The scourge of methadone use

[DesertHarp]

This is a pretty important point of discussion.

This is a constantly changing situation regarding receiving medication during incarceration. I say medication, as in general, there is little guarantee of receiving any medication prescribed to you on the outside once you are incarcerated either at the jail (less than one year) or prison (felony convictions lasting more than one year) level (this describes the general system in the United States).

For instance, here in Vermont, not only will you receive Methadone/Buprenorphine if you received it on the outside, they will actually initiate Medication Assisted Treatment after the fact if you ask for it. Massachusetts, where I am from will also continue maintenance medications, though I'm unsure about initiating treatment.

As drug users, it becomes really clear the political divisions in this country. They have a huge effect on the course of our lives as addicts. For instance, I doubt Texas is going to medicate you. Here in Vermont, possession is still a crime, but in practice, there is hardly any enforcement at the ground level regarding simple possession on the part of addicts. I work with addicts every day and the only people I ever hear of having trouble with the law are folks stealing cars, committing burglaries or shoplifting in the high, high amounts.

It's that typical "living in the Northeast, the West Coast or Colorado" effect.

I see I over-generalized. I'm in the Southwest. That's interesting to hear that Vermont and Massachusetts are more enlightened. There's definitely a correlation between regional politics and local policies toward the incarcerated.

 

[Jnowhere]

Jail is different from prison here in the USA. I've worked in both. Medical follow up is better in prison than in jail. But I never saw anyone, except pregnant women, getting methadone in either type of correctional facility. We used to give out Ativan (a benzo) to individuals experiencing unusual stress (like the death of a close family member,) but very few were given any benzo on a regular basis. Haldol and other antipsychotics are used a lot here in both jails and prisons.

What about diabetes?

 

[DesertHarp]

What about diabetes?

Diabetics have a right to proper monitoring and appropriate medication in any correctional facility in the U.S. A diabetic diet is also considered a right. Follow through on diet isn't always what it should be.

 

[Just a little pinprick]

Diabetics have a right to proper monitoring and appropriate medication in any correctional facility in the U.S. A diabetic diet is also considered a right. Follow through on diet isn't always what it should be.

Im in Hudson County NJ and inside the county jail the nurse visits each tier twice a day with all types of medications,as soon as you enter the building that’ll be one of the standard questions that you are asked,”Are you taking any medications” and after seeing the doctor in the jail and they confirm that you were on the medication on the outside they’ll continue it while you are incarcerated,,,I doubt that’ll include all medications,like pain meds or drugs the jail doctor thinks you can do without,mental health drugs are definitely included in drugs you’ll receive,,,A number of times when I was incarcerated I told the doctor I couldn’t sleep because of opiate withdrawals and was given trazadone at night for the first couple weeks ,I didn’t have a script for it on the streets but the jail doctor prescribed it for me,,I believe I needed to see the shrink for the jail and not the regular doctor….

 

[DesertHarp]

Im in Hudson County NJ and inside the county jail the nurse visits each tier twice a day with all types of medications,as soon as you enter the building that’ll be one of the standard questions that you are asked,”Are you taking any medications” and after seeing the doctor in the jail and they confirm that you were on the medication on the outside they’ll continue it while you are incarcerated,,,I doubt that’ll include all medications,like pain meds or drugs the jail doctor thinks you can do without,mental health drugs are definitely included in drugs you’ll receive,,,A number of times when I was incarcerated I told the doctor I couldn’t sleep because of opiate withdrawals and was given trazadone at night for the first couple weeks ,I didn’t have a script for it on the streets but the jail doctor prescribed it for me,,I believe I needed to see the shrink for the jail and not the regular doctor….

In a jail where I worked, opioid withdrawal was considered a non-psychiatric problem. The psychiatrists were not involved in treating it. Such detainees were put on a "kick kit," which didn't offer much. They got kaopectate for the diarrhea. A few other things, but no opioid or benzo. The alcoholics get more support. They can get benzos to prevent seizures.

Trazadone is an antidepressant that helps promote sleep. Doctors prescribe it pretty readily.

 

[Pickledlemons]

I consider my suboxone a blessing and a curse. It is annoying going to the doctor and pharmacy so often, and I often wonder how its affecting me, like I feel like my motivation is pretty low these days, but it could just be circumstantial, who knows? But I would still rather have it than not, especially with whats floating around the street these days.

 

[Pickledlemons]

In a jail where I worked, opioid withdrawal was considered a non-psychiatric problem. The psychiatrists were not involved in treating it. Such detainees were put on a "kick kit," which didn't offer much. They got kaopectate for the diarrhea. A few other things, but no opioid or benzo. The alcoholics get more support. They can get benzos to prevent seizures.

