I don’t know if any of my readers caught that awful article on bloomberg.com, criticizing methadone clinics and their patients. I’m not going to post a link to it because it doesn’t deserve a link. But I did write to the editor, the writer of the story, and a comment to their post:
I read this disjointed and error-ridden article with sadness. I wish you could spend a day with me, talking to the patients I treat with methadone for their opioid addiction. You’d hear how, for many patients, methadone has been a life-saver. Most of my patients are ordinary people who became addicted before they knew what was happening. A very small number are criminals, and those few get media attention, propagating the myth that all methadone patients are irresponsible criminals. This just isn’t true. My patients are housewives, blue collar workers, secretaries, and schoolteachers. Anyone can become addicted.
Patients tell me how getting into recovery with the help of methadone has allowed them to keep their families together and allowed them to become productive members of society again. And my personal experience overlays the science: we now have 40-plus years of research on methadone that shows it reduces overdose death risk, reduces suicide rates, increases employment, dramatically reduces criminality, and improves overall mental and physical health. But don’t take my word for it; go to this NIDA website and see the research for yourself: http://international.drugabuse.gov You will discover that the treatment of opioid addiction with methadone is one of the most evidence-based treatments in all of medicine. And yet the stigma continues, due to ignorance and prejudice.
Is methadone the right treatment for every opioid addict? Of course not. No medication is right for everyone. Some addicts are too sick for methadone, and others not sick enough. Are there bad methadone clinics? Sadly, yes. But don’t overgeneralize and smear the reputations of good opioid treatment programs by the actions of the bad ones.
I am the medical director at a very well-run program, and proud of it. Not once in the year I’ve worked for them have I been pressured by administrators to “keep numbers up.” I have never been pressured to compromise my medical judgment in order to maximize company profits. In the past I haven’t been as fortunate, and quit programs that I felt put patients at unreasonable risk in order to cut costs, so I do think it’s an issue that needs attention.
Methadone overdose deaths are of enormous concern to everyone. But both the CDC and SAMHSA have published reports of investigations done on methadone overdose deaths. Both organizations concluded that opioid treatment programs did not contribute to the rise in methadone overdose deaths. The increase in deaths from methadone was seen with methadone diverted from pain clinics. Since these reports, the 40mg tablet has been taken off the market for pain, and doctors discouraged from using methadone for the treatment of chronic non-cancer pain. Since these measures were put in place, methadone death rates have started to drop just a bit.
You quote local law enforcement people who likely don’t even know there’s a difference between methadone and methamphetamine. And the officer who thinks methadone patients are induced to rob banks…who is more likely to rob a bank, and addict with a $50 to $200 per day drug habit, or a patient paying $12 per day for methadone and counseling. That’s too ridiculous for words.