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Methadone Opiate Detox and Taper Realities
The following paper deals with the realities of methadone maintenance and detox. Please keep in mind I’m speaking from a NYC perspective; I’m told that clinics are run somewhat differently in other places. The information on the actual detox/ taper process is still true to the best of my knowledge,
A lot of this information on tapering is applicable to ANY opiate. One of the most crucial factors in a taper is reliable, constant access to your dose…and methadone clinic dosing does provide that. For those on other opiates, generally divide all time factors by roughly3- 4- i.e.
Heroin (partial antagonist) - withdrawals 4-6 days where methadone (full antagonist) is 12-14.
Time drug lasts in system: Methadone*(full antagonist) 24-36 hours – Codeine (partial antagonist) 8-12 hours. Most non-methadone opiates are partial antagonists.].
First; about me; (Savas) I’ve done a decent amount of research into methadone, its history, and its usage and effects on society. I’ll touch on this lightly here to give some necessary perspective, as to detox off methadone it helps to understand the nature of the beast you’re dealing with.
I’ve been dealing with the clinic system for nearly a decade, and have detoxed off twice. The first time was before I had all the facts and thus didn’t go to well (I lasted four months). This time I’ve had much greater success.
Part 1: General Overview of Methadone and the System
Methadone maintenance started to be used in the early 1970’s. It’s an easily controlled narcotic, cheap, and therefore was considered an excellent method of controlling addicts while making a profit off of them. It’s main supporters feel that addicts are incurable; they will always take drugs, and therefore why not have the state provide that drug, effectively controlling the addict population (and thus making a healthy profit off of their suffering).
Almost every study on methadone I’ve seen, dating back to the original Dole-Lysander study in the1970’s, is faulty. They make broad claims while deliberately ignoring real medical facts about methadone withdrawal, making such errors as improperly maintained control groups, questionable statistical variance, shoddy data etc... These studies are created to support the present system of methadone maintenance and create the illusion that any other methodology is ineffective. But, bad research is just that; Bad research.
Present day methadone detox is designed not around effective treatment, but around regulation and law. Therefore, with the present system, those attempting to detox are doomed to failure.
(The rules are often designed in such a way that even advancing yourself in life is near impossible; I’ve talked to many the person who has lost good jobs as a result of draconian clinic rules based on methadone control legislature).
You have to remember that to “the system”, you’re just a statistic. Unless you’re lucky enough to get that rare counselor who knows the truth and truly cares and takes a liking to you, you’re just one of many to be maintained and controlled. Even then the help and advice given is “off the record”. They’re limited in the help they can give by rules and regulations.
Their job is to give you your dose and depending on your behavior reward or punish you. People often complain that the system is infantilizing and this is true. After all, they have all the power. They supply the drug that you can die without (literally). Speaking out or objecting to the way things are will bring dire consequences. Often you’ll be “administratively detoxed”, a process which while legal is medically dangerous.
[Note: You CAN die from methadone withdrawal. There are cases in the court system right now of prisoners on methadone who’ve been tossed in solitary when incarcerated and dying from withdrawal. True, it’s often listed as “heart attack” or something similar, but it’s death by methadone withdrawal. Hopefully their deaths won’t be in vain and will lead to real change some day.
Also; administrative detox is a legal term designed to cover the clinic’s legal liability. It has NOTHING to do with drug treatment. It is merely the legally determined safe dosage drop to remove an unwanted patient. They’re aware that often patients being AD’d will seek alternate drug sources before the end, which also effectively removes any liability as well. It’s a cruel and inhuman process.]
So where does this leave you? Obviously angry and feeling betrayed over a system not designed to truly help addiction. However, I’ll tell you now you have to get past this fact. That anger is self defeating and will only lead you to certain failure. If you’re stuck on methadone maintenance, my only advice is to try to be positive and make the best of a bad situation.
(continue to part II for medical facts/ solutions)