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Methadone Today

Methadone Today

Volume IV, Issue III (March 1999)
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My Life on Methadone - Name withheld by request

Special Announcement - ARM:  New Methadone Advocacy Group

Beaten to Death
Cops - T. J.

Giving Birth on Methadone:  My Experience - by Jill

Doctor's Column - Orlaam, Methadone and Withdrawals

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My Life on Methadone

name withheld by request

   I am a typical drug addict with the same history as most of us.  I tried to get off drugs for so many years.   Trying everything available, I was in and out of four or five different 30- to 60-day programs, but I would still end up back on drugs in a matter of no time at all.

 I had two children and a family who all needed counseling because of me.  At the last institution, I told my family, the people in the institution, and myself that if I could not stay clean that time, I would take a gun to my head and end my life.  I was very serious about this, and everyone knew it.  My mother even said, "Yes, please do--we just can't take any more of this, and those kids shouldn't have to see any more of it."

 Then, someone at the rehab told me about methadone.  He said it had worked wonders for his mother, "It's better than killing yourself," he told me, "especially to make your children live with the thought of how their mother died."

 I didn't think too much about what that person said because I was determined to make it work, no matter what.  I tried so hard, but I just never felt like a normal person.  I couldn't even have sex comfortably without feeling very uncomfortable.  I had a very supportive boyfriend who only wanted a drug-free relationship.  He made that perfectly clear; I love him for that and because he doesn't do any drugs or even smoke cigarettes either.

 When I realized that I couldn't keep this up, I started looking into methadone clinics and found relief in my life finally after 23 years of using and trying all kinds of ways to quit.  Since starting this program, I was scared and skeptical about the things I have heard about methadone.  When I made up my mind to get on methadone, I told myself that this is your only change, girl; it's this or nothing.

 I suddenly started feeling normal, and it felt great.  I wanted to do all kinds of things with my kids, but they were almost grown now and had a full life, so I checked out a GED book from the library, found out when the school was having their next test, studying that book day and night, and I passed the test.

 Then I started looking for work and found a perfect job helping the mentally handicapped.  I worked at the group homes and a workshop too.  I found them jobs, I trained them to do the jobs, then I'd job coach them too.  I'd work anywhere from 65 to 75 hours in one week for very little pay.  I didn't care--I just knew this was what I was good at, and I loved working with them.  Since then, I was promoted several times, but I wanted more.  I wanted a career--something I never thought  could ever have.  So,  quit my job and went to college.

 All the money  had made from those long hours went into the bank.  I never had a bank account before, and now  have a checking, savings, and a Money Market account too.  I bought my own car, pay my weekly clinic bill of $70 per week, and all the regular household expenses.  I support my kids, both of whom are on the honor roll; my son is in college, and  send him money too--it feels great that  can.  I pay my own way in life and don't take handouts from anyone.  I'm the one handing out now, and it feels good. I am currently working part time, and  am in my second year in college.

 Thank God for my counselor at my clinic too; without her help in so many things, I don't know what I would have done because my life has turned completely around, and I'm doing all the wonderful things that a normal person should do.

 I have still had lots of obstacles to overcome.  I have been fired from a job because they found methadone in my urine, my fiancé cheated on me with prostitutes--something I used to be.  He caught gonorrhea and gave it to me while I was putting in all those doubles and too many hours at the first job.  I did it because I couldn't say no and partly because I didn't want to.  I loved those big checks.  I wanted to kill him, but I didn't even think about using drugs.  I knew that I could leave him if I wanted to and take care of myself just fine.  I know that I am a great person now, and if he screws up again, I'm out of there.

 I'm currently working part time and going to college part time with a 3.75 grade point average.  I'm married and saving for a big house in the country; life is great!  I owe it all to the methadone clinic, my counselor, the staff there who has given me a lot of helpful study tips for college and who make copies of my report and show it around every time I get it.  They are all just great.  I am the best success story ever, I think.
 I remember when I first started methadone; I'd tell my counselor all the energy I now have. I'm constantly working around the house; I've planted a vegetable and flower garden.  When I told them methadone must give you a lot of energy because I've never been able to do this much, the counselor told me, "No, it does just the opposite--it is you who is doing all these things; it's just the real you coming out."  Now I believe in and love the real me.

 It's a shame that I still have to keep all this a secret.  No one knows that I'm on methadone, and if they did, they would disown me again, and I would be fired from my job.  I really wish we could change people's outlook on this, but I know some of these people personally, and I've dealt with the prejudice too.  I intend to stay on methadone and continue to make my life the best that it can be.

