Wednesday, February 3, 2010

The methadone controvery is a big one!

I wanted to clarify a few things about my son's current use of methadone:
  • I am not an expert on this drug, at all.  Tomorrow morning, I am meeting with my son and his drug counselor at the methadone clinic.  If I am going to agree to use the small amount of money, left in his trust fund, to fund this-- I want answers.
  • The clinic he is going to is reputable.  It's run by a non-profit that I am very familiar with. Our school district contracts their counseling services, and I'm impressed with their counselors.
  • In order to take his daily "dose", my son has to take random UA's. So far, he's taken three.
  • My son is scared of methadone. He is fully aware of the dangers-- believe me, he's run the list down for me. His own counselor says that the maximum length of time my son should be on the program is six months. My son is going for three.
  • Once my son is off methadone, I am fully aware-- as is he, that he could be highly vulnerable to wanting to use.

Obviously, he doesn't want this. I am going to ask a lot of questions and take notes. I'll share what I learn.

In a perfect world--
  • My son would go to meetings, on a regular basis (he's sporadic). 
  • B would not need any kind of prescription meds to deal with his insomnia, stress or opiate addiction.
  • My son could come home to live with us, and go to college and work part time.
  • B would use his outgoing personality skills to become a counselor, and to tell his story to others.
For those of you who wonder why my son can't come home to live with us--

One of the best things I did for B, was to make him move out. My son is beginning to appreciate what he had, by losing it. He doesn't have a comfy home with all the amenities. He cannot afford to go out and eat, buy clothes or have cable TV. His life is very humble, indeed.  He's had to deal with bad roommates, and having his power cut off for not paying it on time.

My son is learning life skills. 

As for his not living in our home-- there is peace again. The constant drama began to affect my marriage.  I got to the point that every time I saw black smudges on door jams, I suspected it was black tar heroin residue.  I found myself searching his pockets for foils; if I found them, it made me sick to my stomach.

With my son not living with me, I do not have to get sucked into his world of addiction.  He is welcome to have dinner with us, or wash a load of laundry.

What I see as positives steps is that my son is working, and he's beginning to adjust to a life at poverty level.  This is not easy, but I think this is very necessary.

Maybe, if my son can stay sober long enough-- and I see some responsibility... we can discuss his going to college and having a job.

Truthfully, I hope that my son will find sobriety and remain on his own.  It's how our kids learn to mature, and I won't be tempted to fall into codependency and enabling him.

PERSONAL NOTE TO ANGELO:  I have read your passionate comments about the dangers of methadone. I'm sorry that you've know many people who OD'd on it.  Actually, I know plenty of success stories. Angelo, it's like any kind of therapy--  one must be responsible with it, know the dangers and risks, and then it's up to them to make the choice.  Suboxone didn't work for him  I think his heroin use had gone on too long, and was too much. So far, the boy that I know and love is beginning to return. I take it one day at a time.
'Nuff said.

Your thoughts?


8 comments:

clean and crazy said...

wow, i was just remembering to when i quit using, i shot up dope on a daily basis it was meth laced with a hallucinogenic i took quite a bit every day. when i quit, i went to jail, my saving grace was i could not hit my own veins to save my life or let me rephrase that it saved my life not being able to hit my own veins.
so when i got out of jail about 2 weeks clean, i had to go home and i hit the bottom hard i never ever want to go through those withdrawals again. EVER. i know his fear, but it is just that, fear. i never knew there was something you could take to ween you off of dope, i never knew there were halfway houses i didn't know where to get help. about four months into this massive withdraw and i am telling you i threw chairs across the room i couldn't think straight. everything made me angry, everything made me cry. i pounded my fists against the walls of my bathroom until my knuckles bled. i can still show you the scars today they are callouses on my hands now. i wanted to die, i couldn't function. i couldn't work because everyone irritated the shit out of me. i couldn't stand to be around anybody i didn't want to look into the mirror. i hated myself and my thoughts were always miserable. i gotta tell you this, cause it's true and funny...
i needed something and i needed it bad i really needed to feel good and i wasn't going to use so i took my sisters husband to a bar to play pool and there was this guy there. a couple weeks later i called him up and slept with him and i felt better!!! i could function and not pitch fits of rage!! then this guy started coming around a lot and i didn't want him to, i just wanted my instant gratification. he thought he loved me, i absolutely hated him and he tried to move into the house with my family and me and i screamed the most horrible things at him to make him go away. he finally did. so i decided there was something seriously wrong with me after 4 months i checked into an outpatient treatment facility. they told me to go to NA. i said what is that like more counselors? and my counselor said no, it is addicts it is like AA only for drug addicts.

