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Conservatives question methadone maintenance (UK)

phr

Ex-Bluelighter
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The policy of giving problematic drug users the heroin substitute methadone – a cornerstone of official efforts to cut the huge amount of crime linked to illicit substance misuse – is being criticised as a waste of money that does little to wean people off drugs and leaves too many of those receiving regular doses of the green liquid living "half-lives".

The fact that David Cameron, during last week's televised party leaders' debate, voiced his concern that too many problem drug users do not manage to shake off their addiction shows that the issue has attracted attention in high places.

A coalition of opponents of methadone maintenance includes the Centre for Policy Studies rightwing thinktank, leading drugs researcher Neil McKeganey and, most ominously for the vast majority of workers in the drugs field who are pro-methadone, many senior figures in the Conservative party.

There are an estimated 330,000 people in England alone who are addicted to heroin, crack cocaine, or both. They are extremely challenging, cost the country an estimated £15bn a year, and commit an estimated £13.9bn of crime annually. A record 200,000 of those 330,000 are in treatment, which usually involves methadone. Drug treatment has expanded in recent years, with around 11,000 drugs workers in England and at least 1,000 drug projects across the UK, variously funded by the NHS, councils, the police, charities or combinations of some of them. Some £800m a year is spent on drug treatment, half of it by the NHS's National Treatment Agency for Substance Misuse.

The Tories want an overhaul of the system, with many more people going into residential rehabilitation and making a serious effort to become drug-free, and fewer being given methadone.

"Methadone maintenance is under the spotlight," says Martin Barnes, chief executive of DrugScope, which represents about 700 local drugs agencies. "There had been differences of opinion in the field for a while because some people weren't comfortable with methadone maintenance."

Their case has been bolstered by the cross-party public accounts committee, which two weeks ago issued a highly-critical report, called Tackling Problem Drug Use. It said that just 15,000 of 165,000 problem drug users who underwent community-based treatment last year emerged free of dependence. In addition, it said it was "unacceptable" that the Home Office had not properly evaluated whether key elements of its £1.2bn-a-year strategy to tackle drugs misuse in England actually worked, and did not know if that strategy directly reduced the huge cost of crime committed by addicts.

"The department [Home Office] does not know how to most effectively tackle problem drug use," the MPs said, before adding that "residential rehabilitation may be effective for those who have failed to 'go clean' in other forms of treatment". That is what the Tories want more of.

The gathering storm over methadone began in late 2006, when former Tory leader Iain Duncan Smith's Centre for Social Justice thinktank published its Breakdown Britain report.

Partly informed by Duncan Smith's scathing critique of methadone, the Tories have in the last two years attacked the reliance on methadone to treat large numbers of addicts as "failed" and "wrong". Shadow justice secretary Dominic Grieve, for example, has claimed: "The government's approach of trying to 'manage' addiction is an admission of failure."

David Burrowes, a shadow spokesman on criminal justice, is one of the Tories who have been consistently questioning the cost and efficacy of methadone treatment, both in the community and in prisons. "It's not for me to cast moral judgments about whether methadone is wrong or right," says Burrowes, a former criminal solicitor whose interest in drugs policy developed from seeing clients with chaotic or ruined lives fail to kick drugs. "We need to look at outcomes, and the outcomes are just not good enough.

"The public expect that addicts have to get off their drugs, but too many end up parked up on methadone. They become dependent on it and end up not being able to contribute to their families or society. I've seen too many individuals on methadone who are living half-lives, and that's not good enough." Burrowes also claims that it does not cut crime – the main justification for the policy.

The Tories want much more effort put into getting drug-using offenders to go clean – what they call "recovery" – and their manifesto proposes abstinence-based drug rehabilitation orders. But some say that is a simplistic response to the complex problem of opiate dependency. Defenders of methadone point out that the policy was introduced by the previous Tory government as a vital harm-reduction measure.

Roy Robertson, an Edinburgh GP and ex-member of the Advisory Council on the Misuse of Drugs, is dubious that abstinence will work for many users. "Most governments have endorsed methadone treatment, not because they liked the implications that drugs are only controlled by this palliative method, but because there are few alternatives," he says.

