Methadone Intervention

Methadone Intervention

It is important to understand that each substance abused does require a different approach in terms of the interventionist. Each intervention is handled according to what substance your teen or young adult is addicted to and what type of detox and treatment will be required for recovery.

Although the substance itself isn’t usually the true problem in terms of recovery, it is important to understand that each substance abused does require a different approach in terms of intervention. A methadone intervention is handled differently than an intervention on a benzo user. There are many misconceptions about Methadone, so we have provided a considerable amount of information here to help families to understand the reality of Methadone as a drug.

Opiates

Essentially, Methadone is a synthetic Opiate. The standard definition of an Opiate is “a medication or illegal drug that is either derived from the opium poppy, or that mimics the effect of an Opiate (a synthetic Opiate). Opiate drugs are narcotic sedatives that depress activity of the central nervous system, reduce pain, and induce sleep. Side effects may include over sedation, nausea, and constipation. Long-term use of Opiates can produce addiction, and overuse can cause overdose and potentially death.”. During later stages of Opiate addiction the narcotic effects can actually stimulate the addict, giving him energy and the ability to “face the day”. Over time prolonged Opiate abuse eventually becomes physically addictive and the body itself needs more and more of the drug or else develops severely uncomfortable symptoms. Standard withdrawal symptoms include sleeplessness, anxiety, restlessness, flu-like symptoms, nausea, muscle aches and pains and severe discomfort.

The most commonly abused Opiates include Heroin, Methadone, Suboxone, Oxycontin (Oxycodone HCL), Vicadin (Hydrocodone), Morphine, Codeine, Fentanyl, and Opium. Abused for centuries, opium, laudenum and morphine addiction reached its height in the United States in the early 1900’s. As a response to the addiction problem, the Bayer Corporation created Heroin to help addicts withdraw off of Opiates. Later, during World War II, Methadone was created to combat morphine addiction. In the late 20th century, Suboxone was created to help addicts to withdraw off of Methadone and Heroin. It is important to understand that each of these substances are classed as Opiates and are addictive and mood altering. Many people make the mistake of substituting Methadone for Heroin and end up addicted to the Methadone.

The most common cycle of addiction involving Methadone is a user who begins using Opiates intermittently, then over time becomes physically addicted and begins using daily. Afterwards there is a 60% likelihood of becoming an IV drug user within 3 years. Eventually, as an attempt to stop using the Opiates, the user switches to Methadone and becomes addicted to it. It is important to understand that statistically less than 1% of Opiate addicts quit using without the aid of some form of intervention or treatment. A significantly less percentage actually quit using Methadone without the aid of treatment. The reason for this is the significantly more difficult withdrawal of Methadone than with other Opiates.

Methadone Withdrawal

Although originally created to combat opiate addiction, it is interesting to note that Methadone has a stronger physical addiction than the most other opiates. Other Opiates create a more rapid psychological dependence, but Methadone has one of the more powerful physical dependencies. In addition to this, Methadone withdrawal is generally up to 3 times longer than that of Heroin or other Opiods. The withdrawal from Methadone is similar to standard Opiates, but much worse. Imagine being unable to sleep for 21 days, during which you are experiencing the worst flu-like symptoms you have ever felt. You are vomiting, nervous, your blood pressure and heart rate is skyrocketing. Every muscle and bone in your body aches. Your hair hurts (yes, we know that biochemically speaking hair doesn’t hurt, but during a methadone withdrawal, everything hurts). And during the entire time, you are aware that if you just take one dose of Methadone, the discomfort will go away. In a nutshell, if you use Methadone to quit using one drug, you very well may find yourself addicted to a much more addictive substance which is incredibly difficult to withdraw from. A terrible situation for anyone to be in. It is the severity of the withdraw that is the biggest objection during a Methadone intervention.

Harm Reduction

Methadone, along with Suboxone, Subutex, and Antabuse is one of the variety of drugs that fall into the category of “harm reduction”. The clinical definition of harm reduction is “any program or policy designed to reduce drug-related harm or impact without requiring the cessation of drug use, targeting the individual, the family, community or society”. A few things are important to understand about harm reduction.

The first is that it is a “solution” that does not involve stopping using drugs. A progressive concept designed to replace one drug with a “more manageable” drug, harm reduction isn’t actually considered recovery from active addiction. It is not about empowering someone to face life without the use of drugs, it is about giving someone a replacement drug(s) that may be more manageable. An attractive alternative for some addicts because they can continue to use a mood altering substance without having to abstain from all drugs…and of course a doctor prescribes it. The reality of Methadone is that 75% of Methadone users are also polysubstance abusers. In other words, they may have quit their primary “problem” Opiate such as Heroin or Oxycontin, but they are now using Methadone in addition to marijuana, alcohol, cocaine or most often benzodiazipenes.

