Tuesday, September 14, 2010

"Acadia Healthcare Corp. Cuts Free Methadone to Uninsured"

"Feetox": a Sept. 2 news report is headlined "Acadia [Healthcare Corp.] cuts free methadone to uninsured" and states some 100 patients will b affected. The Corporation's chief of clinical services is quoted as saying, "... earlier assumptions about methadone are being challenged, including the idea that it is in most cases a lifelong therapy." Let him tell that to a parent whose child has been doing well with methadone treatment and dies of an overdose after being “terminated” from the program because of inability to pay.

Even under the very best of circumstances relapse after treatment ends is the rule rather than the exception, and being poor and without insurance are not likely to improve the likelihood of favorable outcome.

There absolutely has to be a better way, and the hospital and the relevant government agencies have an obligation to find it!
For full article click here.

Alcohol and Methadone

US state opioid treatment authorities were surveyed as to their policies and guidelines (Harris et al. J Subst Ab Treatm 2010, 39:58-64). Eight states “stipulate patient discharge for continued alcohol abuse and … four states mandate or recommend patient discharge for continued failure of alcohol tests.”

Two critical questions are left unanswered. First, what is the evidence that methadone given in constant daily doses (at whatever level) – i.e., medication to whose agonistic effects the patient is presumably tolerant – potentiate the sedative effects of alcohol and thus pose a risk that warrants termination of treatment? And secondly, whatever one may consider to be the danger of continued methadone maintenance in these patients, and on whatever theoretical or empirical basis, is there reason to believe that therapeutic abandonment will be associated with less risk? It would seem imperative for state authorities and methadone treatment providers to ascertain compelling answers to both questions before suggesting or demanding patients be refused methadone treatment for their opiate dependence.

Addressing the Fears Underlying NIMBY:

A physician in Windsor, Ontario, has written about the problem of opioid addiction and the very positive role that methadone maintenance treatment can and does play in addressing it. He describes and corrects some of the major misconceptions that cause so many communities to fight against the establishment and continued operation of methadone treatment services.
See: "A look at the role of methadone clinics - re: Location of methadone clinics".
Click here for article

In Support of NIMBY, Let the Facts Be Damned.

A headline (12 Sept) in the Windsor (Ca.) Star reads: “Meth clinic unwelcome in Somers Point”. The lead paragraph: “Fear gripped West Cedar Avenue residents recently after an 89-year-old homeowner was attacked and sexually assaulted in her home.” The next paragraph: “While a 27-year-old Vineland man, Marvin Sherwood, has been arrested and charged in connection with that particular incident, residents are fed up with problems in their neighborhood and are placing blame for recurring issues on a methadone clinic directly across from their homes.” And then the third paragraoph: “The latest incident is not believed to be related to the clinic, but the clinic’s continuing presence angers residents and is prompting city officials to explore ways to force the clinic from the neighborhood.”

The Press of Atlantic City,
Click for the full story

Thursday, September 09, 2010

The Military Troops and Opiates

Unfortunate that methadone is said to “top the list” of killers in contributing to military deaths, without reference to the fact that it remains the gold standard most effective treatment of dependence. Of course, the fact that until recently FDA was recommending analgesic doses that can be lethal is also not mentioned. Anyway...

Headline in Navy Times Sept 3 “Rx for death: Troop deaths soar with prescriptions for war wounded.” The article describes the dramatic increase in drug deaths in recent years, which in large measure is attributed to the widespread use of opiate analgesics (it reports that “about one in seven soldiers is currently prescribed some form of opiate”). The article does not mention the fact that Defense Dept and VA medical insurance continues to refuse payment for the gold standard treatment of opiate dependence: maintenance with methadone or buprenorphine. Get the full article by clicking here

Getting Priorities Straight - Germany

"Parents of addicts call for acceptance" is the headline of a piece in the Aug 2010 issue of Drogenkurier, which bills itself as "the magazine of JES - Junkies, former junkies and those receiving substitution treatment". The head of one of the leading parent groups in Germany is quoted: "Of course we'd prefer to have our children clean. But the first goal must be to secure their survival, not their abstinence." Difficult to comprehend how anyone, regardless of therapeutic philosophy, could argue with that sentiment. The man who is quoted lost a son to "the politics of drugs" 18 years ago, a suicide by hanging after a long period of desperate and unsuccessful attempt to get help.

Friday, September 03, 2010

A Voice of Reason in the Drug Discussion:

A voice of reason in the drugs discussion: Those who expect yet another diatribe against "maintenance" treatment will be pleasantly surprised by a 1 Sept. article in The Guardian headlined, "Is abstinence the best policy for addiction?". The focus is on an "award-winning advocate of an abstinence-based approach to [drug] rehab," Noreen Oliver, who "... refuses to be drawn into a dispute that, she says, is not only divisive, but misses the point." More specifically, she states that "Any limits on the prescribing of methadone would be the 'antithesis of individualized care and may actually put lives at risk'. There is no need for a fissure in drugs policy, she argues." Complete article: CLICK HERE