Crankinit
Bluelighter
- Joined
- Sep 17, 2007
- Messages
- 6,175
This analogy would be valid if opiates were directly toxic, but the reality is that the damage opiates do to an addict's life are secondary, in terms of money spent, acts committed to obtain that money, broken relationships, etc. While obviously the ideal situation is that the addict would get totally clean and quit drugs entirely, that's never going to happen in a lot of cases, and in those cases maintenance is a good middle path, to free them up from living the active 'addict' lifestyle while allowing them to make the necessary changes to fix their life so they can reach the stage where they no longer feel the need to be on opiates all the time to function.
It also makes the transition a lot easier for the addict, going cold turkey and dealing with withdrawals, then post-acute withdrawal syndrome, all while trying to totally change your life around, would be really fucking hard, and maintenance allows the addict to deal with changing their life, then to slowly come off the drug when they feel safe to do so.
One point I do want to make which I feel is an absolutely valid criticism of the maintenance system is the tendency to park patients on maintenance and simply leave them there, as if methadone or buprenorphine were in themselves direct cures for addiction, which of course is not the case. What needs to happen is that the patient needs to undergo further, ongoing treatment to look at the underlying cause of their addiction and help them address it and turn their life around, but it seems that this rarely happens. If it doesn't, they usually end up eventually getting high on top of their maintenance, or swapping over to getting high on a different drug, and just stay on maintenance year after year without being given a chance to take advantage of the opportunity maintenance has given them.
I'm not saying long term maintenance is necessarily a bad thing, nobody turns their life around in a day, and some people in the end will always need that little bit of chemical stimulation to make their way through life, and there's nothing wrong with that. But just parking people on a daily dose and then leaving them to keep on living the way they were before, without taking any effort to figure out why they ended up needing it in the first place, is a copout and sells both society and the addict short.
Nobody just wakes up deciding to become an addict, almost all addicts are trying to self medicate some physical or psychological problem, but not taking the time to find and address that problem means they're not much better off than they were before. Sadly this doesn't happen very often, I think both because of a lack of funding in public healthcare programs and a distinct lack of understanding about the way addiction works among those who make the decisions. There's this attitude where people seem to feel that simply throwing an addict on methadone will fix them, but it doesn't work that way because addiction isn't a conventional illness. Maintenance serves a purpose in providing stability for the addict while they try and sort themselves out and improve their life, but it is not in itself a cure and shouldn't be treated like one. A means to an end, not the end in itself.
So yeah in short, I think maintenance is a good first step to take if an addict wants to try get their life under control, but it is not in itself a cure and shouldn't be treated that way, and more should be done to help patients address the underlying cause of their addiction so they can, when they feel ready, come off the drugs totally.
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