Sunday, March 01, 2009

METHADONE AND DRIVING: FURTHERING STIGMA, IGNORING THE EVIDENCE!

The Police Chief in Laconia, NH, is demanding a proposed methadone clinic hire an off-duty police officer whenever it is open - allegedly because of fear the methadone may render patients "unstable to drive safely" (the functions of the off-duty officer are not specified). Decades of studies and surveys around the world (most recently a 5.5 year study in Norway published this week in the Journal Addiction) document that methadone maintenance treatment is not associated with increased driving risks.

During these very difficult financial times a Police Chief should perhaps be applauded for seeking ingenious - even if disingenuous! - reasons for gaining overtime opportunities of fellow officers. In this instance, however, the Laconia Chief is displaying ignorance of or disregard for the facts and is doing the entire community a terrible disservice. Full story click here

12 Comments:

At 11:09 PM, Anonymous Anonymous said...

It is very misleading to pretend that patrons consuming methadone at a clinic do not impose a risk to people on our highways. Families as well as the user's themselves admit to nodding off after recieving their daily dose. Claiming it to be another "Stigma" is ludicrous. Methadone is NOT the wonder drug so many paint it to be. In all aspects this form of so called treatment is only enabling the addict. Watch how they behave if they do not get their daily dose and see if their withdrawals are not just has intense if not worse then being on heroin. User's proudly admit they have been on it for years validating that it has only become a substitute instead of the crutch so many claim. The myths and lies are becoming transparent. The reality of methadone is far more dangerous then maintaining someone's addiction just to feed their cravings. Why not work harder on a drug free life, and yes it can be done, even the worst of those suffering addiction have become successful. Methadone is not the answer but just another deadly drug to flood our streets, feed addiction and kill thousands yearly.

Mothers Against Medical Abuse. Org

 
At 11:15 PM, Anonymous Anonymous said...

Maybe this clinic would show it's real practice of Dose and GO if a police officer stood by to watch. If there is nothing to hide then there should be no concerns in having a professional to monitor the sight, right. Or, is this another form of discrimination? Seems like a responsible facility would gladly accept such protection and insight, unless they have something to hide, hmmmm!!

 
At 11:18 PM, Anonymous Anonymous said...

Not sure what office you are sitting in but maybe you should sit outside of some of these clinics or hang out with them for about an hour after they have dosed. SOme have no business behind a the wheel of a vehicle. So stop pretending this drug dose nothing to these people.

 
At 12:25 AM, Anonymous Anonymous said...

This is quite obviously an organized littel "attack" on Dr Newman's comments by anti-methadone hate mongers. Why should the clinic be "happy" to have its patients harassed and arrested by ill-informed police officers for driving> Why not require all physicians who prescribe chronic pain medication to patients with long term health problems that require pain management to have police sitting outside THEIR places of business to arrest THEIR patients as they drive away? We all know the answer to that, though, don't we? It's much easier to garner support against "those nasty ol' junkies" than it is against pain sufferers. However, as Dr Newman pointed out, the studies show that stable methadone pts are NOT impaired by their dose, and records of accidents involving methadone almost ALWAYS involve one or more additional drugs or alcohol on board at the time, or a person who was taking methadone illicitly and was NOT tolerant to the dose.

Methadone and Driving Article Abstracts

Brief Literature Review

Institute for Metropolitan Affairs

Roosevelt University 2/14/08

DRIVING RECORD OF METHADONE MAINTENANCE PATIENTS IN NEW YORK STATE

BABST, D., NEWMAN, S., & State, N. (1973). DRIVING RECORD OF METHADONE MAINTENANCE PATIENTS IN NEW YORK STATE. DRIVING RECORD OF METHADONE MAINTENANCE PATIENTS IN NEW YORK STATE,

When a comparison was made within specific age groups, it was learned that the accident and conviction rates were about the same for methadone maintenance clients as for a sample of New York City male drivers within the same period. The findings from other related studies discussed in this booklet are consistent with the results in this study.

The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol, on simulated driving.

Lenné, M., Dietze, P., Rumbold, G., Redman, J., & Triggs, T. (2003, December). Drug & Alcohol Dependence, 72(3), 271.

These findings suggest that typical community standards around driving safety should be applied to clients stabilized in methadone, LAAM and buprenorphine treatment.

Maintenance Therapy with Synthetic Opioids and Driving Aptitude.

Schindler, S., Ortner, R., Peternell, A., Eder, H., Opgenoorth, E., & Fischer, G. (2004). Maintenance Therapy with Synthetic Opioids and Driving Aptitude. European Addiction Research, 10(2), 80-87

Conclusion: The synthetic opioid-maintained subjects investigated in the current study did not differ significantly in comparison to healthy controls in the majority.

Methadone-substitution and driving ability
Forensic Science International, Volume 62, Issues 1-2, November 1993, Pages 63-66
H. Rössler, H. J. Battista, F. Deisenhammer, V. Günther, P. Pohl, L. Prokop and Y. Riemer

The formal assertion that addiction equals driving-inability, which is largely practiced at present, is inadmissible and therefore harmful to the therapeutic efforts for rehabilitation.

Methadone substitution and ability to drive. Results of an experimental study.

Dittert, S., Naber, D., & Soyka, M. (1999, May).

It is concluded that methadone substitution did not implicate driving inability.

Functional potential of the methadone-maintenance person.

