Bill White interviews a medication assisted recovery advocate:

The problem with the methadone community is we have too many people who think methadone is a magic bullet for that disease—that recovery involves nothing more than taking methadone.

This view is reinforced by people who, with the best of intentions, proclaim, “Methadone is recovery.” Methadone is not recovery. Recovery is recovery. Methadone is a pathway, a road, a tool. Recovery is a life and a particular way of living your life. Saying that methadone is recovery let’s people think that, “Hey, you go up to the counter there, and you drink a cup of…

“Why do I create this torturous situation for myself? Why won’t I just get a job, get ok with being on methadone, and get off it like everybody else? What the fuck is wrong with me?” he said, storming around our house at 5:30 in the morning.

I’d already given up on sleep. I was drinking coffee and writing product descriptions for a catalog. This week, he’s gone down on his methadone dose 10 milligrams. He went down 4 last week. It’s way too fast.

I’m not sure why he feels compelled to go down so quickly, especially right after a relapse.…

Sorry for all the recent tab dumps. Enjoying summer with my kids, work is busy and having a hard time keeping up with the blog.

• Methadone users ‘more likely to carry on injecting’
• Pilot Alcoholism-Treatment Program Targets Gays
• Effects of Voucher-Based Intervention on Abstinence and Retention in an Outpatient Treatment for Cocaine Addiction: A Randomized Controlled Trial
• Unforeseen Benefits: Addiction Treatment Reduces Health Care Costs
• The tripod of recovery (Food for thought about assessing a person’s spiritual dimension.)
• Using propensity scores to adjust for selection bias when assessing the effectiveness of Alcoholics Anonymous in observational studies
• Meaning-Centered Therapy (A great reminder of how deficit focused assessment can get.)

Technorati…

• AMA meeting: More to do on tobacco control
• Outpatient alcoholism treatment - 24-month outcome and predictors of outcome
• Healthcare Reform Must Prioritize Treatment for Addictions, Mental Health, Report Says
• Comparing retention in treatment and mortality in people after initial entry to methadone and buprenorphine treatment

Technorati Tags: tobacco, outpatient, treatment, policy, buprenorphine, methadone

Here’s a great little clip by William White to get you thinking.  Watch it and let me know what you think.

Till Next Time -

You Humble Road Warrior

My husband has taken to his bed for the last several days. He is down-dosing from his methadone a milligram every other day, and it’s been tearing his mood to shreds. He wakes up in the morning, and we go to the clinic together. He comes home and watches a little television. I usually fall asleep with my head in his lap. I get up a little later, get dressed for work, and he goes outside and works in the yard. I come home between classes to be with him, and we usually hang out until it’s time for my…

There are a few parts of my life where I feel qualified to give advice to  others.  I love to give advice to the wives of addicts. I feel comfortable in that arena. I also love to give advice to people who are struggling with writing projects. I’m good at helping them overcome their humps.

There are some areas, though, where I’d rather saw off my own arm than offer advice. Particularly, when my husband asks me for advice or feedback, it scares the hell out of me. First, it scares me because I truly, madly, deeply want to give him…

• New National Report Shows Substantial Disparities in the Levels of Substance Abuse and Mental Illness Problems Experienced among the States
• Could Youth Drug Use Be Making a Comeback?
• Report: Smoking declines as alcohol, drug use hold steady
• Anti-Cocaine Drug Fails in Trial
• Addict on methadone for 18 years

Technorati Tags: research, prevention, policy, prevalence, vaccine, methadone

Here’s a presentation with audio from Bill White in the U.K.

I’m glad to see that he’s addressing palliative care models. I’ve seen similar talks from him on several occasions and this is new to me. I mentioned in an earlier (and controversial) post that his description of MMT was different from my experience.

Treatment providers have long been troubled by the psychiatricizing of addiction. The mental health system is far larger and far more powerful. Fear of being “colonized and devoured” led to a kind of hunkering down that bred unhealthy skepticism (As opposed to healthy and appropriate skepticism.) of research, new…

Researchers recently presented reports that suggest online drug-treatment programs are an effective form of rehabilitation, at least in the short term.  Former U.S. drug czar Gen. Barry McCaffrey approves of the concept and recognizes its economic value, saying, “This Internet delivery behind health care is going to be a big thing for us in the coming years.”

The Second Road from start envisioned an online community that would not only augment one’s chosen program, but also reach people who, for numerous reasons, do not attend meetings. There are high numbers of people who want help, but who often have a stigma of…

Interesting reading about professional helpers’ fear of abstinence at wired in to recovery.

Peapod says, “While the ‘it’s too dangerous to try for abstinence’ argument is widespread in treatment settings, my own belief is that it is a rationalisation for maintaining the status quo.”

I think it goes beyond the status quo issue. The context is much different here in the states, harm reduction and methadone are not dominant here, but there are very similar sentiments among those providers here. I believe that it comes down to a few common core beliefs in many (not all) workers in these field:

• that addicts can’t…

We went away this weekend. He usually picks up his weeks supply of methadone on a Sunday. This Sunday, however, we would be out of town. Remedy? Take 5ml less for the last three days of the week so that Sunday he as at least 15mls to do.

Are you following me?

He’s been on the program a year and half and we’ve gone away before; he’s never really had to get creative. Also, this is following his announcement that he’s pretty sure he wants off the program; so, now… he’s, like, the king of ’self management.’

He’s upstairs right now, practicing his…

Nothing too exciting in the treatment facility survey. A few interesting contrasts between methadone providers and other providers:

Half (50 percent) of OTPs (opioid treatment programs) were operated by private for-profit organizations, compared to 29 percent of all substance abuse treatment facilities.

Facilities with OTPs providing substance abuse treatment services were most likely to offer outpatient treatment (94 percent), but least likely to offer residential (non-hospital) or hospital inpatient treatment (7 percent each).

Another interesting data point:

Over half (55 percent) of all OTPs provided both maintenance and detoxification. Thirty-seven percent provided maintenance only, and 8 percent provided detoxification only.

I don’t know of any local…

Since I started Suboxone treatment 15 months ago, I’ve had my Google Alerts set to track news and blog posts for mentions of Suboxone and Buprenorphine (the active ingredient in Suboxone). Many of the items alerted are news reports of drug busts, where the bustee was caught with some heroin or Oxycontin - and a few Suboxone pills as well. Other alerts are people posting on message boards looking for advice or support regarding the use of Suboxone. And then there are the Suboxone rants.

Usually I just pass up these angry blog posts. Today however I allowed myself to be…

Rowdy Yates makes some provocative points about cognitive impairment associated with methadone, methadone’s legal status and it’s social purpose (treatment vs. social control).

Enjoy.

I’ve been praying all wrong this week. Each morning and evening, after my meditation, I take a few minutes to pray. I find the clarity of mind and the sense of gratitude I feel after meditation lends itself well to prayer. Usually, I ask to be shown God’s will for me and given the power to carry it out, and I think of all the things in my life I’m grateful for.

This past week, however, I’ve been praying for God to give my husband some relief. I’ve been praying for my husband to find a sponsor. I’ve been praying for…

I went to visit my husband tonight at the psychiatric hospital. It was good to see him, and he seems ok. They are dosing him with methadone, and they insist that they can’t not. Apparently, there is a federal law that mandates a patient who is receiving methadone maintenance continue to receive his or her dose if that person is kept away from the clinic; however, this same law doesn’t protect patients who are indigent from being cut off by the methadone clinic when they can’t pay.

I am almost impressed by the elegance of the Catch 22s my husband is…