What’s Wrong with Taking Methadone for Addiction
Of the many treatments available for opioid addiction, Suboxone and Subutex are similar medication assisted treatments (MAT), which are proving to be the most effective. The most successful treatment, however, will depend uniquely upon the individual seeking help. According to NIDA’s “Methadone Research Web Guide,” methadone treatment for opioid addiction in America was first approved in 1972. When I first heard about sublingual medications for opiate addiction treatment, I was taking methadone- a highly addictive narcotic. In fact, methadone was far stronger than the narcotic pain killers to which I was originally addicted.
When people talk about an addict just switching one addiction for another, I completely agree, though I wouldn’t have admitted this when I was taking methadone. I surely would not have wanted to be taken off of methadone, but I don’t think this attitude was doing me any justice. It’s interesting being an addict going through narcotic treatment for addiction. Only a few doctors have seemed to value my opinion over the years. But as the years passed, as did the many doctors and therapists I saw, I began to realize the forgivable ignorance doctors and clinicians have regarding addiction. As I had sought narcotics for recreation for years, I became quite savvy about their particularities. Likewise, after having sought treatment place after place, I became to realize how many more years of using, studying and obtaining narcotic drugs and pain killers I had over the doctors. There is almost no way a student can study drugs and addiction treatment in classroom the way I did by living it for decades. Furthermore, addiction was not simply an interest I had, but a day in and day out reality I experienced from the obsession I had to narcotics. Because of this fact there is a horrible process for diagnosing pain as opposed treating addiction. Doctors will prescribe pain medicine over and over, until there is one hint of a person misusing them. At that point a person is often ripped off of the pain medicine with no taper, propelling this patient into and endless pursuit of finding a doctor who will prescribe the medicine, and making sure the doctor won’t find out they’re hooked. The main problem with this attitude of prescribing ignores the fact that ANYONE, not just upstanding, moral people will quickly develop an addiction to opiate based pain killers. The lack of honest discussion between doctor and patient, coupled with the ignorance of how addiction works creates a toxic atmosphere where patients hide their true situation until it’s progressed past the point which most doctors can understand, much less treat.
When I first started taking I was 18 years old. I remember having to convince a counselor that I was addicted to opiates and needed methadone, but thinking back this was a mistake. Being only addicted to hydrocodone at the time, though my addiction was certainly significant, stepping up to methadone was a reckless decision. Methadone was the bomb! I remember feeling so good I could puke, and I did- over and over as the dosage went up and up. After years of having to convince a family doctor I had a persistent cough, or simply placing my open hand down on a glowing hot stove burner, I had finally found a place where they seemed to jive with my way of thinking- more and more! The dose went up every other day, and if I wanted more I just had to ask. Since there was no methadone clinic in the town where I lived, I had to drive my car to the nearest center each morning an hour away. I remember having to shove my face up and shake my head violently to even keep awake. I am not telling you a lie when I say that I-40 in North Carolina seemed to have 6 lanes going one way for much of the time I was driving to the clinic daily.
The doctors at the methadone clinic did not treat me with any particular goal in mind. It’s always an ambiguous, open-ended question methadone patients face, “How long will I be on this stuff.” The answer to this question is not a therapeutic one. The end of one’s stint on methadone is usually ended for the same reason my treatments were- lack of money, no transportation, an inability to quit other drugs which can require a mandated “detox” from whatever dose a person is taking divided by three steps down over three days. You can increase to about 120 mg of methadone over 3 or 4 weeks, but when it’s time to go due to circumstances which are very typical in the life of an addict, you get dumped off. I remember the first time this happened to me… I spent 3 entire months pasted to the couch in my mother’s living room unable to get up even to urinate for the first week or two…After months of detoxing, I found that the depression and cold chills simply would not go away. I believe that addiction to strong opiates, methadone included, rearranges brain chemicals in a semi-permanent fashion. So although I started methadone as a teenager with an addiction that could probably have been arrested by a 1 to 3 month stint in rehab somewhere, I turned 20 afraid to go outside, broke, depressed and believing only one thing could fix me- more dope. I should’ve been planning my route through school at UNC with a major in International Business leaning towards law school, but instead I was highly fixated (no puns intended) on being able to get more opiate drugs. Methadone had failed me.
One thing I’ve realized having been in treatment for addiction for so many years, is that doctors can often be more concerned with their relationship with the DEA (Drug Enforcement Agency) than with their patients. Doctors must make sure that a patient is safe during treatment, and this I always wondered how in the hell I was being given such a strong narcotic every day, as I was barely able to drive to and from the clinic each day. My girlfriend would often complain because I would nod off- essentially falling asleep- during important social functions and at dinner with the family. I never told her about the day I passed out completely and was awakened by the jolt of a curb I had swerved onto. Had this curb contained a street light, or God forbid- a child, the rest of my life would never have been the same.