The second thing that is important to understand is that the prime area of harm reduction that it is designed to help is not the individual. From a recovery standpoint, if a person continues to use mood altering drugs such as Methadone as a way of handling life situations instead of confronting them sober, he will actually become less able to do so sober. In other words, he will become worse. So, although a methadone user is no longer “shooting up his Heroin”, stealing and sharing infected needles, from a recovery standpoint he is actually becoming worse in his addictions. So who is the prime target for harm reduction? Society. To give a Heroin addict who is prostituting herself, stealing and spreading disease an alternative such a doctor prescribed Methadone decreases the impact on society. The hard cold reality of harm reduction is “yes she will become worse in her addiction from a recovery standpoint, but who cares, as long as she is not stealing from me and you (society)”. It is important that family members of addicts already using or considering Methadone understand this point. Shortcuts always have their price.

The third thing that is important to understand is that many agencies that are permitted to prescribe Methadone receive some form of financial reimbursement (either directly from the addict or from government funding sources). It is not uncommon for a methadone addict to have begun with a relatively low dosage of 30mg/day. Over time the agency quickly raises his dosage so that within a year his dosage is 120mg/day of Methadone. Any time the addict suggests weaning himself off of the Methadone, they conveniently advise against this, sometimes even increasing his dosage once more. The unfortunate reality is that, just like a street drug dealer, these agencies have a financially vested interest in keeping an addict on continual doses of Methadone and their actions often show this.

In deciding to do a methadone intervention on their loved one, many families need to ask themselves the following question in regards to harm reduction. Do I want my loved one to learn to face life without the aid of harmful drugs, or should he continue abusing harmful drugs, stagnating in life.

Recreational Methadone User

The first type of Methadone user is someone who began using drugs recreationally, experimented with Heroin or other Opiates and eventually became physically addicted. Generally speaking, most experimental Heroin users become physically addicted within a year and they become daily users. After becoming physically addicted, the recreational Opiate user becomes more and more obsessed with getting his drug. Trying to avoid the uncomfortable withdrawal and seeking another feeling of euphoria he becomes trapped in a never-ending cycle. Because it is financially difficult for him to acquire his primary Opiate, he seeks out Methadone as a temporary alternative to the uncomfortable withdrawal of his Opiates. He successful avoids taking Methadone for long enough periods to become physically dependant, but of course he is still dependant on Opiods. A Methadone intervention for a recreational user is generally easier than the other types of Methadone interventions.

Daily Methadone Addict

The most difficult type of Methadone Intervention is the daily Methadone addict. For whatever reason he has become physically dependant on Methadone. His dosage ranges anywhere from 30mg/day to 120mg/day. In extreme cases, this is sometimes double that. Due to the severely uncomfortable withdrawal symptoms, rarely does a daily methadone addict quit using without the aid of treatment, detox, or imprisonment. The sad reality is that a daily methadone addict wants desperately to get off of the methadone; he just finds it too difficult. Ideally a methadone intervention can help him find his way into sobriety.

Pain Management Opiod User

The second type of Methadone addict is someone who, after developing some form of painful ailment (surgery, pulled muscles, joint aches, automobile accidents, etc) is prescribed an Opiate (Vicodin, Oxycontin, etc) to manage his pain. Since the body has a tendency to increase it’s tolerance to Opiates, over time he gets less of an effect from the same dosage. To counter, he increases his dosage, possibly even switching to a more potent Opiate to handle the pain. Unfortunately, since the withdrawals from Opiates also includes severe pain, his original pain increases exponentially and psychologically he believes his pain to be somatic (existing in the body). As a result, he continues using the Opiates to “handle the pain” which may actually no longer have a basis in fact. He is now trapped, avoiding the painful withdrawal and searching for the euphoric feeling that another pill can give him. Eventually he becomes aware of the problem with the Opiates and attempts to withdraw on his own. Finding it to be extremely difficult, he seeks out medical advice. They prescibe him Methadone to withdraw off of the Opiates. Initially beginning with a relatively low dosage, over time they increase his dosage. Within a year he is at the maximum allowed prescription. Whereas he found it difficult to withdraw off of the Opiates before, it is almost impossible for him to quit the much more difficult Methadone. He is trapped with what seems to be no way out. If the pain management addict is now using methadone on a daily basis, then a Methadone intervention on a pain management addict is generally just as difficult of an intervention as that of a daily Methadone addict.

Methadone Intervention

Unfortunately, due to the fact of the terrible uncomfortable withdrawal involved with Methadone, delivering a methadone intervention is considered one of the most difficult of all Opiod interventions. In fact, it is this very withdrawal that will be the biggest objection raised by the addict. However, a qualified intervention specialist is qualified to handle any situation and even methadone addicts have a high degree of success in terms of interventions.

There are several other pages that may be of some assistance in helping you to understand your loved one’s Methadone addiction.

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Rusty Marvin
4/3/87 - 7/7/05

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