 Thank you for letting me tell my story.

Editor's Note: This story is unfortunately all too typical.  This is one thing that advocacy works to change--this very real stigma.


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   A new advocacy group for opiate agonist therapies (like methadone, LAAM,  Buprenorphine, and others that may come along) is ready to make this announcement to tell you about ourselves and reach out to YOU for your support.   We have received a grant to form a national organization from the Drug Policy Foundation aimed at changing the policy regarding Opiate Agonist (OA) treatment and thereby improving the lives of methadone patients everywhere in the country.  Our name is Advocates for Recovery through Medicine (ARM).

About ARM and You

 ARM is the creation of many long-time advocates who saw the need for a national organization to support their needs and requests for assistance in the educational/media/political arenas.  Without an expanded membership, we are all simply lone persons trying to convince elected officials that OA therapy is a viable, effective, and lifesaving treatment for victims of narcotic addiction.  Although we have reams of  medical, scientific, and socioeconomic data to prove those assertions, that is not enough.  ARM  needs you to add your voice to the tens of thousands of other voices we know are already out there.  Then we will be heard by those in a position to change the current prejudicial, stigmatized, in some cases incompetent, and frequently uneducated and ignorant attitudes that exist -- those that, in turn, affect every OA treatment patient at the patient level.

 With one very large voice, composed of  many individual voices, we will be spreading our  message by disseminating information and engaging in activities designed to simply force policy makers do the right thing, both under the law and in accordance with medical standards of care.  With the addition of YOUR voice, we can fulfill our mission much more quickly, effectively, and with greater authority as a group that will soon become well-known to all these entities and with a reputation that we have credibility and mean business.

The Community and ARM

 ARM intends to use that voice in a way that will benefit both those in need of treatment and those who simply want a safer, more stable community.  Many do not realize that when OA treatment is offered within a certain community, the addict-related crime drops significantly.  Methadone advocacy has now reached a time when, by working as a large, focused group, we can change the way we all think about this highly effective treatment.

       Despite the fact that methadone, the most common form of OA treatment, is endorsed by organizations such as the National Institutes of Health, the Institute of Medicine, American Psychiatric Association, the American Medical Association, and even the current Drug Czar, as well as dozens of other well-respected and well-known medical societies and individuals with expertise in the field, only about 1 in 10 addicts avail themselves of this treatment.  We believe that is in part due to unavailability of treatment slots in many areas (and even entire states), but also because the "clinic system" as it now exists is not designed to meet the needs of those who are serious about recovery and who demonstrate long-term compliance with the most stringent regulations imaginable.
 Methadone and LAAM have been totally segregated from the rest of the medical community and are thereby stigmatized. The medical community is woefully ignorant about the true facts of OA therapy, which is well established because of the decades of research done on the effects of methadone.   The result of this has been to further lower the self-esteem of MMT patients in general and to discourage many individuals who are most in need of this treatment from seeking it out.

The Clinic and ARM

 The clinic system that was supposed to protect us has also emerged as a harshly punitive system, with many clinics adopting attitudes that tend to intimidate patients into following the rules and, more generally, treating their patients with very little respect. There are rare and refreshing exceptions to this generalization, but even the "best" clinics, those that are most patient-friendly and respectful, are still stuck with a bureaucratic haze of regulations that make no sense in many patients' cases and that increase the cost of this nonetheless comparatively cost-effective treatment.  But the worst "cost" is to the patients themselves and the way this long-term overregulation and maltreatment of patients is known in the addict community and causes active addicts to refrain from seeking help and recovery through OA treatments.  ARM believes that just as punitive measures and intimidation are inappropriate in other medical treatments, they are inappropriate in this treatment as well.

 Active addicts in some areas, who cannot commute the 75-200 miles to the nearest clinic, are not able to conform their hours of employment to many clinics' unusually short, nonnegotiable hours of operation.  They also may not be able to afford the $50-$100 weekly clinic fee.  These addicts comprise the majority of the market for illicit methadone--not the person who has never taken opiates.   And, like a Catch-22, anti-methadone groups frequently point to incidents of methadone diversion as a reason not to increase the availability of this highly effective medication.  Of course, this is completely backward.  This is just one of the many disenfranchised groups ARM seeks to help by fully integrating OA treatment into the wider medical community.  We believe that by removing many of these barriers, we can greatly enhance the lives of so many people who need this treatment but simply cannot live with the daily intrusion of clinic attendance, especially after proven stability has been reached.