Trazadone is an antidepressant that helps promote sleep. Doctors prescribe it pretty readily.

I can't believe they don't give maintenance drugs in jails in certain states. Thats so barbaric. Sorry don't mean to sound condescending. But WTF.

 

[SteeleyJ]

In the U.S., if you get arrested and go to jail, you do not get your Methadone, even though you've been getting it prescibed and legal, which they can verify. The only detainees at a jail who get Methadone are pregnant women. It's brought in special for them.

I hadn't thought about how being a legit methadone client keeps you tied to the matrix. It's like supervised parole. I have heard that methadone is worse to withdraw from than heroin. That's brutal about not getting opioid pain med when really needing it.

I actually just went to jail and for the first time in my life they gave me my methadone. I'm 35 year old male with no health problems except addiction. I was so happy when they gave me that cup and kept giving it to me for 51 days. The United States are finally starting to get thier ahit together a little about opioid addiction.

 

[DesertHarp]

I actually just went to jail and for the first time in my life they gave me my methadone. I'm 35 year old male with no health problems except addiction. I was so happy when they gave me that cup and kept giving it to me for 51 days. The United States are finally starting to get thier ahit together a little about opioid addiction.

I'm glad to hear that. I hope it's a trend that spreads over the country.

 

[DesertHarp]

I can't believe they don't give maintenance drugs in jails in certain states. Thats so barbaric. Sorry don't mean to sound condescending. But WTF.

It gets worse. There was a guy in withdrawal (in jail) from alcohol, who became restless and confused. He was trying to walk, but was falling. He couldn't stay still. The supervising nurse from the medical unit suggested he be put in the "restraint chair." (All four limbs are restrained.) Fortunately, the lieutenant in charge of the jail sent him to the hospital ER instead. He was admitted (suspected of DTs) and given appropriate treatment. A nurse at the hospital told me he was given a large amount of Ativan by the ER doctors. After he was moved to an inpatient unit, they put a nurse one-on-one with him because he was so agitated.

In jail, they watch alcoholics carefully for 72 hours, with a nurse checking their vital signs and other symptoms every few hours. Withdrawal from any addictive substance is stressful, but withdrawal from alcohol is considered the most dangerous, with greatest potential for a fatal outcome. This guy had gotten through the 72 hr alcohol watch, so the nurse supervisor claimed he was in no danger of a medical crisis. She saw his restlessness as bad behavior requiring discipline, so she recommended the "chair."

What I noticed, working in the jail, was that some of the correctional officers were more humane than some of the medical staff. A lot more. A female was withdrawing from heroin, and Kaopectate was not controlling the diarrhea. Female correctional officers had repeatedly showered her and helped her into clean clothing. They told me how sorry they felt for her and how they wished the medical staff would give her some medication to ease her withdrawal. You can never assume that nurses or doctors are more caring than anyone else . . . or even that they care at all. Some of them are real hard-asses.

 

[TheUltimateFixx]

I firmly believe it's a mistake to ever promote methadone and other subs as long-term or even indefinite maintenance. I mean originally it was meant to see you through withdrawal and then be tapered off.

Best use of it is to give someone a time period where they don't have to worry about getting into withdrawal and have the breathing space to get their shit together meanwhile. To just initially get you away from the junk-chasing merry-go-round that doesn't allow for any stability or self-reflection / self-improvement. BUT THAT'S ALL IT SHOULD EVER BE. A tide-over; a temporary crutch to facilitate the transition from junkie life to regular life.

On the one hand I hate how restricted methadone still is is a lot of places and how difficult it is to get on a script for it. On the other I hate how it's pushed as something you will supposedly 'need' to be on for life. The only reasons to consistently take any opiates is A) for relief of chronic pain or B) purely for pleasure. But your body literally DOES NOT require the substance. Yes it gets habituated and integrates the drug into its functions, and gets severely insulted when the drug is withdrawn resulting in distress for the dependent user. But it isn't like fucking insulin to a diabetic. It just isn't. You won't die if you don't have it. You don't need it in your system to live ffs.

If I could write the law, then those who want to get high would have access to legal supply of the stuff they actually wanna get high on (as a heroin user I don't like to he fobbed off with methadone, that's why HEROIN users are heroin users and not methadone users by preference). While those who sincerely wanna get off would get easy but time-limited access to methadone and other subs, to wean them off gently. Or you might even just stabilise them on a dose of diamorphine and gradually reduce, yeah it doesn't hold you as long but is easier to come off.
... If someone genuinely has no more desire for the drug, and is not in pain, there's zero physical need for continued administration. You truly wanna get off, just get off EVERYTHING including subs, with medical assistance if necessary, and just get on with the rest of your life with no chemically-induced restrictions. Just my 2 cents on the subject.