Friday, February 5, 2010

How I cope with my son's addiction and a helpful comment


I don't have a lot of time to write this morning, but I feel compelled to quickly type a response to the very passionate and emotional responses about my son's methadone treatment program:

As B's mom, I have accepted that I have no control over my son's addiction.  My purpose in going to his methadone clinic was to ask questions and to learn.  I received materials to read, which I will do over the weekend.

Some of you might have missed a few key points-- which I posted as comments yesterday. Once again:
  • My son doesn't use IV heroin. He freebases it.
  • The program his methadone clinic recommends is called a "Maintenance Program".  It is a six month program. His counselor says this is a baseline, by the way.  It might be sooner, it might be longer. It all depends on my son, really. If he eats healthier, exercise, it helps-- and I do believe this. There are so many variables.
  • The 21-day program is a detox program.  It worked wonders for my son's former best friend. Overall, it's not the most ideal program. This is what my son originally wanted. Obviously, it wasn't what's happening.
  • They feel that, based on my son's young and tender age, and that his heroin use is not as severe as many of their clients, that their goal is not NOT have him on methadone for more than six months.
  • My son is taking between 38-40 mg of methadone, per day. It is dispensed to him, in liquid form.
  • The State of California has implented very strict guidelines is the dispensing of methadone-- unlike many other states.  Any experts os MMT, please be aware of California State Law, before posting your expertise.
  • While my son shows some signs of withdrawals-- runny nose, in particular, he says he is not experiencing any desires to use.

My opinion?  I'm still in the jury room.  I need to read.

I need to go to work, but I wanted to post a comment that was left by someone I consider to be a true blogger friend-- and someone who I think is a very smart dad.   I totally agree with Ron, in that I believe there is no cookie cutter answer to what works for addicts.

I have a lot of ground to cover, but I'm limited on time. I'm working on responding to so many topics that your comments have brought to my attention.  Thank you for the lengthy comments you are leaving.


To Angelo-- I can read the passion in what you write.  How I wish I could give you a hug, and fill your heart with calm.  You write from the perspective of an addict who still has so much pain.  I do read between the lines. I am not dismissing what you have to say-- but I must remain calm and use my common sense.

Bottom line-- it is my son's decision on how long he will do the methadone treatment. For now, I'm going to give the money, from his trust fund-- and that should just about empty it out.  He's got about two months to figure out if he can get on medical (which will pay for it)-- and that would be good for his diabetes treatment he needs.

Every day, I live my life trusting in my faith and promises that God is with me. I have too many miracles and answered prayers to write in two minutes. I know, that he is real.  For that very reason, I must remain calm. I can't panic.  Panic produces knee jerk reactions.

Here's a comment that I hope none of you missed, it's from An Addict in Our Son's Bedroom:

With my limited expeieince and self taught knowledge about drug addiction the one thing I have learned for sure is: there is more than one way out of this morass. I am learning not to fault someone (my son) for doing it his way instead of my way. I have learned he got into this mess, only he can get out of this mess. He is not using meetings, he is not using suboxone, or methadone, not working steps, or doing really anything you read and hear needs to be done. In fact we had a discussion a couple of nights ago about his methodology for staying clean. He summed it up in these words, "Dad, I am just not going to do that again, can't you understand that?" I wish him well, but he is like his father in one sense, he is very strong willed and if he makes his mind up, that is it. Just like dad I guess. Now how long will those methods be effective? I don't know but it is working today. Today is all that counts. There was a time when I was at a point that my belief was if you aren't working a program you aren't really in recovery. I am not there now. I think I have grown in that I am not responsible for his recovery and if he relapses I am not responsible for that either. I am not "owning" his problem any more. Methadone, suboxone or whatever; what works for others is not a "one size fits all". I think it is individual. Compare it to someone with some other disabling disease that cripples ones legs through accident or disease, some never leave a wheelchair, some require crutches and some eventually walk again. Part of it is physiological and part of it may be psychological. It is up to the addict what they need and it seems to work only when they can really work the issue for themselves. In the past I questioned the recovery part of using one chemical to replace another chemical but now my mind is at a place of "what does it matter if it works". Just use the medical professions motto in deciding on the answers: do no harm.


8 comments:

clean and crazy said...

great post , i have heard and seen many drug replacement programs that do not work or say that it will take years to ween the addict off of. i am grateful for the advances in medicine that they may be able to help some one.

armme said...

I loved Angelo's response....and I think what he is saying is what so many of us on medication assisted treatment wish people would understand.

Me being able to get off methadone quicker than someone else, doesn't mean I am "more" committed to my recovery....or me deciding my life is better on methadone, than it is off it, doesn't mean I have "given up"--it just means that I know myself, know my disease and know that I am far happier being stable and productive on methadone than I was craving, miserable and un-able to move forward with my life when I was off it.

Your son my require longer treatment or less treatment and neither says anything about him and his success in life.

You can take methadone for the rest of your life and be completely useless and you can take methadone for life and become everything you want to be---taking this medication (or any other) for however long he needs to, does NOT decide his fate!
\
PS--I comend you for going to the clinic. So many of us have relatives that will not even TRY to learn about our treatment--they dismiss it, as many in society do!

armme said...

PS--

One way you might try to look at methadone treatment is to stop looking at it as a "replacement" for HIS DRUG OF CHOICE--it is a replacement for the chemicals in his brain that he has warped by his drug use.

Cheri said...

Debby,

I truly appreciated Ron's post of the other day, and I'm glad you have chosen to share it here.

