Replacement Therapy PT3
Lets take a brief look at Methadone, Dolophine,Physeptone,Heptadon and Methadose are just a few names for the same drug that is methadone . It’s a synthetic opioid created in 1937 in Germany,it’s along the lines of morphine and effects the brains opioid receptors in similar fashion as Heroin. It was introduced in the United States in 1947 by Eli Lily but it wasn’t until the 1960s in New York that researchers Dole &Nyswander found methadone as suitable treatment for heroin dependent people. The drug has and is used for chronic pain but most often it’s used to treat opioid dependent individuals with great success.
Studies have found that methadone in adequate doses (20mg-100mg) prevents or reverses withdrawal symptoms and last for twenty-four hours. Further it was discovered that methadone can block the euphoric effects of of illicit drugs (heroin) thereby reducing the disire for the drug. All these things along with the fact that methadone is cheap has made it the option most states make available to the opiate dependent . Distribution varies by country and state.
In the small state of Delaware they have one state clinic that is funded by the state with the patients there paying with Medicaid . There’s two more private clinics where the patients pay out of pocket or copay with insurance carrying the rest. The private sector cost about 90 dollars per week and I think your treated with a bit more courtesy then the state run place. This has been this writers experience and I think many would agree with me. The private sector also gives the patient the choice between Methadone and the latest ‘wonder drug’ suboxone . This book about replacement therapy wouldn’t be complete if I didn’t mention Buprenorphine . It’s the latest weapon to fight the opioid addiction that is sweeping the country. Buprenorphine is most commonly marketed as suboxone and recently a generic version was approved by the FDA called Subutex and is used in the detox to bring people off of heroin , OxyContin ,Percocet and the like without the severe withdrawal . It also has a blocking effect to illicit drugs. It was approved in 2002 and claims to have many advantages over methadone. Success rates vary but it has reported a 40% to 60%effective in certain studies.
In my humble opinion, Suboxone is effective in the short term to abate withdrawal but as a maintenance tool, I can’t see any advantages to it over methadone . I guess it could be a better tool for the person who doesn’t want the stigma of reporting to a clinic and would rather go to the doctor and get a prescription for Suboxone but there’s some things to consider. First off its pretty expensive, especially if you haven’t any insurance. If you don’t mind paying extra not to report to the clinic or so you can see yourself as a better class of junkie I want to think about what got you in this position, if it was prescription drugs you may want to think about trusting yourself to take this as directed. Studies have shown its abuse to be lower then methadone when people are left to their own dosage but I have to be honest if it can be abused , it will . Later in the book we will look at different maintenance programsthat is based on my experience but first lets talk about traditional cold turkey attempts at sobriety.
I have kicked heroin cold turkey in jail on many occasions and it is one of the worst experiences of my life. I’d get locked up for shoplifting or possession and sit in the city jail for 90 or 120 days waiting to go to court. For the first week I’d be in so much pain that no one wanted to be around me. Puking and shitting every ten minutes doesn’t make you popular but the other inmates did like that I wouldn’t eat anything for 5-7 days. I would trade my tray off for fruit because it was the only thing I could keep down. On one occasion I went 17 days without sleep, well that’s not exactly true. The human body can only go so long without sleep so every once in awhile my body would shut down for twenty minutes or so but then it was right back awake. After 17 days of cat naps I finally slept for four hours and I felt wonderful after sleeping for them few hours, insomnia is one of the worst parts of withdrawal because there’s just no escaping your need for the drug. After thirty days I would be sleeping and working out, eatting and healthy, by the time my court date would roll around I’d look like a different person.
I’d tell myself I was going to stay clean this time but as soon as I would be released I’d return to using . I did this over and over and over, and that my friends ,is the insanity of addiction, doing the same thing and expecting different results! A person who kicks without a detox, rehab and after-care program set up is lying to themselves. Drugs are the symptoms of a much bigger problem and if I don’t work a 12 step program or address that bigger problem then I’m destined for failure over and over! This has been my experience and if you’re reading this then you have too or someone very close has experienced the same. I finally found that the bigger problem was me and my thinking , my character defects were staring me in the face but until I was prepared to deal with them I would continue on a pattern of self destructive behavior that plagued me for most of my life. The day I hit my knees and cried out to a God I claimed didn’t exist and ask Him to kill me or cure me was the turning point in my life. Once I became willing to admit that I didn’t have all the answers and that I needed something bigger then myself to battle the demons that raged within me, then changes could come but surrender was necessary .