Barnes argues that every drugs worker wants their clients to get clean, and the "maintenance v recovery" debate is a polarised argument that doesn't help anybody. "The evidence is that methadone is a very effective treatment for helping many people out of their chaos, such as cutting crime," he says. "It stabilises people and helps them re-establish relations with their family."

DrugScope is calling for a balanced treatment system tailored to the needs of the client, incorporating both maintenance and abstinence options.

It is hard to predict what a change of policy under the Tories would mean. While some addicts would accept a place in an abstinence-based rehabilitation centre, many would not. "If there's a shift away from methadone, and spending on services offering maintenance [through methadone] is cut, the danger is that drug users might vote with their feet and drop out of treatment or not come forward in the first place," Barnes warns. "It's a major attraction for heroin users going into treatment that they'll be offered a methadone script."

Link!

Will Conservative plans to overhaul heroin addiction treatment work?
Denis Campbell
Guardian.co.uk
4.20.10
 
"It's a major attraction for heroin users going into treatment that they'll be offered a methadone script."
.... As far as I'm aware, a great deal of Heroin addicts would rather not touch Methadone. I'm one of them. They'd much rather choose Buprenorphine. Infact there should be more than 2 options available to them. Heroin prescription isn't widely practiced when it should be.
They should also be more willing to practice DHC maintainence and even Codeine maintainence.
I'm going to ask my doctor about trying out a twice daily dose of Codeine as I feel it would work much better for me personally than any other type of replacement therapy.
 
"The public expect that addicts have to get off their drugs, but too many end up parked up on methadone. They become dependent on it and end up not being able to contribute to their families or society. I've seen too many individuals on methadone who are living half-lives, and that's not good enough." Burrowes also claims that it does not cut crime – the main justification for the policy.

A. It's been pretty obvious for ages that methadone is a maintenance substance, as a device for weaning physical dependence, it is no more effective than any other long lasting opioid.
B. See what kind of half-lives they live without MMT available.
C. I honestly don't know how you can claim it doesn't reduce crime. Perhaps not all that significantly, but fact of the matter is that some people use methadone as intended; were they not using methadone they would be using heroin, and a portion of those would commit crime in buying and paying for said heroin. It's irrelevant to me though, it seems like public attitude in Britain is getting more and more stupid and blatantly manufactured. Is there something in the water?

Also Ibogaine is such a crock of shite, and I am so tired or hearing hippies offer anecdotal evidence of it's wonders. Maybe it works for some, it certainly doesn't for others, but it's killed quite a few people. So has methadone, but one is medically researched, where as most medical researchers wont touch Ibogaine with a ten foot stick. I know argumentum ad ignorantiam doesn't invalidate your argument, but how exactly do you suspect Ibogaine "cures" opioid addiction?
 
See what kind of half-lives they live without MMT available.

I remember when I was a teenager and my father was going on one of his rants about how he quit alcohol and tobacco without any help (even though he never quit alcohol, just cut it down to less noticeable levels). He told me that heroin addicts didn't need methadone and that addiction can be overcome with thought only. He also went on ranting about how he was given morphine in the hospital after surgery and he didn't become a raging addict and need methadone.

8)

Years later, as his unbeknownst-to-him-heroin-using son, I hate him so many worlds more for saying that. At the time, I had never even touched heroin. To this day, I have still never gone through withdrawals because I've never used more than once or twice in a week. Notwithstanding that, my interest in pharmacology started in my teens, and I knew that he was full of shit.

Now, as a chipper -- who has felt the unimaginable pull that heroin has, has friends in the scene, has friends who have relapsed over and over again, and has friends who are being held in a functional life by methadone -- I know for a fact that he's full of shit.

All that these idiots have been taught is that heroin addicts are evil people who can't be helped and are just bound to be homeless criminals that we should lock up. :X

Maybe if governments across the world stopped pretending that they were stopping addictions by controlling drugs, we'd start seeing less of these "half-lifes" and more productive people who don't lose their careers and lives to unaffordable addictions.
 
