What’s the deal here? Why is it that people who are addicted to morphine, heroin and other opiates are put on methadone (a synthetic narcotic used for more than 30 years to “treat” opiate addiction)? Methadone is a drug that is addictive. Does it actually make sense to trade one drug addiction for another when an addict can be helped immediately through drug detox and a successful drug rehab program?

According to the official descriptions from the Office of National Drug Control Policy (ONDCP), methadone withdrawal symptoms are slower and easier to withstand. The theory is that when it’s taken orally once a day, it suppresses narcotic withdrawal for between 24 and 36 hours. When used as a “treatment” it gives time for the addict to eventually be weaned off drugs entirely. Or so goes the theory.

This is from the product information: “It is possible to maintain an addiction to methadone without harsh side effects . .  .” and “. . . many patients require continuous treatment, sometimes over a period of years.”  – Yes, folks… you read correctly. It says YEARS of methadone treatment!

If someone really wants to get help to end their addiction, why on earth would they take an addictive drug instead of using drug detox and drug rehab to handle it in just weeks, or a few months at most?
Here is another crazy fact: Methadone is given away for FREE to people on the street through methadone clinics. In many instances, people turn around and sell their methadone so they can continue to buy heroin or morphine. Methadone has been available as an illicit street drug for decades. The people on the street aren’t taking it to taper their use and eventually wean themselves off heroin or get through some form of drug rehab. They’re taking it to get stoned, and stay stoned. And by handing out free methadone we’re just keeping them addicted to opiates.

Then, there are the dangers involved in methadone use. A few years ago, the FDA issued a methadone public health advisory because it can suppress breathing and cause dangerous, and sometimes fatal, changes in heartbeat. In fact, there has been a huge rise in deaths due to methadone use – even when it’s consumed in low doses. Six percent of people carry a gene that makes methadone a life-threatening killer, according to the ONDCP.

Providing help to free addicts from the violence, crime and dwindling spiral that they will end up going down is a good thing. Handing out methadone and watching them return to continue to struggle is not. Handing out methadone to anyone for any reason is not a good thing! We have got to change our point of view, and demand some system changes that create the means for all addicts to fully recover and reclaim their lives through proper drug detox and drug rehab.

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Have you seen the new study on methadone? We’ve said many times that methadone is a dangerous drug – its highly addictive, harder to kick than heroin (and just about every other drug around), and methadone-related deaths increased by 400% in just a few years.

Here’s the stats: adverse events connected to methadone increased 1800% during the same time period as the number of prescriptions written increased by only 1300% (although it’s hard to justify the word ‘only’ when you’re talking about such an outrageous increase). The number of methadone-related deaths increased by 400% during that same time.

A new study shows that prescribing guidelines could be a major source of the problem. Check out New information points to safer methadone use for treatment of pain and addiction for more details.

Several coroners in the U.S. have written reports about the dangers of methadone – now we know more about it.  The study opens some doors, but we are not yet out of the woods. Do yourself a favor, stay away from methadone. If you’re trying to get off heroin, go to a good long-term residential addiction treatment center.

There are people who will try to convince you that heroin can’t be kicked. In fact, it can. I’ve done it myself, and know many others who’ve done the same. Don’t buy stories that methadone is the solution – a good drug rehab program is the solution, not more drugs.

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In the new episode of House – hey, why not? Millions of people get their drug information from big pharma commercials, why not a TV series? – the doc in chronic pain changes his life completely by switching his drug of choice from Vicodin to methadone.  He’s long been suffering from prescription drug addiction, but the new one changed his personality. When his colleagues noticed his change in behavior they suspected he was on heroin. But they were outraged to find that he was on methadone instead. They said that mixing methadone with another drug, taking one drink of alcohol or taking one dose at the wrong time could kill him. And that he was twice as likely to die from methadone as from heroin.

Well, yeah, it’s a TV show. But the statistics on methadone-related deaths show the data is correct nevertheless. As of a few years ago, heroin was used by about twice as many people as methadone, but twice as many died from methadone as heroin. In fact, that means it killed four times as many people, not twice as many.

And now that methodone is being used strictly as a painkiller, not to get off heroin, the primary original use for which methadone was intended, the methadone-related death statistics are climbing.

People often don’t follow their doctor’s exact instructions no matter what medication they’re taking and no matter what warnings they’re given.  Things can be even worse with methadone since it stays in the body for longer than other drugs and might still be there even though the pain relief aspect of it has worn off. So, people tend to take their dose sooner than they should, or take a different painkiller, think they’re safe to have a drink, and so on.

The hospital administrator’s solution was to tightly control House’s methadone use. He had to get his precisely-timed dose from her and, although we didn’t see the list of other instructions she gave him, I would imagine they also included absolutely no alcohol and no other drugs without first clearing it with her.

In the end, House decided not to take it. He had made a nearly fatal error with a patient and felt the methadone had clouded his judgment.