Why Take Subutex instead of Methadone
After having spent nearly 6 month recuperating from my first attempt to stop using opiate drugs by taking methadone, I had become obsessed with finding another methadone clinic that would accept me. For better or worse, the Metro Center in Greensboro, NC took me in on a no-pay basis. At $11 a day, methadone costs $333 per month, plus gas and time spent going to the clinic every morning. Obviously it’s difficult to work a job or go to classes when you find yourself nodding off to sleep in the middle of conversations. I remember believing that being on methadone the rest of my life would be a reality, and had considered applying for disability to do so. Effectively, I was planning the ultimate wasting of my life, but luckily I was too fucked up to accomplish even that!
When I was about to turn 30, a friend called me to tell me about a “miracle drug” he had taken for opiate addiction. He was as wasted and worthless as I had become, and so I valued his opinion. He told me he had taken this sublingual pill called Subutex (buprenorphine). As he had been recently ejaculated from another methadone clinic himself, he was in serious physical withdrawal. He told me that one hour after putting this pill under his tongue, he was out mowing his yard. He said this relief lasted that entire day and the doctor had entrusted him with a week’s worth of medicine on his first appointment. I remember this conversation to this day, a decade later, because I was dumbfounded. I asked him if it was a narcotic, and he said he didn’t think so. How in the hell, I wondered, did it work!? I had spent hours and hours before and after the internet was invented researching what I could take to supplement the neurotransmitters and so forth in my brain to feel better naturally without opiates. After having searched and tried hundreds of tinctures, remedies, homeopathic treatments, relaxation, meditation, yoga, exercise, sex, Christianity, Buddhism, and even success tapes by Tony Robbins himself, I was truly battling the idea that there actually might be something, other than dope, for a dope addiction.
Yes, my friends, fellow addicts and doctors seeking advice- yes, there IS an alternative to relying on opiates to treat opiate addiction! You can read my post about my first time taking Subutex and Suboxone, but I’ll write about it here for the sake of comparing it to methadone. Subutex, in my mind, doesn’t even compare to methadone, as one is truly high level dope with a high very much like heroin, and one is simply not that. I want to emphasize this difference here, because a lot of people try to group the two treatments together as simply substituting one drug for another. Methadone is absolutely switching one narcotic for another, and in my opinion is even much more dopey than most prescription pain killer and narcotics. Subutex, on the other hand, though chemically similar to an opiate, works much differently on the brain, but how it works in a treatment plan for addiction considering the entire picture- level of functioning in life- is far different. When I was on methadone, you could say I worshiped it for the most part. Of course I didn’t , but I worked jobs to get money and means to take the drug. I missed school and family functions to make sure I was at the groups or in the town where the clinic was. Most tragically, I was hardly present in my own life, so my ability to play any role in life for another person was simply asking too much at the time.
Subutex (and Suboxone at times) has allowed me to be free finally from opiate drugs- for years now- without having to live in pain and fear which my brain puts forth void any narcotics in my system. I could either continue using opiate narcotics, which is barely sustainable considering the time, money, criminal implications and ultimate physical destruction it causes., or I could have just quit. However I have quit if there ever was anything such as quitting. I quit when I was 22, going to rehab and re-entering college. I stayed away from narcotics for a year and a half, and so when I finished college 4 years later, I wasn’t employable and was very lucky to even have a degree. My grades show a continual decline from the “A” honor roll and Dean’s List the first two years, to shooting for “B’s” my 3rd year, on to begging my senior year professors to be allowed to miss classes, make up tests, do alternate assignments, and God knows what I was supposed to have learned that last year. My point is that in my life, from the age of 18, I have sought narcotics, fucked up, begged for mercy and returned to narcotics. Over and over again I would always find my life to be in one of these phases, and my life revolved around opiates. It’s nice for people to have arguments opposing medication assisted treatment (MAT), but in my life I was contemplating their views against those at the methadone clinic which leaned towards a high “maintenance” dose which always put my life in a downward spiral- far from maintaining anything. How many more years could I bounce back and forth from these two worlds of abstinence and addiction, before I would have just spent my whole life in a tornado? How many relationships could I destroy or avoid wondering whether I should go to Narcotics Anonymous or just be high?
I thank God for Subutex and Suboxone, but I don’t worship it! Instead I find myself engaged, if I could use a summary word… I’m engaged to a beautiful, smart and vibrant girl and look forward to finally know what a marriage is like (at age 39). I’m engaged in the work I do and furthering my education on a path to become an educator at the college level. I’m engaged in my community, and I know what people hold what offices… I vote! I see my doctor currently once a month (at times, every 3 months) and I take the medicine I have for my addiction on a daily basis. I don’t run out at the end of the month, because whether I take 2 or 20, I feel the same. With methadone I would take 160 mg at the clinic (a dose that would probably kill a non-addict), and then I would buy 160 mg additionally every day to go with my dose. No amount was enough and I was dying trying to make myself feel satisfied. Perhaps one day scientists will invent a drug or treatment for addiction that would allow for an addict to stop taking any drugs or medicine altogether without negative consequences and the insatiable appetite for more and more narcotics. When that day comes I will applaud from my grave, but until then I’ll live my life to the freest and fullest- not forgetting to take my Sub after I brush my teeth in the morning.
NIDA- “Methadone Research Web Guide” https://www.drugabuse.gov/sites/default/files/pdf/parta.pdf