tag:blogger.com,1999:blog-2142327341608998711.post2482624772437856933..comments2024-01-10T12:07:21.637-08:00Comments on William Hay, Writer: Methadone Maintenance Therapyhaykindhttp://www.blogger.com/profile/07390376509834647445noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-2142327341608998711.post-34680170078941009302010-03-17T22:18:54.651-07:002010-03-17T22:18:54.651-07:00I love your comment and thank you for adding it to...I love your comment and thank you for adding it to this blog. <br /><br />I know about the research you're referring to. It's really the same with thyroid replacement. We sometimes have to give people thyroid supplements but when we go to take them off the thyroid has shut down and may not start up again. This happens with lithium on occasion. Maybe if we could wait long enough the thyroid would 'reboot' but in reality we don't and it doesn't. The risk of heart disease and other consequences of untreated hypothyroidism simply make adding thyroid solution.<br />The same has held true for people with opiate treatment, a few, and this isn't just with methadone but also with opiates for pain relief. <br />Replacement therapy isn't really that 'new'. Insulin in diabetes is replacement therapy.<br /><br />The other issue of what is "recovery' comes up with one of my closest friends and one of the most 'spiritual people' I know. He required opiate therapy for chronic central pain and I asked him how this affected his prayer life and connection with God. He said it didn't. I believe him. He's not 'abusing' opiates but taking 'medicine' as directed.<br /><br />Dr. Ray Baker did methadone maintenance here and is a really fine Christian too so I discussed it with him as well. He was the one who told me about the people who literally had shut down their pleasure centres and needed lifetime replacement, I think we'll soon get goodfMRI and PET scan data on this. Davidson's lab has done cutting edge Amygdala research in the Wisconsin imaging lab so hopefully one day I'll have some up to date references. I'm planning on searching this out now that you're reminded me of it and hopefully will be able to add it on one day.<br />AA hasn't had this problem and lots of the mmt people have found a home there. It's more commonly an issue in the NA groups. I've even got some people on long term benzodiazepine "maintenance"after alcohol abstinence and they're doing just fine in AA. My alcoholic with severe pancreatic disorder who if he drinks will die smokes pot and I've written the letter for his 'maintenance' pot and encourage him to go to AA. He's still planning on stopping and I just tell him what ever keeps him from drinking I support. Abstinence is great but it's not the only way. Certainly that was the position of the first AA folk. But then AA only requires a 'desire not to drink'. So if MMT don't drink and want to do that program they're welcome and my patients who do had alcohol along their road. I've had the "pure" heroin addicts though and their first drug was heroin andthat's the only drug they've used. <br />It all makes "prevention" and 'early intervention" look attractive too. <br />Thanks again for your incredibly valuable comments.haykindhttps://www.blogger.com/profile/07390376509834647445noreply@blogger.comtag:blogger.com,1999:blog-2142327341608998711.post-38463773053145092182010-03-17T19:28:19.039-07:002010-03-17T19:28:19.039-07:00Thanks for your insightful post.
I did want to po...Thanks for your insightful post.<br /><br />I did want to point out one thing--something the vast majority of lay people, and many of those i n the field of addiction medicine, fail to recognize about MMT. It is commonly seen as a legal substitute for heroin--not "real" recovery, which must be demonstrated by total abstinence from drugs--but maybe a step in the right direction that helps to stabilize lives. It seems that you may perhaps share some of that bias--most do, as I mentioned. <br /><br />However, what many fail to understand is the brain chemistry issues that follow long term opioid addiction--the cessation of the brain's endorphin production, for example. For some this is a short term cessation that will resume in time as they become abstinent. For others, it is permanent. These folks suffer from severe anhedonia, depression, exhaustion, irritability, etc when they become abstinent, and this is not relieved by time as with some. For this group, long term MMT is a medical rebalancing of the brain chemistry, allowing them to feel normal again and to function productively. <br /><br />Relapse rates for those leaving MMT are about 90%--however, success rates for those who remain IN treatment are higher than with any other modality. Yet patients are driven from MMT every day by well meaning loved ones and even by clinic personnel who urge them to "get off that stuff" and "get into REAL recovery". This results most often in relapse and many times in tragedy. These patients are urged to attend 12 step groups, then rejected by these very groups as being in "active addiction" for being on methadone. The patients feel confused, their pride at doing well starts to decline, their shame at being on methadone, rather than being relieved by education, grows through ignorance and prejudice. <br /><br />Please, help your patients to know that recovery is not about what medications one does or does not need, but instead, by the fruits of one's life--are they productive, responsible, reliable, honest, happy? The need for medication to rebalance brain chemistry is NOT the same as addictive abuse of a drug. Patients need to understand the difference between addiction and physical dependence, and to be empowered against myths like "trading one drug for another" and "liquid handcuffs".<br /><br />I am a MMT patient in the USA. I have been on MMT nearly 6 years. Prior to that I spend almost 20 years addicted to Rx opiates. I went through 13 abstinence based rehabs, to no avail. Methadone saved my life, and returned me to a fully functional existence. I now attend the clinic once a month and receive 27 takehomes. This enables me to live a normal life, like anyone else on a long term chronic medication, rather than attending a crowded, noisy clinic for hours on a daily basis. <br /><br />ThanksAnonymousnoreply@blogger.com