i thought she was off her rocker!! there was no way an addict was going to help me. are you kidding i went to jail and came back and they took everything from my apartment!! all they left behind were the rats and roaches and i think they took some of those with them!! no way was i getting involved with addicts ever again. and that is what i told her for the next 3 months. it was only an 8 week treatment, but i was afraid to leave and there was this assignment we were supposed to do before we could graduate and i wouldn't do it because i had no where else to go. but when i went to treatment sometimes it felt a little bit better, but it took those gals 3 months before i would step foot into a meeting.

it is funny because after i went to NA around July of '05 i got a sponsor and i was scared because i knew something was wrong with me. i thought i had hep c or HIV for sure cause i never cared if the needles were clean or if he slept with other people, my ex, i finally went to the doctor on september 9 to see what was wrong with me, i was pregnant, my girl was born on December 28th. a 3 month pregnancy!!
by the grace of GOD go i. i thought it was a tumor in my tummy. we joked about naming her benign.
anyway i just love reading your blog you are showing such strength, it feels good to share from the heart. thanks for listening.

J.R. said...

There is no cure for a chronic ailment like an opioid addiction, only treastment for it. The counselor who told you your son should stay in treatment for six months should be run from screaming--he/she knows NOTHING about what they speak. And your son's hope for a three month stay is also unrealistic. The fact, gleaned from over 4 decades of research and safe usage of methadone, is that most will need methadone treatment for life. Educate yourself to save suffering for both you and your son. An opiate addiction produces changes in brain chemistry--changes that do not heal with cessation of abuse. Methadone treatment is a treatment for this endorphin imbalance in the brain's of the afflicted. What are the costs of leaving this imbalance untreated?? Constant depression and an inability to experience feelings of satisfaction and accomplishment. But with endorphin replacement therapy thru methadone treatment a normal life can be pursued. EDUCATE. And if this counselor isn't well versed in what I speak of, then they are only there for a paycheck or to advance a philosophy. I speak out of care for your son's welfare. Information supporting my comments is throughout the National Institutes of Health website and at www.methadone.org and www.lindesmith.org.
Good luck to you both,
J.R. Neuberger
National Alliance for Medication Assisted Recovery

Dad and Mom said...

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.

Anonymous said...

Hi Mom

I wanted to expand a bit on what J.R. said. He is a man I know personally from my extensive work in the field of MMT advocacy and he speaks the truth. A counnselor assuring you of a six month time limit on MMT and then telling you your son will only be on for 3 months is not one to be trusted at all--they apparently know very very little about the treatment modality in which they work. This can happen sometimes--often counselors take these jobs fresh out of school, or come from an abstinence-only recovery background themselves and they may have personal feelings against MMT. But as JR said, those expectations are totally unrealistic.

The average suggested length of time in treatment, minimum, is 2-3 years. This gives the patient a chance to re-stabilize, both their lives and their brain chemistry. Long term use of opioid drugs causes the brain to cease producing endorphins--the natural opiates. Once the patient becomes abstinent, it may be some time before the brain recognizes this fact and starts producing again, and during this time the patient experiences severe depression, inability to feel pleasure or happiness, anxiety, physical exhaustion, etc. This often leads to relapse, but if it can be gotten through, the brain may start producing endorphins again within a few weeks to months, especially if

1) the patient is young and had a brief period of use

2) the patient had a normally functioning endorphin production BEFORE they began using drugs--it is thought now that some opiate addicts may have a natural deficiency, making them especially vulnerable to opiate abuse.

However, for many patients, esp. long term, heavy user, this may never occur. The damage to the brain chemistry may be permanent. In these cases, methadone works to stabilize and normalize the brain chemistry, in the same way that insulin stabilizes the diabetic whose pancreas no longer produces insulin. Another example would be those who have abused anabolic steroid drugs, and who then must use testosterone supplements often for life because their own natural production has been shut down.

Methadone does not cause a high or euphoria in stable patients. It also blocks the effects of other opiate drugs at doses of about 80mgs a day. The average dose needed is between 80-120mgs some need much more, others less.

People tend to view MMT as a "detox aid" to getting off opiate drugs, but that is not the case for most patients. The relapse rates for those leaving MMT are quite high, 90% in the first year. However, for those who remain IN treatment, the success rates (i.e., staying free of illicit drugs, leading a productive and law abiding life, etc) are much higher than with any other treatment modality--65% to 90% depending on the clinic. Even the WHite House recognizes MMT as the most effective treatment for opioid addiction.

Your son may well NOT need long term treatment, but 3 months is way too short to expect it to do any good--no studies at all support therapy of that length.

