Friday, August 28, 2009


Especially in the US, advocates of methadone (and buprenorphine) maintenance treatment express outrage over the word “substitution”! It would seem more productive if they focused their attention on acts, rather than on words. Thus, one of the oldest and most effective self-help and advocacy groups in Germany calls itself (itself!) JES...“Junkies, ex-junkies, and those being substituted.” And what have they and allies accomplished? First, there are over 70,000 patients receiving “substitution” with methadone in Germany - hardly 20 years earlier there were none; no one group or individual can claim the credit, but JES has been a critical voice. Also, this year on July 21 the 11th national “memorial day in tribute to the victims of the drug war” was marked in dozens of cities, large and small, throughout the country. A journal (cover image shown here) put out jointly by JES, parents’ groups and “German-AIDS Help” gave the highlights of the day for many of these cities. A case in point: Recklinghausen – “the 60th largest city in Germany”, describes its treatment efforts as follows: SUBSTITUTE FOR DRUGS - dependent patients participate in the substitution program and thereby avoid the possibility of death.”

Critics, and especially American critics, of the label German drug users and former users adopt for themselves should reflect on the situation at home: can anyone imagine a large public demonstration in America honoring the memory of victims of the drug war? Let alone dozens of such demonstrations coordinated throughout the US? Would anyone deign to condemn a group as courageous and effective as JES because of the name it uses - proudly and unapologetically - to define itself and its members?


At 11:04 AM, Anonymous Anonymous said...

I think sometimes we focus on these small things (semantics) because we feel like it's something that we can change...where as the bigger problems are overwhelming and seem impossible to fight.

I have caught myself, more than once, getting caught up in the details and avoiding the bigger problem...mostly because I feel as though I can probably get someone to stop using the word SUBSTITUTION, but I might never get them to change their over-all view of methadone treatment.

As a group, methadone advocates have become hyper-sensitive and immediately defensive in situations where they would get much further if they just listened to what someone had to say.

Instead of focusing on this groups use of the word "substitution" we SHOULD be focusing how we could what they have done--so that we can use whatever words we think would be suitable!

I don't know how many times I have seen someone new come to a message board and use one "wrong" word or say one "wrong" thing and have them run off because they are critisized for such things, rather than have their story heard....the way to change the way people think is not by jumping down their throats for such minor "infractions"....we are our own worst enemies at times!

We must learn to PICK THY BATTLES!

At 12:22 PM, Blogger RGNewman, MD said...

Agree with ARM-ME - as the famous Pogo said: we've met the enemy and it's us.


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