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pros and cons of methadone maintenance
pros and cons of methadone maintenance
I was wondering what the pros and cons were of methadone maintenance. I was clean for 3 1/2 years up until December when I relapsed. Since that time I have not been able to get more than a week clean, and I have been prescribed suboxone several several times. I was seriously starting to think that I can NOT get clean and maybe i should just settle for being on methadone. I got some off the black market and i have been taking 30mgs for the past two days and I feel really great on it. I value your opinions. There are alot of good poeple who post on this board and offer excellent advice.
I have found great peace, contentment and LIFE with methadone maitenance. I no longer want to live a life where I have to think about how to NOT use every minute of every day....sure it subsides with time, but even the slightest trigger brings it back, in force.
This is how I see my addiction now: its something I have to live with, the card I was dealt. I feel pretty lucky that there is a medication for what ails me. There are TWO even! So many folks have NO options.
You will continue to be depedent on drugs. YOu will have to jump thru hoops at the clinic. In the beginning you will be so freaking happy not to feel like ******************** every day that you will not care WHAT you have to do, it seems worth it.
Then you will go through a period where you blame methadone for keeping you "trapped" in dependency on drugs. This stage happens for two reasons: first because suddenly one day you will realize your doing a lot of work and spending money for a drug that doesn't get you high. Second, because the drug works SO well you forget your an addict and start to actually believe that it was all a dream.
The next stage can go a few different ways:
-you taper very very slowly (without allowing any discomfort-this will take YEARS) \
at the end of this taper you will either feel OK drug free (still an addict, but feeling pretty good about life without medication) and you will get on with your life OR your drug addiction will wake from it's sleep and you will feel like ******************** and either use or go back to methadone. You have no control over which way this will go: your body and mind will decide for you.
-you will JUMP from methadone, pissed off at it for reasons that make no sense. You will most likely go back to using if you choose this route and either end up overdosing or going to jail or going back to methadone with a huge chip on your shoulder. You MAY make it out without using, but you will be a VERY VERY rare individual. The funny part is everyone that does this THINKS they are the one that will make it, despite the obvious risks.
The final stage
-you will peacefully slide into a comfortable ACCEPTANCE of your illness and either take the medication that makes your quality of life what you want it to be or you will accept how you feel without medication and hope you don't relapse.
I can only tell you what I did. I stayed on methadone and I have never felt this stable or content. I have no desire to change that. I don't think about addiction as how good or bad I can be or how weak or strong I can be....I look at addiction as something I have and something I have to deal with one way or another-the way I see fit. I look at my recovery in terms of WELLNESS, QUALITY OF LIFE and how little I want it to interfere with living the life I want to live. That includes a treatment that interferes very little with my life, as I have extended takehome medication.
I hope this helps. Your going to get a lot of flack both ways PRO AND CON. Just try not to make it about MORALITY and SPIRTUALITY. The God I believe in would never judge someone for becoming sick and then finding a way out.
Sorry for the typos.
Methadone is a big step and is not for everyone, but used correctly and for the right patients it can truly be a lifesaver! However, most clinics require that you have been using for at least a year straight before they will admit you, so since you were clean up til last december that might be a problem.
It is important to know going in that methadone is a commitment--not something you can easily jump off of if you get frustrated with clinic BS, etc--and you want to be sure you will have the necessary income to pay your clinic fees as you do NOT want to endure an administrative withdrawal. Methadone has a long half life--one of the reasons it works well for addiction treatment as you do not have the big ups and downs you get with short acting opiates. However, this also means that it stays in your body much longer and takes a longer time to taper off--months, or even years for those on higher doses--and jumping off without a slow taper can kill you and will certainly make you horrendously ill for a long long time. Done correctly though, with a proper taper, there is no need to suffer.
Of course, as you are finding out, it's not just a matter of getting off drugs--it's STAYING off that is the problem for so many of us. Here's why.....
