Letters Page #986

Subject: RE: #971, Does it ever END?
From: methinfex@mindspring.com
Date: Apr. 28, 1999

Lynn and Jimmy,

People can and do remain drug free after stopping methadone maintenance treatment, but the big question is: how long does it last? The sad fact is that the longer one has been out of treatment the more likely he/she is to relapse. The "State Methadone Treatment Guidelines" (CSAT TIP #1), page 30, says:

"Although short-term abstinence is common, it appears that only 10-20 percent of patients are able to achieve long-term abstinence once methadone maintenance is discontinued."

I don't know how they've defined "long-term abstinence", but I recall other statistics (which I can't refer you to because I don't have them in front of me) showing most people relapse by the end of their first year of abstinence. As the years go by the number who remain abstinent steadily declines.

Is this a reason not to try to withdraw from methadone maintenance? Not necessarily. Rather it is a reason to not beat oneself up if a withdrawal attempt fails. It is also a reason for treatment providers to support those who choose to remain in treatment or are not ready to withdraw. It is why the family and friends of an addict need to be supportive if their loved one does not feel ready to leave treatment. Also, methadone programs need to make it easy for former patients to return to treatment with a minimum of hassle, and without reinforcing feelings of humiliation and failure.

Regarding the few who do achieve "long-term abstinence", the "State Methadone Treatment Guidelines" says:

"The psychosocial characteristics of those who are able to successfully discontinue methadone maintenance treatment have been studied, with the aim of assisting others to get off methadone. Remaining opioid-free requires addressing personality patterns, family issues, job skills, friendship patterns, health practices, and recreational activities, among other issues."

My partner withdrew from methadone maintenance treatment about three years ago and has been doing well ever since. I know first hand that it can be done, but for one of her I know countless others who were not so lucky. Many who were stable and doing well while on methadone returned to drug use after leaving treatment. Some overdosed and died. Some made it back into treatment and are doing well again. Some are too ashamed to come back.

You may not believe that addicts and alcoholics are "different", or need anything more that will power to overcome their addiction. But this is not an issue of belief, as are UFOs or little green men. The hard, unwavering, scientific fact is that there is indeed something "different" - something out-of-kilter - in the brains of opiate addicts (and alcoholics) that no amount of will power can correct. Methadone, however, does correct the problem, and does it well: studies show that MMT is the most effective form of treatment available.

I congratulate your husband for his success in tapering his dose. It is a difficult thing to do. I urge you both to take it slow. If your husband feels any discomfort or drug cravings stop the taper! Wait for his body to adjust before continuing. He may even have to raise his dose a little in order to stabilize before he can continue.

There is a guide called Coming Off Methadone at Rose Withers' site Heroin Addiction - An Addicts View, which you might want to explore.

Good Luck. It can be done, but the outcome very much depends on the individual, and sometimes it takes a few tries. Maybe a good approach would be "expect the best but prepare for the worst!"

Sincerely,

Eric Peterson, MIE