Sunday, September 17, 2006

DEMAND FOR METHADONE TREATMENT

In the London (Ontario) Free Press of Aug 22 is a story headlined: "Methadone Clinic Overrun by Visitors." It's a good news story - testimony to the motivation that exists among opiate dependent individuals for treatment. Reference is made to "stunning numbers" of applicants for admission. The hoped-for common sense response will be for City Government to plan immediately for rapid expansion of treatment capacity to accommodate promptly all who can benefit.

13 Comments:

At 3:21 PM, Anonymous Anonymous said...

"Good news"? Methadone is a killer and is almost impossible to get off without a doctor involved. If you are a parent like myself and your child has a pain killer problem like vicodin he can kick it at home. Methadone is 10x worst than any painkiller.Methadone clinics are profit centers. My kids went to a methadone clinic,told them that they were on vicodin 4-6 10mg a day.Now they are on 150mg of methadone a day,and I have a huge problem.

 
At 12:12 PM, Anonymous cayuela7@hotmail.com said...

I understand very well what you mean, dear "parent" , but problem is not methadone itself, which is a very good medicine, as you say a "painkiller". Trouble is all around it, people affected should try to make sense in all this mess.

 
At 2:38 PM, Blogger RGNewman, MD said...

Anonymous expresses complaints about methadone maintenance treatment that are not uncommon. The reality is that for many (not all!) people dependent on opiates, treatment on a long-term basis is best. The frustration of being obliged to receive treatment for years - sometimes for life - applies to patients with the entire range of chronic medical diseases. It is particularly frustrating with methadone treatment since it is subject to unparalleled laws, regulations, standards etc., that are imposed on providers and patients alike.

As for the profit incentive of health care providers, this indeed can present conflicts of interest - but that is true of American medical practice in all fields. One hopes that the vast majority of medical care practitioners and facilities offer highest quality, ethical care. If there are reasons to be concerned over the practices in any particular case, then complaints can and should be made. It's probably easier to do so in the case of methadone treatment providers, since they require on-going accreditation and approval by a variety of different bodies - and of course if there is reason to believe a physician (ultimately a named physician is responsible for the care given to every patient receiving methadone) one can register complaints to the state licensure body.

 
At 6:53 PM, Anonymous KRISTAN HILCHEY said...

Dr. Newman

I would like to ask what YOU think of the new DATABASE that CSAT is launching to (I believe?) 50 programs soon?

The DIGITAL ACCESS TO MEDICATION (D-ATM) database is being set up so patients that are in areas where a national emergency takes place will be able to get treatment at other OTP's?

As a patient and an advocate the proposition of the government tracking and compiling information on me-as a drug addict- is both scary and yet comforting when one considers the alternative.

I guess I am curious what you think? It's ODD to me that ONLY methadone patients are going to be "in" this database with SO many other types of chronic lifesaving medications that need to be administered to patients in a crisis?

Do you think this is a step forward for us (the patients) or does it move us a huge step backwards in the movement towards treating methadone patients like ANY OTHER medical patient?

 
At 7:16 PM, Blogger RGNewman, MD said...

Dear Kristan - I share your concern - and then some! FIRST, if the intent is truly to help patients in the event of a catastrophe, then it should be agreed that every patient can accept or reject being listed (just as everyone can accept or reject buying flood insurance). SECOND, given the stated intent, it should be guaranteed that upon discharge from treatment for any reason whatever the name and all other ID info will be deleted. THIRD it should be made part of the law that this "registry" can be used for absolutely no other purpose - not research, not anything. FINALLY: the only rational justification for a registry would be to ensure that in case of catastropher some other methadone provider could give a dose of methadone that for a non-tolerant individual might be lethal. But this emans one would have to keep the registry current RIGHT TO THE CURRENT DAY - if someone had been on 100mg of methadone, and the registry was just 5-6 days out of date, then giving 100mg might be very dangerous to the patient who had "missed" medication during those few days. Being current right up to the prior day is almost impossible to ensure. So . . . there's zero purpose in the registry, I believe. In any event, were I a patient, I would object vehemently (just one person's view).

 
At 6:09 PM, Anonymous KRISTAN HILCHEY said...

