND OF SOBRIETY YOU WANT. So if you don't like the first meeting you go to, shop around! and remember, it only takes two people to have a meeting!

4) HAMS- Harm reduction, Abstinence, Moderation support. HAMS is a free of charge, peer-led support group, for those who with to reduce the harm in their lives associated with the use of alcohol, and/or mind altering drugs. Harm reduction is a set of practical strategies,intended to reduce the negative consequences of high risk behavior. A non-judgmental approach, that attempts to meet the person "where they're at" in there drinking/drugging. It accepts that high risk behaviors, are part of our world, and attempts to minimize the negatives,instead of ignoring them, or condemning the person, whether they choose to abstain, or reduce their use. There are 14 elements, that are implemented to achieve set goals.
An interesting approach, you can learn more at www.hams.com

I hope people have found this lens helpful. I will be adding to it periodically, so check back now and again. Thank you you for joining me! Amy Price- Marcotte