I also agree that there needs to be more to MMT than just “medicating” someone. There needs to be some type of counseling or 12 step type program so that the addict can work on the “core” issues which led to their addiction in the first place. Some ppl disagree, but I wholeheartedly think this is a major factor in recovery. The clinics that I have attended have all been “for profit” or private clinics, there are no “free” clinics or gov’t funded clinics anywhere around where I live. At one clinic I did feel that they were only interested in the money. The “counseling” sessions were done once a month which was required by the state and all it consisted of was signing a paper saying I had talked with the counselor. Half the time I never saws the same one anyway (the turn over was crazy) and I had already tried utilizing the counseling offered at this clinic and after going through all my “story” with one, I got tired of having to repeat it to a different one next time and there was no sort of rapport allowed to form in this type situation. However, the other for profit clinic I attended has the same staff that they had since they opened 8 yrs ago and you are able to form a counselor/pt relationship there that you can count on. The staff all live in the area the clinic is located in, so they have a stake in the patients that come through that clinic. While I have never attended a clinic that does this, I have heard that some clinics require weekly or biweekly sessions w/a counselor in addition to several group sessions as well. So I think it all depends on the clinic and what is behind the motivation of the clinic. I say all that to say this, there are good clinics out there and there are bad clinics out there. I agree that counseling and deep soul searching needs to be done in addition to the medication for a pt to get all the tools they will need for a real chance at recovery. However, there are problems with every type of program like this and while there are those out there who are just abusing the program, diverting the medication and still in active addiction, there are those of us who actually are trying to do the program right, keep our addiction in remission (because with or without methadone or other meds like suboxone) an addict will never be cured 100% from their addiction, It is always there, waiting for the first chance it can to poke it’s little head back out and gain a threshold in the addicts life again. I don’t care if you have been totally off any meds and drugs for 40 yrs, you are still only in remission.
I would much rather be able to keep my addiction in remission without any type of medication, but that isn’t possible for me. So in the end, I would much rather be on MMT and be able to keep a handle on things, work through my issues without having to deal with the cravings and withdrawals, and live a more stable life with my husband and our two boys, even if it means staying on methadone for the rest of my life. The alternative to that is so much worse.

Your comment raised some red flags for me, so I hope you will allow me to challenge you a little, gently I hope!

Yes, there are many people in recovery for addiction to heroin or other opiates who did not use methadone in their recovery. That’s great for them. But there is a temptation for family members and even treatment professionals to use this fact to shame people who really do need long term methadone treatment. Reading between the lines of your comment, I suspect you are not happy with your loved one’s path to recovery. I hope you have read 10 Things You Should Know About Methadone. And I hope you will be very careful that you don’t allow your discomfort with MMT to become a barrier to your loved one’s recovery –especially since MMT appears to be working.

Your loved one should not need to prove that MMT is “completely necessary to treat heroin addiction,” that their “brain is forever damaged” and therefore will always require MMT, or give you any other “line of defense.” Your loved one is an adult and their path to recovery is their own. Chances are your loved one tried many options (home detox, counseling, rehab) before even considering MMT. MMT is a lot of work and often a long term commitment. It’s not something most people want but rather what they eventually conclude they need. If MMT is working for your loved one, please offer them your enthusiastic support.

I have worked with hundreds of people who are opiate dependent for over 10 years. Recovery is a process of finding what works for each person. Some people can quit on their own. Others need counseling. Others need short term residential treatment. Others need long term residential treatment. Others need methadone treatment for 2 years. Others need methadone treatment for decades.

Treatment for decades is okay too. MMT is well studied, and many people participate in MMT for decades with no significant side effects.

For many people, methadone is the only realistic path to recovery. It is the only thing that works. And since it works, those who require a further “defense” (why are we having to defend an effective treatment?) might be wise to reflect on why they feel that this path isn’t good enough. The goal of the reflection would be to figure out if the feeling is based on what works best, or is instead based in social stigma relating to “addicts” and judgments about the moral superiority of recovery via 12 Step Meetings versus recovery via medication-assisted treatment. This matters because your negative feelings about MMT may influence your son or daughter to give up an effective and possibly life-saving treatment.

Thank you for your comment. It’s clear you care enough to think, read and wrestle with this. I care enough to give you my best response even if it challenges you a little. If you still need to continue this dialogue, please comment back to me. This is important. Best of luck to you, and your loved one.

Though I understand Debby’s desire to see her son well and whole again, referring to methadone as a “frickin’ poison” to be “purged” from his body shows that she is still unclear on the concept of MMT.

For example–if a diabetic, whose life had been saved by the administration of daily insulin injections, unexpectedly found themselves without their insulin one day–let’s say they went camping at a remote locale and forgot to bring it–they would quite naturally become ill. They have a chronic illness and their body depends on the insulin to keep them stable. They would experience severe symptoms and would have to cut their trip short to get back to the drug that sustains them. In that case, would the family members of the patient likely say “I hate that fricken’ poison” in reference to the insulin? No. They know that the medication is not the culprit–it is treating the disease that is the culprit and keeping it in control.

Certainly it would be nice if no one needed any kind of medication and no one were ever ill. However, for most chronic illnesses that require long term medication, people do not view that medication as a “poison”, but as a lifesaver, allowing them to have their loved one around and stable.