In any case, him being on methadone wouldn’t have worked for the series because one of it’s main attractions (in the same way people are driven to slow down to see a bad traffic accident) is House’s personality – which completely changed during this episode.

TV show or not, I hope people take this information about methadone to heart. It may not tell the whole truth, but it has more truth in it than any of the ads you’ll see on TV from drug manufacturers. Unless, of course, you happen to listen to the warnings – which are issued in such soothing tones they somehow don’t manage to get the point across that the drugs are very dangerous. That’s why the prescription drug death toll is climbing, and that’s why more and more people are finally getting the message and showing up in addiction treatment centers to get off them.

Boy, I’ll bet this episode will have some people up in arms. 

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A second methadone clinic is opening in Pennsylvania, where heroin addiction is “rampant.” Methadone clinics are controversial – some says it’s trading heroin addiction for methadone addiction and, in fact, it is. Even the director of the clinic, Glen Cooper, acknowledges that methadone treatment is not a cure, and that it ”works best” in tandem with counselling. Which they also deliver. The counselling, I assume, is an actual drug rehab program that gets people off drugs completely – heroin and methadone.

The public in the area are suspicious – they don’t want a bunch of ’drug addicts’ around, and they don’t particularly care what drug they’re taking. Cooper’s response? ”I think people should keep in mind that people in methadone treatment programs, if they are successful, are no longer using drugs and don’t need to steal.”

I’m not sure what he means by ‘if they are successful,’ or they ‘are no longer using drugs.’ Does he mean that if they’re successful they’re no longer using heroin or methadone? If that’s not what he means then, yes, they are using drugs. They’re using methadone.

True, they don’t need to steal. They get their drugs from the clinic and it’s either free – not likely, since it’s a for-profit organization, or they’re relatively inexpensive.

Either way, it would be nice if we could expect something more than  they ‘don’t need to steal’ from a drug treatment facility. Sure, that’s a step in the right direction but how many are actually taking the next step – becoming completely drug-free?

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Drug addicts – even those with a prescription drug addiction or abuse problem, not street drugs – often wind up selling drugs to others to support their habit. In North Carolina, a person selling prescription drugs could wind up in prison for murder. doing that could wind up being charged with murder. That’s North Carolina cracking down on prescription drug addiction and abuse.

The most recent case, only the second in the area, the first was a methadone related-death, involves as 23-year-old man who sold fentanyl - an opiate painkiller similar to OxyContin, heroin, methadone and morphine – to a 19-year-old who died of an overdose.

In case you’re not aware of this, that could have been the very first time that 19-year-old took the drug. He may just have been experimenting.

I’m sure this law would also apply to people who share their drugs with others. And, if things get really tough, it will (and should) also apply to people who leave their drugs around where others can get them.

That may seem harsh, but how would you feel if your kid died from a drug they were given by a friend who got it from their parents’ medicine cabinet? How would you feel if someone else’s kid died because your kid got your drugs from your medicine cabinet? It’s happened many times. And many of those who don’t die develop a prescription drug addiction or an addiction to any other drug, and, even though they’re alive, their lives are ruined. As are the lives of their family and friends.

This kind of incident is a prime example of why you have to educate yourself, and then your family members, on the dangers of prescription drugs. And on the possibility of prescription drug addiction.

Zero tolerance is really the only solution. But if things have already gone past that, the next thing needed is a drug addiction treatment center that knows how to handle prescription drug addiction. It’s not always the same as regular drug rehab - stopping some prescription drugs can be medically dangerous. Talk to a professional prescription drug rehab specialist to find a good solution that suits your particular situation.

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I’ve written several blogs about how difficult it can be to get off methadone. A drug addiction treatment center that gets someone off heroin or other opiates is almost always preferable – it gets the person off the original drug without getting them hooked on another. The methadone is an added, usually unnecessary, step and it can be more difficult to stop taking than the heroin or opiate they started with.

Case in point – Tara Tovey started with an OxyContin addiction. Her doctor put her on methadone treatment. She started at 140 mg/day and stayed at that dose for 6 months. She then worked with her doctor to gradually decrease the dosage – she only dropped it by 2.5 mg every two weeks, and even that would sometimes be so devastating she’d wind up spending a whole week sick in bed.
 
She’s been tapering off for nearly one year and should be completely off it in September – one and a half years after she started her drug addiction treatment program. Tara is 19 years old.

Most people who go onto methadone treatment are parked on the drug for years without any further attempts at a real drug addiction treatment program that will get them off it.
This story demonstrates how easy is it to develop an OxyContin addiction, and how difficult it can be to get off methadone. In the beginning she tapered the dose by less than 2% every two weeks and still suffered.

With all due respect for Tara and her doctor’s persistence and hard work, I have to say if they had been able to find a good drug addiction treatment center, they would have been able to get her off the Oxy without methadone. It still would have taken several months for full rehab, but she wouldn’t have had to go through the agony of methadone withdrawal. I would advise anyone who has a heroin or OxyContin addiction to explore that avenue first.
 