Government ought to do more to subsidize Suboxone rather than Methadone. And without either, well... other than the few who taper down with kratom using extracts (yes it's possible, I did a 2-week taper of plain leaf kratom to get off 80mg/day oxy, and now I'm completely off.) If you have a decent tolerance, you can start with the potent liquid extract, then UEI, then finally plain leaf. By the time you get through, you'll be amazinged by how benign the withdrawal is. To be fair, I think the majority of MMT/Sub patients feel that switch was better than returning to their original DOC. Kratom has a lot of research available - almost too much, causing information overloads. If there's enough interest in me writing up some taper schedules based on what has worked for me, I'd be happy to do it.

I watched a documentary called Methadonia. One guy had been going to a single clinic since the early 1970's. I really can't imagine spending the rest of my life doing that.
 
This type of thinknig makes me sick...Seriously, I usually feel like I seen so much ignorance that it dont faze me so much these days, but this shit is just, Damn. Makes me....furious.

First of all, 200,000 of 330,000 are on methadone?? Do you realize that that means that almost TWO THIRDS OF YOUR ADDICTS ARE IN SOME FORM OF TREATMENT??

Holy shit, that is a GREAT success....The fuck are they complaining about?

Second, they want to focus on "recovery" which apparently to them has to equal abstinence 100%....Well, think about it for just a second, and realize with yall ignorant, stupid asses that addiction has TERRIBLE recovery rates, and hardly anybody ever fully recovers, and the ones that do have long periods of sobriety and success usually do it with methadone or suboxone, some kind of maintenance therapy whether its long or short term....You much less likely to succeed even at KICKING nevermind stayin clean for any noticeable amount of time, doin it on your own without replacement meds. Its just ridiculous--if u can take away the pain and physical suffering and struggle, it makes it that much more bearable to get thru the beginning which can be the hardest part. People say fuck it and get high becuz there aint NO REASON TO FEEL THAT WAY (sick) when you could be feeling better--and the choice is to do it with heroin, methadone, or sub. Its gonna be one or the other or the other, so might as well leave that option for addicts so they can commit to gettin clean or just gettin better off than they are, becuz if not, the pull of gettin well when you are sufferin like that is too strong. Most people cant, or just straight up dont want to, kick cold without nothing to help.

They are insisting they need better statistics, that not enough ppl is stayin clean long term "FOREVER"...maybe this is news to them, but you cant expect to have some kind of recovery rate even higher than 50%, look at the statistics for long term, permanent sobriety w/out relapsing....They are so small...And that just a fact of how addiction is...But if you count people on maintenance, people who use but way less frequent and maybe just "relapse" from time to time (I rather call it a informed decision to use in a controlled situation, becuz unlike the bullshit gospel NA stays preachin, some addicts CAN go back and get high once in a while, while still stayin clean for 99% of the time , so I dont think its fair to call that a "relapse" if it aint a mistake and its a conscious choice that is followed by gettin right back into the 'clean' lifestyle the next day. And ive done it, so i know other ppl can too.) But anyways...My point is that if you are lookin for pure, totall 100% abstinence from all drugs MMT and SMT included, you will have TERRIBLE rates of success...but incluce ppl on maintenance and shit like that and it looks alot better. Still not great , but better . And if you include the people who cut down a huge amount from their use, and manage to just chip or stay clean most of the time but still go back now and then, but still spend 90% of their time clean, well shit, thats better than bein a fulltime user too, aint it? If u counted all those ppl, and the ppl gettin help from maintenance therapy, the numbers would look alot better, but no it got to be some unrealistic kind of shit that will never happen.

They aint gonna force addicts to do it "their way" by takin away some of the only things that can help long term "hopeless" addicts live a half way normal life. Compare the life of a career dopehead with a methadone patient. Now tell me that the methadone is a mutha fuckin ' half life'.....Please....I think its up to the user to judge the quality of their life, and maybe to them, just bein off dope and chillin for a little while is damn satisfying for the moment. Maybe they are happy as shit in that "half life" so nevermind that, bunch of uneducated, simple-ass politicians makin a problem outta one of the only well known, well proved, decently effective solutions.

you cant expect fuckin miracles yo--do the people talkin all this garbage even know anything at all about this shit they judging? Any person educated on drug use and addiction with a 2 year college degree could tell them that to expect the things that they are demandin is just straight up foolish and totally unrealistic.

