Methadone Maintenance Treatment is most recognized as a harm reduction strategy for severe opiate dependence. Less understood or appreciated is its potential as a safe foundation for personal recovery from addiction.
Addiction is a lingering, recurrent and forceful compulsion to take drugs that alter mind and feeling. The compulsion of addiction is a problem deeper than mere habit. Addiction has lost connection to any reason or rationale for starting to use drugs in the first place.
Physical dependence occurs when your brain becomes used to the routine presence of an opiate drug taken every day. Chemical changes occur in the brain and require you to use an increasing amount of opiate drug to obtain effect. Withdrawal symptoms occur when the drug is stopped.
Opiate drug addiction and physical dependence fuel each other into a downward spiral of increasing use and deteriorating health.
“I can’t believe that I’m entirely responsible for my addiction.
For so long, I had no idea what I was doing to myself or why.
But I am responsible to be active in my recovery.
It is the nature of addiction that I cannot be passive.
Each day, I need to do the things necessary to protect and to grow in my recovery.”
Methadone is a drug that relieves the withdrawal symptoms of opiate dependence. It releases the opiate addicted person from the immediate and pressing physical need to take opiate drugs.
When used under medical supervision, methadone does not produce any state of intoxication. It does not alter thought or feeling and does not contribute further to the compulsion of drug addiction.
Recovery is a process of learning to enjoy life without the use of intoxicating drugs. Its necessary foundation is acceptance for the compulsion of addiction.
The medical and social consequences of opiate drug use may be both immediate and tragic. But the learning and practice of recovery can take time to provide safety from relapsed use.
Methadone Maintenance Treatment provides a safety net during a time that a client may integrate recovery into their day to day life, choices and relations. In addition to the short term relief from physical withdrawal, maintenance treatment offers opportunity for stability in lifestyle and recovery from addiction.
“The way I see it, methadone saved my life.
Recovery helps me enjoy it.”
Phase I of treatment spans the time from entry into treatment through to safe stabilization on a proper methadone dose and early abstinence from drugs of intoxication. This phase may last for a few weeks - or may persist for a longer time with concurrent addiction.
Phase II of treatment is an ideal time to solidify the principles of recovery into daily life. There is a great deal that may be learned about relapse prevention, healthy boundaries, learning to live in the day and with a priority to personal and spiritual health. Personal involvement and active participation in lifestyle change and in recovery from addiction will differentiate those who do well with methadone treatment - those who come to enjoy renewed stability in their health, work and family life - and those who persist in an addicted life of chaos and crisis.
The integration of methadone treatment with a personal program of recovery is not different than the temporary use of nicotine replacement medication with behavioral changes to stop smoking.
“My methadone doctor only encourages me to be active in my recovery program.
I don’t know why some of my recovery supports are so against methadone treatment. Its the only reason I am alive to hear what they have to offer.”
But the physical changes of opiate dependence - and the compulsion of opiate drug addiction - both persist over long periods of time. The duration of methadone treatment reflects the persistence of these effects - and the devastating consequences of relapsed use.
An extended period of time abstinent and on a stable, moderate dose of methadone allows for the practice of recovery learning and for gradual readjustment of opiate receptor activity within your brain.
“I don’t understand why there is a division between methadone and recovery. Its obvious to me that methadone is an outside medical issue of treatment.”
A bare minimum of one year in Phase II of treatment is a standard recommendation at our facility. Common experience finds that a gradual taper of dose is then more easily tolerated during Phase III of treatment.
It is during this last phase of methadone treatment that all attention is directed to living a life in sobriety and with a day to day mindfulness to your personal program of recovery.