Nevertheless, the most important thing is that her doctor cared enough to get her through it and not park her on the drug. And Tara persisted. Hats off to both of them.

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As I covered in a recent article, methadone-related deaths increased by 700% between 1999 and 2006, and the numbers are still rising. Yesterday’s New York Times article about methadone deaths definitely shed some light on what’s going on. Until a couple of years ago, the dose recommended by the FDA was 80 mg/day - enough to kill some people who are not used to taking opiates. And it’s killing some people very quickly – they don’t even have time to get addicted or get into a drug addiction treatment center.

Doctors not understanding how to prescribe the drug is another major factor. Of course, they followed the FDA’s recommendations.

The third factor is that patients sometimes take more than is prescribed because they don’t get the immediate relief they expect. But because the drug is already in the blood-stream, they overdose.

The fourth factor is the combination of drugs and alcohol. This is probably where drug addiction treatment should come into play. Doctor’s aren’t looking at the patient’s history to see if they can be relied upon to not take other central nervous system depressants – including alcohol. The doctor who prescribed the methadone to one person who died knew of this history and said he told the patient to stop drinking. Well, as anyone familiar with addiction knows, telling someone who’s taking drugs or drinking a lot to stop is simply not enough. They need the help of a drug addiction treatment center.

Bottom line - this is one area where doctors just don’t know what they’re doing. Nor do the patients. Nor does the FDA.  There might be studies out there somewhere that could have predicted something like this happening with methadone but, since drug companies that conducted the studies don’t exactly have a reputation for putting all the cards on the table, we don’t really know.

Drugs are a little like politics – if you don’t really do your research and understand the issues, you can wind up voting for someone who can wind up with some big, and unfortunate, surprises.

Do your research, look for drug-free solutions, and if you or someone you care about has a drug or alcohol problem, get them into a drug addiction treatment center. The prescription drug addiction epidemic is bad enough – we don’t need people getting killed by these drugs right off the bat.

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A methadone clinic opened up about two years ago in Indiana. The goal was to provide a closer location for those on methadone treatment – which is supposed to help heroin addicts through withdrawal so they can then get through drug rehab at a drug addiction treatment center so they’ll be drug free. 

I get tons of responses from readers of this blog whenever I write about methadone treatment. They tell me how it’s saved their lives and that it was a last resort.

According to a recent news article, the clinic in Indiana is using it as anything but a last resort. The requirements for getting methadone from this clinic are that the person has been addicted to an opiate for at least one year.  And many of the people they’re servicing are addicted to prescription drugs – it’s opiates, so it would be OxyContin or a similar painkiller – that they were given by their doctor and then couldn’t quit.

Wow. So much for methadone treatment being used as a last resort.

“They don’t want to lose their job or lose their kids,” said the program director. “They come to us because they want to be safe, and they want to be legal.”

So, now, instead of long-time heroin addicts being addicted to methadone, we have people addicted to methadone because they couldn’t quit taking OxyContin or some similar drug because of surgery or an illness.

The program director says they’re supposed to get daily methadone for a while but are supposed to start weaning off it within three to six months. He said it works for some, and not for others. Of course. That’s because they’re getting methadone instead of going to a drug addiction treatment center that can help them with their addiction.

Prescription drug addiction – especially OxyContin addiction or addiction to another painkiller – is like heroin addiction. Just like we’ve been saying. And, like heroin addiction, the solution is drug rehab. Not methadone.
 

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This week’s Prescription Drug Addiction Radio Show (on WGUL 860 AM on Sunday night, July 20 – 9:05 p.m. Eastern, live online at www.860wgul.com) will feature pharmacists talking about the problem of – guess what – prescription drug addiction. Here’s what Larry G, the show’s host, has to say about the problem:

“The drug companies call them pain pills and the drug addicts call them Oxys, Roxies and Blueberries. The doctors call them alprazolam and on the street they are called Ladders, Bars and Totem Poles, but horribly it is now estimated that deaths that include prescription drugs are surpassing deaths from guns in the United States.”

Drug rehab in Florida has especially got it’s hands full – Florida medical examiners reported 8,620 drug-related deaths in Florida in 2007, and about 69% of them involved prescription drugs. The drugs that were involved in the majority of deaths were methadone, benzodiazepines, oxycodone, hydrocodone, and morphine.

The saddest thing is that, unlike people who take street drugs, many of the people who overdose on and die from prescription drugs though the drugs were safe, and never saw it coming.

Larry G, a pharmacist for 30 years, is doing our society a great service with this radio show. Tune in, find out more about prescription drug addiction, and get anyone you think might need help into a drug addiction treatment center asap.  Also, check out Drug Rehab Referral for additional info on prescription drug addiction, street drugs, and drug addiction treatment.

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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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