I would love to see how the crime goes up and how the problems with addiction increase once they take away methadone programs. Do you really think that takin away that lifeline will force addicts to get clean, and 'teach them a lesson', that they can do it without all these 'addictive drugs that just trade one addiction for another'? No, lots of them will just get back on dope. Its so fuckin simple, and I really feel like these folks must be retarded , that they could miss these extremely obvious, simple truths about the situation.

I could go on about this shit all day but Ill finish it up, but for real....This article is just so full of shit its hard to know where to begin or end...
 
How about we as a community help people with benzo needs as well. That's right, Benzodiazepines. Scrub that; repeal all drug laws altogether so we can make our own minds up as informed adults - about any drug. If you're an opiate user, you get a methadone/bupe script and a reduction program and all the other fucking thrills. As a benzo user, you're in the gutter mate.

As a long term benzodiazepine-dependant person, you get kicked out of doctors surgeries asking for a serious reduction program. I have engaged with Drug Intervention Programmes in my area and they treat you like a fucking criminal; you'll get counselling for six weeks and maybe some referral to a CBT group. I have no respect for any of these lawmakers ridiculous policies and their civil servants, and I don't recognize their laws.

Fuck the law, let's take our freedom back.
 
You see, the main problem (aside from this subject being from the dark ages) is that most people simply refuse to accept personal responsibility for anything. Fucking retards.
 
Government ought to do more to subsidize Suboxone rather than Methadone. And without either, well... other than the few who taper down with kratom using extracts (yes it's possible, I did a 2-week taper of plain leaf kratom to get off 80mg/day oxy, and now I'm completely off.) If you have a decent tolerance, you can start with the potent liquid extract, then UEI, then finally plain leaf. By the time you get through, you'll be amazinged by how benign the withdrawal is. To be fair, I think the majority of MMT/Sub patients feel that switch was better than returning to their original DOC. Kratom has a lot of research available - almost too much, causing information overloads. If there's enough interest in me writing up some taper schedules based on what has worked for me, I'd be happy to do it.

I would like to hear about using krantom to taper from Opiates! Please post it!
 
this will never happen its just the tories drumming up support off the "blue-rinse brigade" middle classes. some comments from the u.s.a and elsewhere on BL amuse me, as they think the U.K. has some enlightened drug policy with regards diamorphine scripts. This is certainly not the case and the amount of addicts out of the 350,000(ha,ha figure imo) that get goverment funded heroin on tap is less than 700 patients i believe. the only real choices for maintenance here are meth and buprenorphine(luckily suboxone is not prescribed)
 
Methadone sucks.

I think the government should issue heroin to get people off Methadone. It would be safer and easier to ween people off of and they would actually enjoy it more with less risk. Heroin used to be a medicine you know.


Its all about the stigma...Methadone wasnt the street drug. it wasnt demonized like heroin was....so forget about the science and go with whatever is more acceptable sounding at the time.
 
I dont really think it sucks at all.....It was the one thing that made it possible for me to get off heroin. Methadone works for the longer-term addicts, people who have tried other options before, repeatedly, and it didnt work for them. Methadone aint a good choice for people who dont got long term habits, or people who got small habits. If you aint been in it AT THE VERY LEAST a couple years, 5+ or so, and if you aint already tried shit like rehab, detox, suboxone, etc, then you probably wont benefit as much from methadone as somebody like me or others in a similar spot.

BUT, If you are a person who tried, tried, and failed to get clean in other ways and just kept fuckin up, kept relapsing, and feel like you at the end of your rope, methadone is probly gonna work for you.

I dont know about other ppl, but I needed to be on a opiate 24/7. Bein on a long acting opiate like methadone let me have a normal life and do all the shit that I did before bein a dope addict. It is the medication that treats the "disease" of addiction. I dont believe in that disease idea, but say you do. Most people promote that idea.

So, if its a disease, then why cant we use a medication to treat it? Methadone and suboxone are the treatment medication that treats the disease, so why is it looked at as such a bad idea?

