Do you belong to junkjunk.ning.com? I’d love to have your perspective and experience heard there. We have a Monday night chat you might enjoy too in the chat room.

I’ll try to get busy on number 9 and 10!

Thanks again and keep commenting!

If it’s not working (he is still using) I’d look at an increase in dose before deciding it’s not a good treatment fit…8mg is a moderate dose…16mg is a common dose so he has some room to increase his dose if needed.

Tell me more!

He is a hard core poly substance abuser, but primarily IV heroin, for 10 years. He has never but together any significant clean time. He got state insurance a few months ago, so he started seeing a psychiatrist. He also went to a 28 day treatment center after a brief relapse. Along the way he saw another doctor. All advise him to stay on Subox, 8mg/day, but he has got it in head to get off. I have some influence in that he values my opinion. I’m thinking I should encourage him to stay on it? Obviously, these professionals know he is very high risk.

As far as stigma…I don’t think people should even tell anyone. The all or nothing recovery is a huge myth, I myself was very biased against methodone/Subox. I know now it some addicts only hope.

I agree with the statement that MAT should be a “part” of recovery and that the others need to work in conjuction with MAT. I have always felt that MAT alone was just treating the physical side of the addiction. Counseling and 12 step type program needed to be utilized in conjunction with MAT to work on the mental aspect of addiction. One without the other is not adequate.

MAT w/o a recovery program means that even if you successfully detox off the methadone, the real reason behind your addiction is still there and your chances of staying clean are basically zero.

The same with the recovery program alone. I failed traditional treatment 4 times and I was starting to think I was hopeless! Within just a few months of getting out, every single time I would fail. Looking back now, I wish I had known about MAT then! I think I would have had a better chance of recovery if I had been on MAT along with the “traditional” recovery program.

I have been on MMT for 10 years now and while I never intended to stay on it this long, (I was an opiate addict for over 16 years) and I have family members who don’t understand why I am still on MMT and think I should get off. BUT I am not too niave to believe that I can get off MMT to please anyone else. It has to be when I am ready and again, I never intended to stay on it this long, but I remember what it was like to be an addict and if it means one or the other, then I will stay on MMT the rest of my life.

I also want to comment on what Zenith said about the clinic using your dose as a reward/punishment. You don’t know HOW MANY TIMES this has happened at the clinic I use to attend. It was so frustrating! Why didn’t they see continuted opiate use as a “problem with the treatment” rather than the pt misbehaving? I mean come on, that is the whole reason behind opiate addiction being treated with ORT anyhow, because we now know it is not a behavior problem but a real physical problem. So that says to me if someone is still abusing opiates, or starts testing pos for opiates after years of stable treatment, then something is wrong and their treatment needs to be adjusted.

My “couselings” sessions there were a joke! I was required to see the counselor once every 3 mths and all that consisted of was siging a treatment plan that they already had typed up by copying my last treatment plan. There is no real counseling that goes on there. (I get my counseling from an addiction support group and a 12 step program that I found on my own, but again, I would NEVER tell them I am on MMT because they think I should be free of ALL substances.)

This was also the same clinic that has a silent dose cap at 120mg. Long story short, I had been on MMT for 8 years at the same clinic and 120mg for over 5 years. I was a pt who never caused any problems, had not had a bad UA in over 6 years and even paid my clinic fees a year in advance with my income tax refund.

I was having actual w/drawals symptoms which the nurse documented in my chart and severe cravings. When I asked the doc to increase my meds, he refused and told me I had to have a peak and trough. I ahd no problem with that because I KNEW I was having problems and the test would prove it. My results were T 213 and P 508 which according to the info I had on P&T showed at the very least there was problem with a drastic difference in my P&T amounts. That he should have at least considered split dosing but he said I was OVER medicated and reduced my dose! I tried to show him the info I had gotten about P & T results, but he refused to even look at what I had. He misinterpreted my peak and trough to suit himself, reduced my dose and told me if I couldn’t be maintainted on 120mg then maybe it was time for me to get off methadone treatment.

Needless to say, I left that clinic. But that is the kind of things MMT clients face with clinics these days especially the for profit clinics. It sounds horrible of me to say this, but I felt like they were just a legal drug dealer. They could go up on their prices, they could withhold what I needed just because I didn’t do exactly what they wanted, they could increase my dose or decrease my dose based on what THEY wanted and not on what I NEEDED and what was I going to do? NOTHING! Because at 120mg a day, I am dependent on methadone and wouldn’t dare do anything to give them cause to kick me out or rapidly detox me.

On the same token, I am thankful for MMT. It gave me my life back when I thought I was hopeless and would never get better.

It is just sad that there can’t be some kind of “happy medium” where the clinics give the pts the respect they deserve and some control over their own treatment plan.