Thank you so much, Dr.Newman, for taking the time to answer. This has been weighing on my mind since the last AATOD conference when I first heard about it. Not only am I concerned about being "tracked", but this database will use FINGER PRINT recognition to bring up the information on a patient.....which brings up almost PSTD type panic in many folks with addiction who have been in and out of jail. I would not be surprised one iota if many people who were just starting treatment, who were asked to hand over their "fingerprint" for this purpose, didn't run out the door immediately at the idea!

I believe this will be optional, but I have a feeling if the patients don't "opt in" then they will be left to fend for themselves in a crisis as a punishment for not giving up what is probably the very last "dignity" they are afforded as an MMT patient.

With states all over the country tracking people,the medications that they take and the doctors that prescribe those medications---along with the senstationalism of the "ONE PILL CAN KILL" type of media---it is only a matter of time before the "public" starts demanding that all MMT patients are tracked in a database regardless of confidentiality laws. But don't get me going on that, or I will be rambling to you about it all night!

Thank you, again, for doing this blog. I read it OFTEN.

 
At 11:46 AM, Anonymous Anonymous said...

The Ontario government has set up a task force to consider ways and means to improve methadone maintenance programs. You can learn more here:

www.methadonetaskforce.com/

 
At 6:51 AM, Blogger christian said...

I am on 160 mg of Methadone wafers. I have been on maintenance for 9 years and never had a dirty UA. My problem is we do blood methadone levels to get the right dose at 100 mg the Blood test said i metabolized the dose in only 23 hours so i was slowly moved to 180 then i was scared of the high dose and took myself back to 160 mg. I WANT TO KNOW WHY THE DOSE AS THE YEARS GO BY WEARS OFF AROUND 2-3 AM ? I DOSE AT 5:45. IT IS SO STRONG A WITHDRAWAL FEELING I CAN NO LONGER WAIT TILL 6 AM. wHAT HAS HAPPENED? aM I SLOWLY METABOLIZING THE DOSE FASTER AFTER ALL THESE YEARS? I TRY TO TALK TO THE STAFF THEY WANT $$$ FOR ANOTHER BLOOD TEST .WE ARE NOT REWARDED FOR BEING GOOD ANYMORE TEXAS

 
At 1:21 PM, Blogger mike said...

you anonymous people are stupid i used to do close to 500mg of oxycontin a day methadone was great. It's your own stupidity if you wanna go up to 150mg, i never went passed 50 and never had a problem wasnt even 2 years and now im tapering dose down to 30mg np in a few months. The whole point is to have a doctor help you get off you dumbass.

 
At 6:10 PM, Blogger sonofboognish said...

dont worry christian i been on 150 4 three years mike is an ass hole, he probably came off a vic. rehab, my wif used 100 mg of morph and takes 50 mgs' of done, he lies about his habit. i usewe 2 take 1000 mgs of morph a day, thats close to wat he says he took if u compare oc's 2 morph and teres no way i could have been ok on 50. its ok 2 go up ive abused my done b4 at 450mg's and i didnt die so u should b fine christian, as 4 mike quit throwin round words when u dont know shit ass hole, rob g ( a real m.d. clinic patient)

 
At 8:18 PM, Anonymous bwhtiwnt2b said...

Yeah if your child has a vicodin problem he could try to kick it at home, But as an opiate addict i can almost guarantee that your child uses a hell of alot more opiates than u think! Scarry thought is'nt it. I was up to using oxycontin to get up in the am and then whatever i could get my drugged out filthy hands on just to "maintain". I thank GOD everyday that they built this clinic near my home because if they hadnt i might be dead!! I injected morphine,oc,dilaudid and more. it was then that i finally realized tat i needed the clinic. I wanted to grt better for my kids and for all of those that i love. and with the help of methadone i have been clean for 17months.

 
At 9:23 AM, Anonymous Anonymous said...

I have no real argument to make in regards to whether or not this is a good idea. To each their own I suppose. My issue is with the person who says that as a parent, they'd let their child "kick it at home" without involving a doctor. There's something wrong with that. I don't care if it's a small or large addiction, if you're any kind of parent, you shouldn't ask your child to sit at home and deal with their addiction alone. At least let them go to a doctor to talk to someone.

 
At 6:31 PM, Anonymous Anonymous said...

To the lady who's son is dosing at 150mgs. The clinic did not force him to increase his dose without him asking for it. Before you blame the clinic. Ask your son if he was honest with you about the amount of vicodin he was taking. I hope both of you will find help for your problem.

Yes, clinic are profit centers. That's the way capitalizm works in America. Why we need a non-profit healthcare.

 

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