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Methadone - AndrewB and all interested

Posted by DianeD on May 1, 2001, at 10:52:16

In reply to Re: Buprenorphine - where to get it now? Mexico?, posted by Anna P. on April 24, 2001, at 15:57:20

Thanks AndrewB for the nice words and gentle prod :o) It's been quite awhile sense I've both talked to you and been here at Psycho-Babble. Psycho-Babble gets depressing for me so
I rarely come. I haven't email you because nothing new or positive is happening. And as you know I can only talk so much about Methadone. It gets me down.

Re lying. I find I just can't seem to pull them off. First off, I'm no good at constructing them, and then I'm not quick enough on my feet when they are challenged. I get giddy.
I do have the very real pain in my lower back, hip and left leg from an injury in '95 but it has currently slacked off. Maybe I'll stick a clove of garlic up my butt. They say that will give you
a fever. Really ;o) At least I'd look and feel bad.
Seriously tho, I'm trying to get up the nerve. I fear the rejection is what it is. I don't think I could take another door slamming in my face. Another avenue blocked off.

Also, I get the impression you have to be in some kind of special pain to get methadone. Cuz if you'll recall a friend of mine was dying of lung cancer and her doc refused (even after her
begging) to switch her to Methadone claiming it was too heavy duty and he'd loose his license (talk about being an ignorance asshole). So, is my pain considered enough today?
I have yet to find anyone with personal experience in obtaining Methadone from a private physician outside the MMT clinic setting.

There's supposedly a compassionate pain doc in Springfield, OR.

Question: Can doctors track your medical history? Meaning , could this pain doc without my knowledge somehow find out and contact past docs of mine? in order to discuss my
medical/drug history?

My arguments for methadone over other pain meds will be
1. It doesn't incapacitate you. There is no "High". Except the high from finally being free of your insecurities, fears, doubts, fatigue.
2. Is long acting (24 - 36hrs) No ups then downs.
3. Once right dose is reached you can be maintained on that dosage indefinitely. You don't need more, more, MORE! like all other pain meds.
5. Does not impair ones mental or physical faculties.
6. It is non toxic. It does not damage your liver etc. I have Hep C (had Hep.B).

The excerpt below is from a legal proceeding Re BAART (a MMT program I was on for awhile in SF) and the city of Antioch. Antioch doesn't want a MMT clinic in their town. But that
is besides the point. This came from . I had to search for it under baart_brief2.html, sense they reorganized the website.

Methadone is a long-acting synthetic narcotic that occupies the brain’s opiate receptors. But unlike
heroin, which floods these receptors and then wears off in a relatively short time, methadone
occupies the receptors in a steady and prolonged fashion, stabilizing the neurochemistry of the
opiate-dependent brain such that neither a "rush" nor a "high" is produced.7

Because of its chemical properties, methadone has been used in the treatment of narcotic addiction
since 1964. Methadone can either be prescribed to withdraw an individual from opiates by
gradually decreasing oral doses over a relatively short period of time or it can be prescribed as a
maintenance treatment. When prescribed as a maintenance treatment, patients are stabilized at a
dosage medically appropriate to their individualized circumstances. When administered at an
appropriate dosage, methadone quashes narcotic craving and prevents opiate withdrawal
symptoms for 24 to 36 hours.8 Methadone patients do not experience a euphoric effect (a "high").
As leading medical authorities note,

the common conviction that `methadone keeps you high 24 hours’ reflects a
misunderstanding of the effects of a properly adjusted dose. The property of
[methadone] being long acting (24-36 hours) allows the patient to receive a dose, and
then function in a stable manner, without the four hour cycles of euphoria and
withdrawal that characterize heroin use . . . . In fact, the therapeutic window [of
methadone] is quite wide.9

Because methadone creates a cross-tolerance or "blockade" to other opiates, persons on
methadone also do not achieve a euphoric effect by taking such drugs. Thus, a patient’s efforts to
get "high" by using heroin or ingesting additional amounts of methadone are futile.10 The very
reasons that make methadone a highly effective treatment for opiate dependence (not readily
producing a high and inhibiting the euphoric effects of other opiates) also render it an unlikely drug
of abuse. Indeed, instances of primary use of or addiction to methadone are extremely rare.11

Methadone does not impair a patient’s mental or physical faculties. In fact, research shows that
methadone patients receiving proper dosage do not suffer from decreases in intellectual capacity,
reaction time, attention span, or hand-eye coordination.12 A patient on methadone can study,
attend school, work, drive a vehicle, or operate hazardous machinery without impairment of
judgement, cognition, coordination or reflexes.13 As a typical study of methadone patients notes,
the subjects "held positions across the spectrum of the job market, including lawyer, architect,
musician, film producer, housewife, construction worker, social worker, secretary, laborer, and
doorman."14 The study matter-of-factly observes, "[t]here [is] no relationship between the nature
of employment and dose or the number of treatment episodes."15 Methadone simply enables
patients to continue their normal daily activities and routines at the level of their natural abilities. In
this respect, an individual stabilized on methadone is like the diabetic who requires insulin, the
person who takes daily medication to control high blood pressure, or the person who undergoes
regular kidney dialysis.

Lastly, persons who are stabilized on methadone do not develop a tolerance to the medication and
thus can usually be maintained on a given dosage indefinitely.16 As is well-recognized by the
medical profession, "the use of medications as maintenance for the control or suppression of
chronic illness and metabolic deficiencies is not unusual."17 Again, methadone is comparable to
other physician-prescribed maintenance medications, such as insulin, which make patients feel well
and function normally. Consequently, medical professionals concur that persons prescribed
methadone should be considered no differently than other patients receiving medical care.18


7 See A. Goldstein, Methadone Maintenance Treatment, Drug Strategies (1998); See also
Kalpana Srinivasan, Scientists Urge More Methadone for Heroin Addicts, Austin-American
Statesmen, December 9, 1998 (quoting Dr. Alan Lesher, Director of the National Institute
on Drug Abuse, that it is incorrect to regard methadone as a heroin substitute).

8 See Lowinson et al., supra, at 407.

9. J.E. Zweben & J.L. Sorensen, Misunderstandings About Methadone, J. of Psychoactive Drugs, July-Sept., 1988, at 275.

10 See Lowinson et al., supra, at 407.

11 See Institute of Medicine, Federal Regulation of Methadone Treatment 116 (R. Rettig &
A. Yarmolinsky eds., 1995) [hereinafter 1995 IOM Report]. Evidence suggests that most
cases of diverted methadone use involve heroin dependent persons who either lack access to
methadone treatment or who are prescribed inappropriately low doses of methadone for the
severity of their opiate dependence. See 1995 IOM Report, supra, at 113.

12 See N.B. Gordon, The Functional Capacity of the methadone Maintained Person, in
Methadone Treatment Works: A Compendium for Methadone Maintenance Treatment
(Monograph Series 2), (New York State Office of Alcoholism and Substance Abuse
Services, 1994) available at mono2.htm.

13 See Lowinson et al., supra, at 406.

14 Id. at 412.

15 Id.

16 See id. at 407.

17 Id. at 405.

18 M.J. Kreek & M. Reisinger, The Addict as Patient, in Substance Abuse, A
Comprehensive Textbook 822, 826-27 (J.H. Lowinson et al. eds., 1997).




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