Introduction

Welcome to the Methadone Information Exchange

Many methadone maintenance patients, myself included, have found it difficult to obtain reliable information on the drug that we must take every day to maintain our quality of life. Misinformation is rampant, and most of what is heard paints a negative picture of methadone maintenance treatment and those who participate in it. Rumors such as, "it rots your bones," and, "it's the same as using heroin," or, "they're still just trying to get high," are pervasive in society as well as within some areas of the substance abuse treatment profession. But the truths of methadone maintenance treatment are much more positive than what one usually hears.

Thirty years of research have proven methadone maintenance treatment (MMT) to be the most successful treatment for opiate addiction, resulting in the cessation of drug use and criminal behavior. MMT is more effective than abstinence oriented modalities such as 28 day treatment programs and 12 step groups alone, and with quality treatment patients can lead full, functional, productive lives for as long as they are maintained. Contrary to the common stereotype of methadone patients as unemployable, dysfunctional, "legal drug addicts", the real methadone patients are as diverse as any cross section of society; they go back to school, start families, obtain respectable employment, pursue hobbies and other interests; they disappear into the mainstream.

Despite the remarkable improvement methadone maintenance treatment brings to the lives of those suffering from opiate addiction, the delivery of treatment leaves much to be desired. Too common are the programs that base their treatment style on a concoction of War on Drugs morality and abstinence oriented techniques. Whether the fault of overbearing state regulations or misguided clinic policy, these programs ignore proven MMT protocols while staff act more like police enforcers than health care providers.

At some programs success is gauged by the size of one's dose, not by personal stability and productivity. Clinic staff express disdain for the medicine they dispense and the patients who depend on it. Counselors have been heard to say, "I have no respect for anyone on methadone longer than two years", and, "You're doing well, but I really thought you'd be on a lower dose by now." Patients are confused and feel pressured to reduce their daily intake of medicine, even though it may be inappropriate and dangerous.

Some programs limit the maximum allowable dose of methadone to an arbitrary amount, sometimes well below proven effective levels, making treatment almost worthless for many addicts. Other programs limit the maximum length of stay in treatment to as little as 6 months, discharging patients to face relapse, disease, and even death.

Exploitation of patients' dependance on medication is unethical in any medical field, yet it is business as usual at some MMT programs. Critical adjustments to a patient's methadone dose can be withheld until the patient jumps through the desired hoop. For example: "We will not correct your dose until you have attended three group therapy sessions". Sometimes medication is withheld altogether: "If you don't provide a urine sample right now you will not receive your medicine today." The message is, "We will deny you adequate medication in the hope that your suffering and fear will be great enough to compel you to do whatever we ask, because we don't have the time/money/staff/experience/training to treat you according to normal standards of ethical medical care." As a result, nurses and counselors can become corrupted by power, and forget, assuming they knew to begin with, that methadone is medicine, not a reward for "good" behavior.

There are many good methadone maintenance programs, but we need more. More access; more choices. There are less than 1000 MMT clinics in the United States providing life saving treatment to only 1/8 of the country's opiate addicts. The states of Idaho, Mississippi, Montana, New Hampshire, North Dakota, South Dakota, Vermont, and West Virginia do not have or even permit MMT. In states that allow MMT, the clinics are often far apart and have long waiting lists.

Advocacy groups such as the National Alliance of Methadone Advocates (NAMA) and their affiliates promote expansion and improvement of methadone maintenance treatment with emphasis on preserving patient's dignity and patient's rights.

Through education and advocacy, NAMA's goals are to:

• Eliminate discrimination toward methadone patients
• Create a more positive image of methadone maintenance treatment
• Help preserve patient's dignity and their rights
• Make treatment available on demand to every person who needs it

NAMA's strategies are to:

• Talk publicly about the productive lives led by people successfully maintained on methadone
• Establish contact with elected and appointed officials
• Attend community meetings
• Prepare and distribute educational material
• Participate in media interviews
• Create a unified voice with which to reach the public on all issues of concern to methadone patients

The Methadone Information Exchange (MIE), an affiliate of NAMA, is a patient run, patient oriented source of support and information for those involved or interested in MMT. MIE challenges stereotypes and misinformation by providing a place for MMT patients to be heard.

The Letters Page is a bulletin board type forum where MMT patients and professionals from around the world discuss issues, ask questions, share ideas, and offer support.

Filing Cabinet contains reference material organized by subject into 'folders'. Each folder contains links and/or original material related to the folder's subject. Subjects include Federal Regulations, Drug Interactions, and more.

MMT Directory is a continually updated list of all the methadone maintenance treatment programs in the United States. Invaluable for those seeking treatment or traveling patients.

Sites & Resources is a list of methadone related WWW resources (links, mailing lists, chat rooms), books and literature, newsletters, and more.

Much of MIE's content comes from readers. Please write with your ideas and suggestions.

This is your voice, so speak up!

Eric Peterson, Editor
Methadone Information Exchange
Jan. 27, 1999