There are many websites where you can find more information on MMT and ask questions from those who have been there. You can Google "We Speak Methadone", for a good one. I hope you stop by. This is an important decision and there is a lot to be learned.

Anonymous said...

One other thing. I was reading your first blog entry and just wanted to let you know that while the 12 steps work well for some, they do not work for everyone. This disease is for many primarily one of the brain chemistry and people often begin using simply because they are trying to self-medicate a crippling imbalance. Oftentimes, medication is necessary to a full recovery. Some also need support groups and others may not.

I myself had a twenty year addiction to Rx painkillers. I went through 13 abstinence based rehabs, thousands of 12 step meetings, had three sponsors, worked all the steps, read all the literature, prayed, did all that was suggested to me--and still I was miserable. At one time I was clean for 4 years--the most unhappy four years of my adult life. I was even tried on various antidepressant drugs, but since they target serotonin, not endorphins, they had no effect.

Since my first day on MMT almost 6 years ago, I have not used. My life has turned around 100%. I work full time, I have my own home, in the suburbs, am married and have three boys (26, 18 and 10) and am very happy indeed. I do a great deal of work to educate others about what MMT really is and is not and to dispell the stigma and prejudice that surround it.

Debby of Oxycontin and Opiate Addiction: A Mother's Story said...

I will share what I learned this morning, in a day or two. Let me say this-- I need to post a synopsis on my son, so that people can better understand where we're coming from. My son just turned 21 years old. He has not been smoking heroin for a long time. He doesn't IV the drug. He is, fortunately, young enough in the disease and age that a short-term, regulated program is promising. We live in California, where methadone clinics are tightly regulated.

More later.

Angelo said...

Hi Debby,
You miss understood me. Please read this whole post. I think it is important. I did not say my friends died from methadone overdoses. I said my friends who were on methadone would be clean while taken the methadone so when they came off the methadone there system was clean and they would do a bag of heroin which caused them to OD. Many people think they can handle a full bag and they can't because they been clean a while, while being on methadone. What I was saying was that if B decides to come off of methadone after 3 months he is GOING TO HAVE A FULL BLOWN METHADONE HABIT. He will be in severe withdrawls. I swear to you I think these people who work at the methadone clinic must sign a contract stating they are not allowed to tell the customer that they will have a methadone habit after there detox is finished. There is no such thing as a methadone detox. You will have a methadone habit after a methadone detox. The half life is very long. The withdrawls are just like heroin but worse because it last for a long time. My concern was that after 3 months B will stop the methadone and will feel the withdrawls and he may turn to a bag of heroin to relieve the withdrawls. He must realize his system is clean and he may not be able to handle a full bag of heroin and that is how my friends died not from the methadone. I wanted you to mention to be when it is time that the detox ends that if he craves the heroin and gives in to it to do very little at a time. Being clean from the heroin for 3 months is a long time and a full bag is a lot to someone who is clean. This is what I was talking about. I want him to stay on the methadone. He needs maitenance. Please Debby tell hi it is working so why not just stay on it. I hate to say this in fear you may get angry at me but I don't think B will make it without the methadone. He has insomnia already do you know the anxiety he is going to have when the detox ends? He'll never make it to work. These counselors know only 1 out of a million make it after a detox. They do methadone detox just to get you on maitenance. It's a business Deb. In the last week of his detox he will start feeling different. The last couple of days he will notice he can't sleep then he will be getting anxiety. A few days after detox will be big problems. I just don't want B to use heroin to feel better and overdose. Just go right back on the methadone. When B is is on methadone for a few years or so and he is clean that whole time he can come down over a long period of time. Even if it takes 2 years to come off you need to do it extremely slowly. Remember, the half life is very long. Right now B needs to stay on it and he needs to be aware that if he does the detox and he gets urges to use that he needs to know NOT TO DO A WHOLE BAG OF HEROIN. This right here is the cause of most overdoses. A person who is clean decides to use again and doesn't realize a whole bag is very potent because there use to doing a few. I'm sorry for rambling but you need to tell B this. This was my major concern. I'm angry at the counselor saying he things a 3 month detox should be OK when he knows when those 3 months is up he will have a full blown methadone habit. I will get you some links where you can ask questions about methadone and you will see that nobody can detox from methadone without going through methadone withdrawls. The thing is if B handles the withdrawls he still won't be well enough to be able to go to work which is another problem. He also doesn't have a support outlet like AA or NA and a sponsor. I am so sorry for a long post but I wanted to get my point across. IMO B's life depended on it.


Angelo

Angelo said...

Debby, Please reread JR's and both post by annoymous. They are saying everything I believe. It is the real truth. I want to thank them both for a great response.