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We have it from the highest level; methadone outperforms other treatment interventions. The Cochrane Collaboration study the evidence over the effectiveness of interventions and publish their findings. They’ve just published one on methadone.
It’s actually not new as such, but updated, but it does contain new studies up to 2008. What was the question they wanted to answer?
Do patients do better on methadone than when they go for other sorts of treatment? Mike Ashton, with input from David Best, has analysed the review nicely here:
Another question comes to mind for me though: what does “better” mean? What sorts of things are you going to look at?
For instance, is maintenance better than other treatments at helping people achieve the goals they set themselves? For instance, a drug-free recovery? The trials didn’t look at that.
Is maintenance good at helping people achieve not just the absence of pathology, but the addition of positive qualities to life? For instance, happiness, enthusiasm, integration, good parenting, hope, growth, jobs, education, volunteering etc. The trials didn’t look at these.
Did the trials compare maintenance with high quality recovery programmes using integrated services, evidence based psychosocial therapies, assertive referral to mutual aid, role modelling, recovery coaching and long term aftercare? No, they didn’t.
So are we any wiser?
I think methadone maintenance can achieve a significant number of benefits for clients; that it is good as far as it goes. For many of us who suffer from opiate addiction it doesn’t go far enough.
From a public health perspective and a criminal justice perspective methadone looks like good news. For an individual coming to services who wants to reach high and achieve a drug free recovery with much richness in life rediscovered is it really the best way? The evidence can’t tell us.
That’s why the Recovery Academy is so important to us. We need to find out what the evidence is for what helped thousands of us to recover and maintain enduring stable recovery.
I’m aware this approach can be criticised for being reductive; it’s not a question of just one way or the other, but we do need to be careful about research findings.
Methadone maintenance was not best for me; I have very good reasons to believe it would have imaired my recovery. It might not be best for others too, yet for too many in the UK, it is effectively what you get.
Methadone never worked for me, just kept me small and dependent not only on the drugs but also on the agencies that provided them. Abstinence-based recovery has given me freedom and self-determination.
“Methadone Is Not Best When It Keeps One Addicted For Decades”
Extract Research Notes;
http://www.drugaddictionrx.info/patient/methadonemedicine.html
By Peter Vanderkloot (Advocate For Peoples Rights)
Extract Para (1) Or Do I Emphasize Methadone The Institution-System Of Chemical Parole That Endevours To Keep 10s Of Thousands Of The Most Vurnable Under The Perverse And Avaricious Bureacracy ? Extract Para (4) The Reality Is Also; The System Through Which Methadone Is Provided Is A Uniquely Oppressive Bureacracy That Greatly Reduces The Benefits Of The Medication And Generates Harm Where None Existed Before,Methadone Is Itself A Tool Of Harm Reduction ,The System That Controls Methadone Is A System Of Harm Production. Para (6) The Most Obvious Harm Caused By The Clinic System Is Due To The Attendance Requirements. The Entire System Is Designed Around Observed Ingestion ,And Continual Monitoring.
I looked at the figures released by the Scottish Goverment at the end of the ten year ‘Harm Reduction’ Policy. They had shown that when the policy was first introduced in 1996 there were 140,000 individuals being prescribes Methadone. By the end of the ten year policy (2006) this figure had increased dramatically to 490.000+ being prescribed Methadone, as well as other substances. Bear in mind that Scotland has a population of around 6m, so i fail to see this as being the best tool to tackle addiction.
To much effort is being placed providing maintenance and not enough towards abstinence. I was told that my Methadone prescription was only to last for two years. During the 15 yrs i spent on Methadone i had never heard of abtinence, nor was i encouraged to aim for it, therefore i did not believe a drug free life was possible. I am sure i am not the only one that shares this experience.
Lol, i forgot to add my main point to the last post.
Methadone may the best for wider society, but as for the individual that has to endure more years than necessary sustained on methadone, i think not!
Kane I wonder if the numbers above are the number of annual prescriptions for methadone. The Scottish Government reckon that there are aound 24,000 people currently on methadone.
While methadone is a route to recovery for some, the deficiencies in our treatment system mean that effectively many addicts are “parked” on it with little effective psychosocial intervention. I’ve heard too many folk tell me that they didn’t know recovery was possible or that there were treatment options focussed on that goal.
That really is not acceptable.
