More on methadone

An article I linked to in my last post referred to Neil McKeganey as a critic of methadone. I wasn’t sure that was a fair characterization, but this editorial makes it clear that he is a critic. While he’s sometimes dismissed as a critic, I haven’t seen criticism of the methodology of his studies. This editorial is worth a read. Here’s an excerpt:

Methadone will undoubtedly continue to play a role in our drug-treatment services, but not as a drug provided for ever-increasing numbers of users for ever-lengthening periods, with little or no expectation of their eventual recovery.There is in the world of drug-abuse treatment a division between public knowledge and private knowledge, exemplified in the following conversation. I was speaking recently with one of the UK’s top medical advisers on drug addiction. We were discussing methadone when he said that if his daughter had a heroin problem, he would do all he could to get her into a residential programme.

“When I am prescribing methadone in my day-to-day work,” he said, “I know in my heart of hearts it is not a solution to the individual’s drug problem but the only option I have for the majority of addicts I am seeing”.

There is a simple truth here but one that is rarely shared, namely that methadone has all too easily become the drug-addiction treatment for the masses. There are no superstar heroin addicts or drug-dependent doctors signing themselves up for long-term methadone programmes. Residential rehabilitation is the gold-standard treatment for those who can afford it or those who are lucky enough to get it on the state.

Our masses, however, need more than the cheapest treatment if they are to live a life that is not dictated by the rhythms of their drug addiction. What they need are fewer drugs and greater support in their attempts at remaining drug free. And that is no quick fix.