Gordon, N., & Appel, P. (1995, January). Functional potential of the methadone-maintenance person. Alcohol, Drugs & Driving, 11(1), 31-37.

Surveys on employability and driving behavior of MTSs revealed no significant differences when compared to normal population. It is concluded that MM at appropriate dosage levels, as part of treatment for heroin addiction, has no adverse effects on an individual's ability to function.

Influence of Peak and Trough Levels of Opioid Maintenance Therapy on Driving Aptitude. Baewert, A., Gombas, W., Schindler, S., Peternell-Moelzer, A., Eder, H., Jagsch, R., et al. (2007). European Addiction Research, 13(3), 127-135.

This investigation indicates that opioid-maintained patients did not differ significantly at peak vs. trough level in the majority of the investigated items and that both substances do not appear to affect traffic-relevant performance dimensions when given as a maintenance therapy in a population where concomitant consumption would be excluded.

Opioid dependence and driving ability: a review in the context of proposed legislative change in Victoria.

Lenné, M., Dietze, P., Rumbold, G., Redman, J., & Triggs, T. (2000, December). Opioid dependence and driving ability: a review in the context of proposed legislative change in Victoria. Drug & Alcohol Review, 19(4), 427-439.

A review of the performance studies, including only a small number of driving studies, suggests that opioids, and in particular methadone, have limited effects on driving skills.

The influence of analgesic drugs in road crashes.

Chesher, G. (1985, August). The influence of analgesic drugs in road crashes. Accident Analysis & Prevention, 17(4), 303-309.

Methadone, as used in treatment schedules for narcotic dependence, produces no significant effect on measures of human-skills performance.

Influence of narcotic drugs on highway safety.

Gordon, N. (1976, February). Influence of narcotic drugs on highway safety. Accident Analysis & Prevention, 8(1), 3-7.

A review of the literature on narcotic drug use and driver safety indicates that narcotic users do not have driving safety records that differ from age-matched individuals in the general population. Maintenance on methadone also does not appear to increase driving risk.

 
At 9:46 AM, Blogger hanachan said...

Always to good to have folks express their views - that's why the website exists. The facts (as presented with references by one of the writers) speak for themselves: there's nothing inherent in constant daily doses of methadone that would lead to driving impairment. As for "watching how patients behave if they do not get their daily dose . . . " - imagine how pts with epilepsy "behave if they don't get their daily dose," or cardiac patients without their meds, or asthmatics, hypertensives, etc! Robert Newman

 
At 1:23 PM, OpenID armme said...

It's not the idea of "if you have nothing to hide you won't care"...it's the whole idea of privacy, dignity and confidentiality that gets people to go to treatment.

Do you really think these people are going to be stupid enough to do something illegal at the clinic, anyway? Why would they do something "bad" at the clinic with their counselors, doctor, nurses and security officers watching?
\
This is just another excuse for Laconia to prolong the enevitable in hopes the CMG will give up.

Not a chance.

 
At 1:23 PM, OpenID armme said...

It's not the idea of "if you have nothing to hide you won't care"...it's the whole idea of privacy, dignity and confidentiality that gets people to go to treatment.

Do you really think these people are going to be stupid enough to do something illegal at the clinic, anyway? Why would they do something "bad" at the clinic with their counselors, doctor, nurses and security officers watching?
\
This is just another excuse for Laconia to prolong the enevitable in hopes the CMG will give up.

Not a chance.

 
At 6:18 AM, Blogger James said...

This comment has been removed by a blog administrator.

 
At 6:26 AM, Blogger peter said...

This comment has been removed by a blog administrator.

 
At 7:48 PM, Anonymous Anonymous said...

I am currently a methadone patient. I am also a Class 1 driver, hauling tractor-trailers in BC, Canada.
There are no effects on my state of consiousness whatsoever from the drug. Ive never "nodded off" from my dose. (people that do are probably still using heroin as well as methadone)
Since getting on the program last summer I have been freed by the chains of addiction and have made important changes to my lifestyle to keep it that way.
As well i have been tapering off the methadone. By the end of summer I'll be completely off of it.

 
At 9:58 AM, Anonymous Anonymous said...

We are on the methadone maintnence program because it provides a sense of normacy in our lives. It allows us to go to work and spend time with our family, it allows us to actually function in our lives without running to the bathroom to throwup, or staying up all night sweating with chills not able to sleep but being so tired your exhausted and can hardly stay awake. We dont need to buy pills or dope just to not feel sick. After a person is on the clinic for a while and gets there life together there able to taper off at a safe amount and continue living there drug-free life.
I started using drugs to get high, it was a great feeling I loved it. After years of pill use i would get sick if I didnt get high the next day. It got to the point for me where i didnt even buy drugs to get high anymore, I bought them so I wouldnt be sick!!..
As far as methadone & driving goes.. the methadone doesnt actually "kick in" till about 2hrs after dosing, no matter your size or metabolism. I take 90mg daily and I NEVER nod out driving,working,sitting...

 
At 8:11 AM, Anonymous Anonymous said...

my daughter has been on methadone treatment for 7 months now. It has totally changed her and not for the good. She lies all the time, she's stolen from me, and she has been picked up by the police for her driving. Last week she was stopped for driving all over the road, she's lucky she didn't kill herself. She nods off while she's doing something with her hand in midair. She has been in numerouse accidents that she claims aren't her fault. I haven't seen any improvement in her at all.

 

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