I want you to know Wayne and I are praying for you and B as you go through this time, that God will guide your steps and your decisions.

Hugs,
Cheri

zenith15 said...

Hi there

Unfortunately, Calif. is one of the only, if not THE only, state that still allows 21 day detoxes due to their almost complete failure rate. They simply almost never work.

That being said, your son's tender age is certainly a consideration. Whether or not he used heroin IV, not quite as much. Heroin used intranasally is almost as potent a rush with instant euphoria as heroin injected, and every bit as addictive.

What this will depend on is not his willpower or determination--it will depend on his brain chemistry, whether or not the damage done to his brain's ability to produce endorphins is permanent (hopefully not, due to his youth) and whether he produced endorphins normally in the first place (pre-addiction).

What I would urge you to consider is that the relapse rate, across the board is 90% in the first year for those leaving MMT. The risks of such a relapse are many--jail, job loss, contracting a serious illness, even death. Whereas staying ON treatment for the recommended amount of time (2-3 years) harms no one and increases his chances of success.

And, if he does do this brief treatment and relapses, please, mom, please don't make him feel as though he has failed. Methadone treatment is not and never was intended to be a detox aid. So many folks have this wrong, but that is NOT the goal of treatment--even some clinics fail to do their homework here. I would urge you to read the writings of doctors Dole and Nyswander, who invented MMT back in the 1960's, and what they discovered about short term treatment. If he needs to return to treatment please encourage him to do so immediately. It may save his life.

Also, if you wish to speak with someone in the field (a counselor in an MMT clinic in CA) who knows more about the rules and regs there than I do, just let me know and I will hook you up--she's a very sweet person.

Angelo said...

"You write from the perspective of an addict who still has so much pain".

That's what you said about me. That is probable the most true words said about me. So much pain. You have no idea. Or maybe you do huh?
I agree with you and you are going about everything in the best way give it a wait and see approach and a one day at a time. Your a very good judge of character.

Angelo

zenith15 said...

Last comment for now--I ran across this and thought it might be of interest to you:

“Leaving Methadone Treatment: Lessons Learned, Lessons Forgotten,
Lessons Ignored” - Prepared by Stephan Magura, Ph.D. and Andrew
Rosenblum, Ph.D., National Development and Research Institutes, Inc. The
Mount Sinai Journal of Medicine Vol. 68, No. 1 January 2001.
This paper reviews the published research literature on post-discharge
outcomes of patients exiting from methadone maintenance programs. Virtually
all of these studies document high rates of relapse to opioid use after methadone
treatment is discontinued.
• 21-Day Detoxification: Research has also shown that outcomes have
generally been poor after short-term heroin/opiate detoxification; almost all
detoxified addicts rapidly relapse to heroin/opiate use.
• Ideological Issues: There have been expressed concerns about the
ethics, wisdom, necessity, and expense of maintaining addicts on opiate
replacement indefinitely, possibly for the rest of their lives. Lifelong
maintenance is not ideologically appealing, but the empirical evidence
strongly suggests that premature discontinuation puts the patient at great
risk. Until more is learned about how to improve post-discontinuation
outcomes for methadone patients, treatment providers and
regulatory/funding agencies should be very cautious about imposing
disincentives and structural barriers that discourage or impede long-term
(chronic) opiate replacement therapy.
• Premature Discontinuation: Most patients who left methadone
treatment were not identified by their clinic as therapeutically ready for
discharge; and, among patients who began a therapeutically planned
discharge, most left methadone treatment before completing their tapering
schedule.
• Discontinuation Risks: The detrimental consequences of leaving
methadone treatment are dramatically indicated by greatly increased
death rates following discharge. Criminal-legal involvement,
Page 3 of 3
incarcerations, and hospitalizations appear to be great risks for former
methadone maintenance patients.
“Methadone Maintenance vs. 180-Day Psychosocially Enriched
Detoxification for Treatment of Opioid Dependence – A Randomized
Controlled Trial” - prepared by Karen L. Sees, DO, Kevin L Delucchi, Ph.D.,
Carmen Masson, Ph.D., Amyu Rosen, Psy.D., H. Westley Clark, M.D., Helen
Robillard, RN, MSN, MA, Peter Banys, M.D., and Sharon M. Hall, Ph.D.,
Department of Psychiatry, University of California, Francisco and San Francisco
Veterans Affairs Medical Center. Journal of the American Medical Association
(JAMA), March 8, 2000, Vol. 283, No. 10.
The NIDA-sponsored UCSF Treatment Research Center attempted to make
“detoxification” successful by increasing the duration from 21 days to six-months
and by providing very intensive support services such as counseling, group
therapy, education, and vocational advice. This was compared to standard
methadone maintenance without all of the therapeutic enrichments. Regrettably,
once methadone reached low dosage levels in the 180-Day Detoxification group,
dropout and heroin relapse rates dramatically increased.
• MMT Better than Detox: Methadone Maintenance Treatment (MMT) has
been shown to improve life functioning by increasing retention and
decreasing heroin use better than long-term (six month) detoxification.
• MMT Reduces Risk Behaviors: MMT decreases criminal behavior; drug
use practices, such as needle sharing, that increase transmission risks for
human immunodeficiency virus (HIV) and Hepatitis C (HCV).

Heather's Mom said...

Debby,
I don't know anything about MMT except what I have just read in this post and your last (and the comments). I'm impressed with you honestly saying you don't know, and the research you are doing, and knowing that ultimately it's not in your control. I applaud all you are doing and really just wanted to comment to send support, love & huggs :)
God bless.