Im just puttin shit out there, like i said i dont believe in the disease addiction model, but thats for another thread.

Im just sayin. A drug that has allowed millions of people to recover into a much more normal life and be happy really dont "suck." It would be great if we had better options. But for now, methadone is a drug that really helps alot of the "hopeless" "shoot dope til i die" "gave up" addicts find a new and better life, so it cant be all bad, i can testify that shit my self . Just puttin a different opinion out there. And becuz it does that, is all the more reason why it needs to be open and available to the ppl who needs it.
 
This is one of the tories most absurd policies to date - and that's really saying something! Imagine what would happen if a party formed a policy to try and get patients off medications for other chronic illnesses like depression or high blood pressure. They would be rightly pilloried and ridiculed. Why then is it OK then for politicians to meddle with the treatment of patients who are addicted to opiates?

"It's not for me to cast moral judgments about whether methadone is wrong or right," says Burrowes

Actually it's the tories' puritanical ethics and prejudice over drugs and addicts that lie behind their criticism of methadone. Luckily, even if the tories do get in, the policy's so unworkable that I'm sure it'll be quietly swept under the carpet in no time.
 
I heard the WDs from Methadone are worse and longer lasting, and people are more likely to OD because they dont get as much euphoria so end up over sedating themselves trying to get the same high....it does help the WDs though.


The advantage of course is that its a controlled carefully measured tapering dose....that is the good part about a methadone program, and yes that can help.

Still, some of the other options sound a little better. Europe seems to be ahead of us in drug treatment options.
 
Methadone is a harsh addiction and its a swap. I wouldn't say it sucks as it has kept alot of people alive but I think with the advent of buprenorphine there is a better way [which in better I mean less physically addicting] method to treat opiate addiction. I was on methadone for 2 years, impossible for me to make a clean break from 'done. It was a rough, rough time trying to taper off. I was alot younger than so my thinking was definitely different but I don't know. Plus now with buprenorphine out there it makes it much easier for people to consider switching from meth to bupe.

I cant wait till somebody comes out with a Suboxone documentary.

Here is a link to the documentary someone mentioned above, Methadonia. Which is pretty good. Alot of benzo talk and I hate the way they pronounce methadone.

http://video.google.com/videoplay?docid=5888306773553221655#

peace,
seedless
 
The consequences of stopping methadone prescriptions or reducing a patients dose can be terrible. Patients will either turn to illicit opioids usually heroin, where their reduced tolerance puts them at risk of OD, or they will go into withdrawal.

Methadone patients who've had their prescriptions stopped, often a punitive measure for positive urine samples, suffer such severe depression when they go into withdrawal that some are driven to suicide. The fact is that methadone is a life saving medicine for many patients.
 
I dont mean to insult you, but when you deliberately spell words wrong while trying to make your point you end up discrediting the position by making it look stupid. There are some very good arguments for legalization or decriminalization or perhaps just for more humane methods of regulation which would include utilizing rehab over prisons for non-violent offenders. When you come in with a post like "y dont they just leave people alone and totally legalize drugz " nobody is going to take that seriously, including most other drug users.
 
conservatives question methadone maintenance (UK)

Methadone saved my life..and Suboxone is a good friend of mine. I am a recovering herion addict and I am sure I would be dead by now if it was not for Methadone. It helped me to live a some what "Normal" life. I only had to spend 80 bucks a week rather then 300.00 a DAY.........I am glad to say that I am now off both of these drugs. I felt a relapse coming at me a month ago, I got my ass to Dr. I am now taking Vyvanase for ADHD. I am sure the ADHD is responsible for all my insanity over the past 35 years. I always seem to be on the right path when I am treated for the ADHD..Docs are getting hard to come by. So now that I found one to treat me with out givin me a bunch of bullshiit I am a happy girl. But they should never cut the cord on any Methadone clinic, infact they should build more buildings and let them open clinics just like gas stations.........there are more addicts out there then we even know....Closet addicts, ashamed, and not ready to admit to them selfs that they are out of control and need help......I was lucky the obsession has lifted for now and I can live easy today:)
 
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