AN INDIVIDUAL’S REFLECTION ON METHADONE

Author – Anonymous (but with an interesting view!)

“ I wanted to write about methadone.  Something I thought I knew about.  It would be easy.  So I’d bolster my knowledge with a few statistics, Government policies and initiatives, and general opinions. I spent days bogged down in pharmacology reports, reading documents from medication trials, outcome statistics of maintenance dosing – trying to research the history from its discovery to its uses today.  Looking at manufacturing firms.  Why its favoured over above suboxone or naltrexone in the treatment of long-term opiate users. I watched videos on YouTube from the perspectives of doctors, prescribers and users.  There were just more links.  It’s exhausting and I was at a loss.  The majority opinion I found was. Methadone  =  good.

Things I learned?

No one seems to know or agree on the exact number of clients being prescribed methadone in the UK. Somewhere around 150.000, to the cost of around £3-4000 per client, per year. Around 2% are private prescriptions. 17.5 million pound it cost the Scottish government last year.

There was a trial last year on habitual long-term injectors of street heroin. This was done in 3 places in the UK. Each was split into 3rds, with a third treated with 80ml of oral methadone. A third with an injectable methadone, and a third with injectable diamorphine….

The results of this medical experiment

The oral methadone users continued using heroin, with a small percentage achieving stabilisation.  The injectable methadone users, reduced their heroin consumption, and again a tiny amount attained stabilisation……… The ones given injectable diamorphine, responded mostly to the treatment and stopped using street drugs in much higher numbers. Of course, you are providing them their drugs for free. They don’t have to go and score. But……. In both cases of injectables prescribed, it was advised for the user to take regular doses of oral methadone “on top” regularly!

One video, a man who’s worked with clients and dispensed methadone for 20 years. Giving us the advice, he gives to methadone users. “You will know the right dose for you. If you feel yawny and stretchy before getting your dose in the morning, increase your dose, it should last you 28 hours a day.” he says.  “If you are on 70-80 ml a day but are still using or want to use on top, go up 10 or 20 ml. “. “If the methadone isn’t working, increase your dose.” He said “You should feel comfortable, so experiment.“…….  What is comfortable to an opiate user?

The guy is genial and friendly. A nice bloke. I would have loved this man. Looking at the comments under this video, current users of methadone do to. One stood out. A lady, claiming she was prescribed 240ml, then went up to 330ml.  She also claims she was pregnant and gave birth to a child that didn’t have withdrawal symptoms. I don’t see how her second statement is even remotely possible, but after reading other comments it seems very high dose scripts are quite prevalent now.

Experiments indeed.

Tolerance (greed …… COUGH!) to opiates builds massively … and if users can get a free, unlimited supply of their drug of choice, for decades in some cases, for the rest of their lives in others, why would they not? I’m not pointing fingers at front line staff working in the substance field. There’s an issue with opiate abuse. with large numbers of service users and limited time, funds, and options. “Methadone is cheaper.”  admits another Dr, when asked why its still prescribed over Buprenorphine. Methadone has been the favoured way for decades in treating clients.

Yet I wonder how Drs and dispensers would feel,  giving a synthetic replacement Crack, for habitual crack users? A “safer” form of alcohol for alcoholic? Pharmaceutical grade amphetamines, MDMA and cannabis? What about the user unable to quit GHB or meth? How would the Government, the public feel about treating these Substance users under the same model? I’m sure they wouldn’t feel comfortable with this. I know I don’t, but that’s how used we are to methadone maintenance.

Would providing these people with these drugs help them? If not, why not?

One fallacy I’ve seen in this information again and again, is that methadone doesn’t get you high. Which seems a ridiculous statement. Granted, it doesn’t feel like mainlining heroin, but nothing else does, (though I’m wondering if injectable methadone directly into a vein is akin to it) but once a therapeutic dose hits the system, 45 mins to an hour after drinking it, the user does get the warm glow, the calm euphoria, like smoking heroin. Higher doses do induce gouching and can lead to overdoses. So, it does get one high. Anyone who says it doesn’t want to perpetuate this lie for some reason. These same people say “methadone stops the cravings for using “. Well if it does, its because it gets you high, satisfying the need to go out to score.

We are providing a certain section of the drug community a lab made supply of their narcotic of choice. “To help them.” So why not all problematic substance users?  

One Dr in the US who prescribes methadone says “long-term chronic opiate use, can impact the brain in a way, that can be un-rectifiable. These clients have a brain disease that means the best cause of action maybe a lifelong, methadone prescription.”

I thought this once too …… !!! “

Author

Anonymous