The Stigma

 OA treatment has been scientifically researched and proven to be the most effective means of stabilizing an opiate addict and reintegrating him or her into society as a productive and functioning citizen (as is the case with so many stabilized methadone patients with whom the "public" is typically unfamiliar--again, because of the stigma). And while ARM in no way believes that OA treatment should be the only choice available to an opiate addict seeking treatment, neither do we see any reason to treat this medical success story with the shame and stigma that has become associated with it for little or no reason whatsoever except the ignorance of people making the policy choices in the area of chemical dependency treatment in general and treatment of opiate addiction in particular.

 And if an opiate addict does make the choice to treat his/her chronic and fatal (if untreated) disease with OA therapy, then that treatment should be as patient friendly as any other legitimate medical treatment for any other chronic, relapsing disease.  Many people seem not to know, or are unwilling to accept, the fact that the field of medicine has identified narcotic addiction as a disease.  Many of these people would like to keep "the argument" on a moral plane rather than the health issue that it is.

What You Can Do

 We hope you will join us in calling for a change in the current policy of segregating OA therapy from other medical procedures and practices.  We want the chance to also educate individual physicians to the facts about OA treatment--not the stigmatized myths that are currently in vogue. This change will benefit not only the addicts who need this therapy but also their families, friends, employers, and the surrounding community.  It is a win-win situation for everyone involved.

 If you are interested in helping ARM achieve these goals, we have two areas of activity:

 (1) First, we need volunteers at the state and regional levels (our current plans call for 5-6 "regions" managed by a Regional Manager who will have to be a very committed and talented volunteer.

 We are then seeking volunteers from each state, and we can use several in each state because there is so much to do.  People in all  these positions will have access to real support at the national level, particularly in terms of getting you the materials you need to do the job (we are currently in the process of preparing those materials, but it shouldn't be long before we are ready to take applications for specific volunteer positions).

 These positions are not limited to methadone patients exclusively.  We would like to involve the families and friends of patients when possible.  If you as a patient have a good relationship with your family doctor, counselor, spiritual advisor, or other person, we welcome all who are in harmony with ARM's mission to become involved in this endeavor.

 Please look to future editions of Methadone Today for specific "job descriptions" and how to apply.  But if you already think that such a position might appeal to you, please send us some initial contact information so we know how to get in touch with you when we begin filling these slots and just in case you miss the MT edition that contains the job YOU want.

 (2) Although we are going to be operating under some grant monies, they will by no means cover all the expenses we will incur.  We are looking for people who are willing to pay dues or have fundraising experience or ideas. There are several levels of membership, including clinic membership, but details are being worked out.  If you think you might like to help ARM in this way, please contact Methadone Today.

 Remember, you do not have to give a lot of time to ARM.  You may only have a few hours a month available to donate.  We can still use you as long as you are reliable.  Everyone needs to help a little for this to work.

 ARM is staffed by a number of very experienced and dedicated people. Please feel free to write to ARM in care of Methadone Today (address and E-mail on last page), and one of the staff will at least attempt to answer any specific questions you might have about our exciting new organization!

 Thank you for your interest,
 From the current active members of the Board of Directors:
Carole Larsen, Esq.; Beth Francisco, Editor; Malcolm Dickson; & Robin Robinette.

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Beaten to Death

Nassau County, New York

        Thomas Pizzutto was a thirty-eight year old  methadone maintenance patient incarcerated for traffic offenses in  the Nassau County, New York Jail.  It is alleged that he was  beaten to death by the correction officers.

         The beating occurred after Mr. Pizzutto requested to be dosed.  Methadone Today is attempting to ascertain, and hopes the federal officials who have taken over the investigation will ascertain, whether Mr. Pizzutto was improperly being denied his dosage or if the beating was somehow directly linked to his status as a methadone maintenance patient.

        One thing which is clear is that after the beating, the jail officials are reported to have coerced Mr. Pizzutto into signing a false statement exonerating them on the promise he would be dosed.  - END

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by T.J.

 While on a clinic in Hollywood, FL, my husband and I were stopped by a patrol cop in the parking lot of the clinic. We had just gotten dosed and each had four take homes.  We had them together in the same "lock box", which is a requirement at that clinic and I believe in the state of Florida.

