Recovery-oriented Methadone Maintenance, part 5

Bill cites a methadone advocate making an important distinction–treating dependence vs. treating addiction.

The stigma attached to methadone is also shaped by the expectations of methadone treatment as a system of care. Methadone advocate Walter Ginter comments on such expectations:

Patients, former patients, staff, policy makers, and the public expect the methadone treatment program to treat addiction. While that is a reasonable expectation, it is not what Opioid Treatment Programs (OTPs) do. OTPs treat opiate dependence, and they do it very well. Most patients on an adequate dose of methadone do not continue to use opiates. However, opiate addiction is more than dependence on opiates; it is dependence combined with a series of behaviors. OTPs (with a few exceptions) do not treat the behavioral aspects of addiction. The behavioral aspects are not treated by a medication but rather by counseling, therapy, peer recovery supports, and 12-step groups. As long as well-intentioned people go around saying that “methadone is recovery,” it is going to continue to be misunderstood. Methadone is a medication, a tool, even a pathway, but it is not recovery. Recovery is a way of living one’s life. It doesn’t come in a bottle.547

5 thoughts on “Recovery-oriented Methadone Maintenance, part 5

  1. "Methadone is a medication, a tool, even a pathway, but it is not recovery.." Although methadone can help treat opiate dependence, it seems as if users of methadone can also be dependent on it.

  2. so when people use methadone as a medication, a tool, and/or a pathway to recovery, and consequently are able to live their lives in a manner consistent with recovery – why won't others in the recovering community accept them as recovering?

  3. That's what I've been trying to explain in some of the other posts. Maybe I've failed.Much of the recovering community believes that its survival as a community depends upon unity. This is why people who identify as in recovery from other problems (sex, gambling, stealing, spending, food, etc.) are not thought of as part of the community. The same goes for people with drinking problems who have found other paths to resolving their drinking problem–moderation, church, psychotherapy, etc. This reluctance to accept them as "one of us" isn't evidence of animosity or condemnation. Rather, it's the sense that you and I don't share a common solution to a common problem.

  4. One more thought. At this point, my recovery would probably be unaffected by the presence of MM patients in my community of recovery. However, I've been in recovery for nearly 20 years. What might it mean for the recovery of an opiate addict in the early stages of drug-free recovery (days or weeks) to be hanging out with MM patients? Its easy to imagine that being difficult for the MM and drug-free people in the early stages of recovery.

  5. Many, probably most, people who are in abstinence based recovery have tried unsuccessfully to use chemicals in the manner that MM patients do. For many people who are in abstinence based recovery successful maintenance was a fantasy that had to be destroyed as a prerequisite to the painstaking process that recovery requires. Abstinence is therefore perhaps the most important value in the recovering community. Reinforcement of this value is one of the key functions of community.People in abstinence based recovery, especially early recovery, can not afford to debate the necessity of abstinence.MM can be perceived as a threat to this value. A community of abstinent people in recovery might also threaten MM patients, but in a different way (it might also provide hope).It is hard to imagine reconciling these two. MM patients should not be demonized or stigmatized by the recovering community, they are victims. MM providers are at the root of the problem. They offer false hope to many more people than they help.

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