(I’m dedicating this post to Bill, the Dad at the blog Dad on Fire. Keep up the good work Bill, and peace and safety to you and your family.)
Settlers of the American west learned that their best weapon against fire was fire itself.
Today, scientific researchers are studying the effectiveness of fighting heroin addiction by prescribing heroin.
What they are finding:
If you give medical grade heroin by prescription to people who are addicted to street heroin, they reduce or stop use of street heroin.
Um, wouldn’t it be better if they didn’t use heroin at all (you might ask)?
Of course. But the people eligible to participate in the studies are people who have not been able to stop using heroin even with treatment. All other treatment options have failed them, and they are looking for something that actually works.
Um, isn’t the whole point of heroin treatment to help people stop using heroin (you might ask)?
Of course not. The point of heroin treatment is to help people stop suffering harm associated with heroin use –more specifically, use of street heroin.
Most of the harm associated with heroin use is actually only associated with heroin acquired on the black market and consumed in the context of a raging compulsive and chaotic addiction. In comparison, much less risk of harm is associated with heroin acquired by prescription and consumed in the context of a drug treatment program under medical supervision.
It’s not demon heroin (or OxyContin or other pain killers), it’s demon addiction.
It’s hard to win the battle unless you can accurately name and recognize the enemy.
The pioneers faced their challenges head on. It took bravery and bold thinking to fight fire with fire. But when a prairie fire grew large and threatened to wipe out home, farm and family, that’s exactly what they did.
The settlers started their own fires. These small, controllable fires would consume anything flammable near the homestead. Deprived of fuel when it arrived near the homestead, the larger fire would either burn out or follow a different path away from the homestead.
I’m grateful for bold scientists, institutions, governments and people living with addiction who dare to try to fight heroin with heroin.
I’m grateful that they recognize that the ultimate goal is not to prevent drug use, but drug harm. I’m grateful that they care more about preventing harm to people who are living with opiate dependence than they care about controlling people with opiate dependence.
And I’m grateful that they are brave enough to pursue this goal even at the risk of criticism from those with less noble motives.
{ 3 comments… read them below or add one }
My son benefitted from methadone in that it helped him stabilize his life – stabilize is used loosly, more of a relative term. Through this form of treatment, he was able to maintain independent living and work. The difficulty, however, is that due to methadone’s long life in the body, detoxing became difficult. Ultimately, he needed rehab to help him get off it. From an addiction standpoint, M is more addictive than heroin. Time will tell if my son will get this victory. Too many ‘lost battle’ stories, I am a little weary of them. -CC
CC, Welcome and thank you for commenting.
Just to be clear about terminology, the term “addiction” implies compulsive use of a substance in spite of negative consequences. Methadone is taken as a medication in a healthy, non-compulsive way as a recovery support because of positive effects.
Having said that, it is true that the body becomes physically dependent on methadone in the sense that if methadone use is abruptly terminated, the body goes into withdrawal. This is true for many medications, of course.
Methadone withdrawal symptoms are more uncomfortable than heroin withdrawal symptoms for many people. The good news is that methadone doses can be tapered over a long period of time, such as six months, making the detox experience much less uncomfortable than a “cold turkey” detox.
I’m not trying to nitpick…it’s just that using the term “addictive” to describe methadone plays into the inaccurate idea that methadone treatment is “trading one drug for another” meaning trading “one addiction for another.” This idea contributes to stigmatization of methadone patients, and may prevent some people who would benefit from methadone from accessing a potentially life-saving treatment.
Blessings to you, your son and family.
Exactly right, Tom.
Many people believe that methadone is “more addictive” simply because the withdrawal period is longer. However, that is not what determines the addictiveness of something. Addictiveness is determined by the reinforcing factor in using it–by how intensely it creates a desire to use it again. Crack cocaine, for example, is intensely addictive even though the physical withdrawals are minor compared to many other drugs, because it creates such a strong urge to use it again–the high is so intense.
Methadone, on the other hand, is very slow to cross the blood-brain barrier. For this reason it provides no rush and a less intense high than short acting opiates. ANd for stable patients, it provides no high at all. When people leave methadone treatment and relapse, for example, they almost never relapse on methadone–they relapse on heroin or vicodin or oxycontin, etc–something that gives them that rush and intensity. If methadone were TRULY so much more “addictive” than heroin, why would people not relapse on IT instead?
Additionally, most folks have the idea that methadone treatment should not be open ended–that the patient should be on it for a short while and then get off. This is also untrue. Methadone treatment was never intended as a short term detox aid. The founders of MMT, Dole and Nyswander, knew from the outset that methadone treatment was aimed at correcting an imbalance in the brain chemistry–an endorphin deficiency–and that many patients would require long term–even life long–treatment to maintain stability, just as with any other chronic physical or mental illness. We don’t push schizophrenics to get off their medication, or manic depressives, or epileptics, because we know that if they do, the likelihood is that their symptoms will return. The same is true of this disease. 90% of those leaving MMT relapse within one year. Yet despite this statistic–and despite the fact that those who remain IN mmt have the best success rate of any treatment modality in existence today–people continue to push them to “get off that stuff” and get into “real recovery”.
The lives this well meaning but misguided advice has destroyed are many.