As an Attorney who defends drug cases in Portland and Gresham, I deal with many clients who use methadone to prevent opiate withdrawal. Methadone has been available in the United States since 1947. This drug is a synthetic narcotic that is used, primarily, as a replacement drug for people addicted to heroin, morphine or other opiate drugs. It is also used for long term management of chronic pain. Methadone has a potential for abuse and addiction that is similar to heroin or morphine.
An entire industry has arisen around methadone in its use to control withdrawal symptoms in opiate addicts. Methadone clinics serve thousands of addicts on a daily basis, administering doses of the drug directly to clients.
Used in a proper treatment model, methadone can be quite useful. When an addicted person transfers their need for heroin to methadone, engages in treatment and gradually reduces the dose of the drug (called titration) the person can end up drug free and clean and sober after a period of time. Proper titration can take months.
The problem is that many programs simply administer methadone, fail to have clients engage in meaningful treatment and continue people on methadone indefinitely. This is an incredibly bad idea for a number of reasons.
First, methadone is dangerous. The drug is a powerful respiratory and cardiac depressant. Mixing methadone with other depressant drugs, like Xanax or alcohol, can cause a person to pass out and stop breathing. Used long term, methadone can build up in a person’s body fat. When the body fat becomes saturated it “dumps” the excess methadone into the blood stream and can cause an overdose, even when a person is taking their prescribed dose.
Second, methadone is not a cure for addiction. Heroin addicts who switch from heroin to methadone are just as addicted to opiates as they were before. They experience euphoria when they dose and they experience the same symptoms of withdrawal as the dose wears off, the most common of which is extreme fatigue (called “the nods”) which people experience in the afternoon. People who replace heroin with methadone without treatment will still think like an addict and act like an addict. It is very common for a methadone patient to use the drug as a bridge between heroin doses.
Third, the methadone clinic milieu is a culture of addiction, not recovery. The environment itself can lead to relapse and new criminal activity. Heroin dealers know that methadone clinics are a good place to sell heroin and they frequent the areas around the clinics. This environment and easy access to drugs, is dangerous for addicts trying to recover.
Some probation officers feel that addicted probationers perform better on probation when they are using methadone. Even if that is partly true, the truth is that methadone patients are always at a high risk for opiate relapse. Once in relapse they will return to all of the drug acquisition behaviors that led them into legal trouble in the first place.
Methadone is an old drug. There are new, more sophisticated, alternatives that can actually help people become completely clean from opiates. Treatment is a necessary component in this process. As a Portland Drug Crimes Lawyer I believe that new medication and treatment modalities that actually get people clean from drugs are preferable to the use of methadone. I see too many of my clients who use methadone relapse into drug use and criminal activity.
Source: JFO Rourke Blog