 The cop insisted the box be opened, and he then took one bottle, opened it and smelled it.  He walked to his patrol car and put the box inside of his trunk. He came back to hassle my husband again, and I went into the clinic to see if someone could help us.

 We were very lucky as the directors office had a "one way window", and a nurse and three counselors had been watching this happen. A nurse called for another officer but before that officer arrived, the cop that had our take homes was gone.

 We were given replacements but had to file a complaint. I did not have a problem with that, as the nurse and counselors also filed. The police department in Hollywood did not at that time (and probably still does not) think much of the program.  Of course, nothing came of the complaint, and we did not hear a thing about it ever.

 The one good thing that came out of it was that that particular cop was not seen again at the clinic. I still feel that he committed a crime, but because of who the victims were, it was OK.  Sad to say, I don't think this will ever change.  I really get mad when I think of that day, but I felt we did the right and the only thing we could have done.  But still, this cop got away with harassing us and stealing from us.

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 Giving Birth on Methadone

My Experience

by "Jill"

 I gave birth just before Christmas to a beautiful baby boy.  I've been a methadone patient for over 20 years, and I have two older children, both born while I was on methadone.  One had mild withdrawals at birth and was successfully treated with paregoric; the other baby had no withdrawals at all.

 This is the experience I had giving birth this time.  While I was in labor, a nurse was getting the room ready.  She said she was putting a syringe of Narcan next to the bed "in case the baby has respiratory difficulties" at birth.  I was alarmed.  I asked her, "why Narcan?"  I thought Narcan was NOT supposed to be given to anyone on methadone or an opiate unless it's an emergency, like COMA or overdose.  She said they "did this all the time" -- that babies sometimes have respiratory difficulties from the epidural or drugs given to mom during labor.  I figured they knew what they were doing,  but apparently they didn't.  After the birth, I re-checked the TIP book, "Drug Exposed Infants", and it stated Narcan is NOT supposed to be given to a baby born to a mom on methadone, even if there is respiratory depression!

 I had told the doctors and staff that I was a methadone patient knowing that they might treat me "differently" (badly), but I figured it was best for the baby if they knew.  Well, "Jacob" was born gasping for air.  They gave him not one, but THREE, doses of Narcan within a half hour!  My poor baby was thrown into terrible withdrawals.  Within an hour after I gave birth, I went to see him in the neonatal intensive care unit.  The staff there told me his withdrawals were because of the methadone; I told them it's because of all that Narcan!  I showed them what it said in the TIP book, which I had conveniently brought along in my suitcase. The pediatrician got visibly nervous.  Jacob was transferred shortly afterward to a nearby hospital; I was told it was because they had a "better" neonatal intensive care unit.

 The second hospital had Jacob on phenobarbital to control withdrawals, but he wasn't doing well.  I told the pediatrician that I had given birth several years ago and that the baby did really well on paregoric.  Luckily, this doctor agreed to change to paregoric, and Jacob improved dramatically.

 Even though I volunteered the information that I was on methadone (a legally prescribed medication!), they tested the baby's first stool for drugs.  It showed up marijuana.  I was puzzled; I admitted I smoked a joint in the first month of pregnancy, BEFORE I knew I was pregnant.  They said this test could tell what the mom had ingested since conception.  Because of the positive for marijuana, they wouldn't release the baby until Social Services could send people to my house to check the "home environment".   They found a nice, clean home, well-stocked with food, clothes and toys, presents under the tree, etc.

 Needless to say, I was not happy with the way the baby and I were treated. The final kick-in-the-butt:  Social Services told me my name is now on a register of "child abusers" in the State of Michigan!  At least my beautiful Jacob is now healthy and safe at home.
Note from Nancy Rose (DONT's VP/Secretary): "Jill" is a close friend.  I was lucky enough to be invited to share in her birthing experience, along with her husband and oldest daughter; it was beautiful to see a baby being born.  But, I was appalled watching what "Jill" and "Jacob" had to go through after the birth.  Methadone is a legal medication!  Medical staff and others need to be educated about it.  And a suggestion: try to have a knowledgeable friend with you in the hospital to "advocate" for you!
Editor's Note:   Nancy IS a knowledgeable advocate--however, the doctor made it sound as though Narcan was the ONLY thing that would save the baby's life.  Now we know that is NOT true.  Please make sure that your advocate takes it to the top official in the hospital before allowing a baby born to a methadone mother to be given Narcan for any reason.


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