Drug Rehab Has to Be Done Right to Get Someone off Methadone or Heroin
If anyone is considering going onto a methadone maintenance program as a solution to heroin addiction, you should have a look at this news article that describes one person’s experience trying to get off methadone. Getting off methadone cold turkey is anguish - I can tell you that from personal experience, I’ve gotten off both heroin and methadone. Methadone was worse. Your best bet is probably a good medical drug detox program to help through the withdrawal, and then drug rehab after that to get down to the bottom of the addiction problem and continue the rehabilitation of your body.
Sometimes getting off drugs, especially opiates, can be pretty hard on you emotionally. Taking opiates by-passes the body’s natural endorphin production - the natural production process slows down because the drugs are supplying what’s needed. When you stop taking the drugs, it can take a while for the body’s endorphin production to fully kick back in and get up to snuff. As endorphins are natural mood elevators and painkillers, you can feel a little miserable for a while.
If you get into a longer-term residental drug rehab program - we’re talking about months, not weeks - and you’re getting the nutrition, exercise, and so on, that you need to get healthy, things should kick in just fine and, by the time you leave drug rehab, you’ll feel pretty good. Probably better than you have in a long time, actually.
However, some people get discouraged when things don’t change quickly enough. This is one of the reasons people think drug rehab doesn’t work. They expect things to change but don’t necessarily do all the things necessary for that change to occur, and they don’t do them long enough. So, they wind up back on the drug. Or on methadone replacement therapy.
If you or someone you care about is trying to get off opiates, bear the above in mind. Find a good long-term residential drug rehab program that understands all the elements that makes recovery possible and has them built into the program. And if you’re having a really hard time with withdrawal, consider doing a medical drug detox prior to the drug rehab program. It doesn’t take long and you can get through withdrawal safely and with a minimum of discomfort. Then you’re properly set up to get through the longer process of full rehabilitation and recovery.
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Again, this is ridiculous. Anyone who attempts to jump off methadone cold turkey is going to have problems because methadone produces dependence. There is a big difference between addiction and physical dependence–anyone taking an opioid for more than a few days becomes physically dependent on it, but not necessarily addicted. If and when a person wishes to undertake a taper off methadone, they must look at several things first. Do they have a stable home life? A good support system? Stable employment (if able to work)? Have they been free of illicit drugs for at least 2 years? Are they tapering because they want to and feel they are ready, not because of outside pressure?
If so, and they want to taper, then they should begin a slow taper at a rate of no more than 10% of their dose every 2-4 weeks and taper all the way down to 1mg. Doing a taper the proper way will not result in horrible withdrawal symptoms–in fact, most people tolerate this very well indeed. It is when people become impatient with the process and try to rush through it that it becomes unpleasant and relapse rates rise accordingly. Most inpatient rehabs cannot keep a patient long enough to do a taper at this rate from a dose of more than 20mg or so, and many will not even take methadone patients until they are on a very low dose or off completely.
Being in methadone treatment is NOT the same thing as being in active addiction, and there is no reason to believe tat everyone coming off methadone treatment is in need of “drug rehab”, any more than everyone completing a treatment for smoking cessation by finishing the use of a nicotine patch needs treatment for smoking. Not all addiction patients in this day and age have the social problems that many did decades ago. Assuming that everyone is homeless, jobless, unkempt, poorly educated and in need of extensive social rehabilitation efforts, or that they all have harmful family dynamics or childhood abuse issues that need to be uncovered through extensive counseling, or that they all have a “spiritual malady” that can only be repaired by a belief in God, prayer and group meetings is wrong. Some people MAY have these issues and they should be offered appropriate care and referrals–but not all people need this. I have personally been to rehabs where they sat us all down and instructed us in personal hygeine, how to dress for a job interview and how to avoid being late for one and rude to the interviewer, how to avoid beating your spouse and kids if they angered you, or slugging your co-worker on the job, how to stop promiscuous sexual behavior, stop smoking, and so on–all things that I and many others there had no issues with and did not need. Treatment is usually one size fits all, despite claims of individualized treatment plans. There are many patients who simply need assitance in breaking the physical bonds of addiction and that’s it.
There are others who, even after years of being clean and sober and of doing everything suggested to them (going to meetings, working steps, calling sponsors, proper diet and exercise, etc etc) find that their natural endorphins never return to a normal functioning state–the damage done has been, sadly enough, permanent–as illustrated by CT scans of the addicted brain, psychological testing and behavioral observation, and lack of response to other therapies for the ongoing depression, malaise and cravings they feel. In these cases, long term MMT may be necessary to stabilize the brain chemistry and allow the person to live a more functional, happy life. There is no need to demonize a medication simply because it is an opiate, or causes physical dependence. Opiates are naturally occuring substances in our bodies and we all have them–that is why we have opiate receptors. Not having enough of these enorphins cases acute distress, inability to feel pleasure, etc.
It is important to give any attempt at abstinence a fair trial of at least a year or so, to see if the endorphins will begin to come back. They may not make a full return by that time and patientce must be utilized, but some improvements should be noted. If there is no improvement at all, there is no need to go through the rest of your life in misery, relapsing and going to rehab after rehab after rehab–as I did, 13 times–because someone tells you it is wrong to take medication appropriately prescribed and to feel better because of it.
Comment by Zenith — May 10, 2008 @ 4:58 pm
I have recently been involved in a methadone program because I had been taking oxycontin regularly for back pain and could not get it easily, so I figured if I go to the clinic I could get methadone for the pain. I did get the methadone, but now I have stopped going to the clinic and I am having really bad withdrawal. I don’t want it anymore. I don’t want to be dependent on any drug. I don’t want to have to have a drug to be able to get out of bed or to be able to clean my house or to even be able to get motivated enough to take a shower. I hate the way my life is since I have been dependent on this crap. I don’t have insurance and I can’t work without a drug, so I don’t have a lot of money, I need some help with a program that I can afford. Please help me if you can.
Comment by Lori — May 30, 2008 @ 5:15 am