Long term opiate users often shut down their brain's production of endorphins (the natural opiates). The brain simply recognizes that it has plenty of opiates on board and there is no need for it to make any, so it stops. This is why, when you stop using, you feel so awful. Endorphins regulate mood and control pain, and enable us to feel pleasure, joy and happiness. Without them, we feel severely depressed, anhedonic (unable to feel pleasure), anxious, exhausted, highly irritable, and desperate to feel "normal" again. even after the initial withdrawal symptoms of diarrhea, chills, sweats, etc subside, this continues for weeks. Often people relapse while trying to stick it out--but if they can hold on long enough, usually sometime within that fiirst year the endorphins will begin to slowly start working again as the brain realizes that you are not going to be doing it's job for it anymore. But for a significant portion of long term opiate addicts, this NEVER happens. The damage done to the brain chemistry is permanent. endorphins are never again produced normally, and the patient continues to feel the way they did shortly after ceasing opiate use without getting any better, no matter how much time passes.This almost always leads to chronic relapses, as a life without being able to feel normal joy, pleasure and happiness is not much of a life.
Methadone restores a normal balance to the brain chemistry without causing a high or euphoria in stabilized patients. The patient feels normal and can work, drive, and live a normal life without impairment. Unlike most opiates, methadone does not cover ALL the opiate receptors, leaving about 30% open to encourage natural production of endorphins if the brain is still able to do so, thereby promoting healing of the brain chemistry while still on MMT. Some are able to taper off after a few years in treatment and do well--many find that they need to remain on treatment for an indefinite period--even for life. But addiction is a chronic, biological disease of the brain chemistry. Some diabetics, for example, must take insulin daily for life because their pancreas no longer manufactures it, and some addicts take methadone daily because their brain no longer makes endorphins. Though some people don't like the comparison, it is actually quite accurate.
I tried buprenorphine myself, and found that it did not work well for me. If you have tried it without success, methadone may be a good next step for you. But please get to a clinic as soon as possible--taking unprescribed methadone off the street can be VERY dangerous and can easily kill you. If you do get on a clinic do NOT take more than prescribed or mix it with other drugs or alcohol. This is a powerful, potent medication and people do not realize how easy it can be to overdose on it, without even realizing you have taken too much. I cannot stress this enough--methadone is NOT a "party drug" or something to play around with.
Anyhow, good luck to you and I hope it goes well for you.
Thanks everyone for the comments. In particular, Robert thank you for the constructive critisism. And yes, it does upset me. I dont understand why i cant seem to get clean again. I was clean for 3 1/2 years and my life was good. I used to think i would never use again. Then I got off interferon for Hep C, and i started having really bad cravings and never told anyone and eventually found what i was looking for and relapsed. I told myself i could just do it once in a while. that was almost a year ago. Robert, if you could help me figure out why i cant get clean again I would appreciate it. I go to NA almost everyday, i have a lot of friends there. They put up with my bull******************** and they know i am not clean. I do have a desire to stop but i hate being dopesick. I know that is part of the reason. Could it be that i have to hit bottom like before to be able to stop. God i hope that is not true. My bottom was horrible before, jails, overdoses that ended up me up in a coma for a week, it was bad. So what it is that makes some poeple be able to stop and others not be able to stop like myself. Is it that i need more treatment than NA, like suboxone or a detox, or is it that in my head i want to use more than i want to get clean. Thank you for your support. I have been more honest in this forum because it is easier to tell you poeple the truth than it is my friends in NA.
You are right, i do have to get clean sooner or later, I am no different than other addicts. i can not use sucessfully. my life is so unmanegable. i try to act like i am a normal person and i have a lot of poeple fooled. If they only knew. I wonder what my boss would think if he knew I go on shoplifting sprees at lunch to steal ******************** and pawn it for dope money. If i dont stop i am going to get arrested one day. Or i wonder what they would think about me going to a quack doctor to get 240 roxis a month that really only last me a week if i am lucky. I am starting to think that maybe i should get clean sooner than later. I should just end the suffering. Of course, I am saying all this now while I am not in withdrawal. Once i start going into withdrawal my head gets a little crazy. And i am short on options at the moment. I cant afford suboxone anymore. I could maybe buy some when i get paid off the street. I am not willing to commit to methadone. I cant go into a detox center because i cant take off work or let my family know that i am using. I am in a real bind. All because I thought i could handle one fix.
I will try but it probably wont be until Wed when I get paid. Ill keep you posted.