Methadone Epidemic: A Case Study

Currently in Ontario there are approximately 30,000 people, between the ages of 15 and 49, using illicit opioids on a regular basis. (Hart 2007) Opioid use is a costly and dangerous social problem and is the fastest growing drug problem in the country. The good news is that there is a treatment that has been proven by research and evidence to be effective. Methadone Maintenance Treatment (MMT) is a long term treatment program used to treat opioid dependence and addiction.(Source) MMT works by preventing withdrawal symptoms in opiate users. It also prevents the euphoria the user is seeking from other opiates. MMT uses the drug of Methadone to do this. Methadone is a synthetic opioid commonly used to treat opioid dependence.(Source)

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

There are many people in the world today that are drug addicts and cannot quit by themselves which is where the methadone clinics come into the picture. Methadone reduces the withdrawal symptoms therefore making it easier to quit drugs. Even though methadone is supposedly proven to be safe, it seems to have biases and stigmas associated with it because it is an opioid medication and many people can become addicted to it as well as have serious side effects. For individuals who aren 't willing to quit using drugs, they offer needle exchange programs that reduce the risks of infections and diseases. Needle exchange programs are important in a society like today because a

Methadone Maintenance Therapy (MMT) is used with opioid dependency and is an opioid replacement therapy. MMT typically replaces heroin with Methadone which is a cleaner substance than heroin, and is used to avoid withdrawal and allow the user to function normally within society. MMT has been around for the last 50 years, and research studies have been conducted to address the benefits and the complications associated with this replacement therapy. This paper will examine some of the advantages and disadvantages associated with MMT and reflect on personal ideals in accordance with MMT.

The purpose of this briefing memo is to provide recommendations to Council of City ABC on certain aspects it may or may not include in its zoning provisions with regard to methadone clinics and dispensaries. In the following sections I will provide my input on the provisions laid out by council.

In the video Opiate Addiction: Understanding Replacement Therapy, Scott Farnum talks about methadone replacement therapy. There were many topics covered in this video and the topics were introduced in a psychoeducational format. The topics covered included a brief history opioids, brain chemistry, post acute withdrawal syndrome, abstinence based treatment programs verses harm reduction, and how an individual asses the damages of opioids on the brain. As a counselor in training, I found all the information useful because I have not studied methadone replacement therapy in detail.

Methadone misuse leads to flash visual evoked potentials in newborns. In the article by McGlone, Hamilton, McCulloch, Boulton, Bradnam, Weaver, & Mactier (2013), they conduct a study about mothers who abuse drugs and are prescribe methadone and end up misusing the methadone. The infants of the women end up being born with abnormal flash VEPs. The researchers concluded that the abnormality is due in part to the prescribed methadone and not the other drugs that these women were abusing. A control group was implemented to compare the flash VEP with healthy, drug free infants. It is also concluded that methadone binds to ocular as well as to brain tissues, which explains why it has an adverse effect on the infants visual and neurologic development.

Methadone is a drug that is primarily used to treat patients who have developed and addiction to opiate agonists such as Heroin, Oxycodone, Morphine and Hydromorph Contin. (Canadian Public Health Association. N/D.) Methadone is also used to treat chronic pain. In treatment patients will undergo a physical exam and blood work to ensure their body can handle the drug. A test is also done on the patient to determine the level of opiate withdrawal the patient is in. Once the patient is determined to require treatment they will be prescribed a dose of Methadone to relieve their withdrawal symptoms as well as reduce cravings. Methadone itself is a synthetic opioid which acts on the same opioid receptors as other agonistic opiates. (Canadian Public

¨ More than a quarter of a million Americans are enrolled in methadone clinics, where they participate in “methadone replacement” or “methadone maintenance” to treat narcotic addictions to heroin or morphine, or prescription painkillers like oxycodone, hydrocodone, OxyContin or Vicodin.¨ (Novus Detox, 2016) Clinics that treat opioid addiction use several combinations other than methadone to be effective. In addition to daily methadone treatments, there are also random drug test to make sure the individual is complying with the program. There is also individual and group counseling that provides education and support with each being customized with goals set forth by the patient. Some addiction require patients struggling to seek professional help with a psychiatrist and/or speciality

The primary intent regarding addiction from the social work perspective should be to help the general public understand that persons addicted to opioids, much the same as victims of any chronic relapsing disease, deserve to be treated with compassion and respect as they seek access to medical treatment for their disease. Having that foundation, the use of methadone can be a very efficient, non threatening alternative treatment. Social services should be meaningfully incorporated into the process at the onset of one becoming involved in the legal system by way of addiction. Policies and procedures that greatly enhance the assessment, intervention, and treatment of addiction should be as visible and available as the authority figure prominently appears in

The heroin epidemic’s impact on this nation has demanded action to be taken. Currently, the United States is placing an emphasis on stopping doctors from unnecessarily prescribing opiates such as Vicodin, Percocet, and OxyContin to patients because it often leads to heroin addiction. Furthermore, the country is beginning to focus its efforts on “harm reduction,” which is “a set of practical strategies and ideas aimed at reducing negative consequences associated with [heroin] use” (SouthComm Business Media LLC, 2015, para 12). One form of harm reduction is giving users clean needles at no cost. Offering help to addicts when they come for free needles will increase their chances of recovery, and clean needles prevent the spread of deadly diseases such as HIV and Hepatitis C. SouthComm Business Media LLC (2015) further notes, “…it costs only a dime for a needle versus $90,000 for three months of hepatitis c treatments” (para 14). Another form of harm reduction being used to combat heroin is the use of Naloxone, which reverses the effects of an overdose. Many police officers, medical personnel, family members of heroin addicts, and heroin addicts themselves carry Naloxone with them in case of an overdose. Finally, Suboxone treatment is considered as one of the more effective ways to reduce harm. Suboxone is a drug that blocks the user from getting high and makes it to where they do not crave the drug (SouthComm Business Media LLC, 2015, para 24). Stopping the

“We are going to work with the people who are so addicted and we are going to try like hell to get them off that addiction… The scourge of drug addiction in America will stop, it will stop(Donald Trump). In this quote, Trump promises to stop the Opioid Crisis that has been ravaging America for more than a decade. Today, in 2018 more people are dying from this epidemic than the soldiers who died during World War II (CNN). People have been prescribed opioids that are supposed to help them manage their pain, not get them addicted and kill them. Doctors were taught in medical school to prescribe opioids frequently (From Pot to Pills). Dr. Mark Wallace, a specialist in pain medication from the University of California in San Diego states that when

Heroin addiction is a growing epidemic, especially here on Long Island. People of all ages, gender, race, and ethnic backgrounds struggle with this addiction. Heroin is a highly addictive analgesic illegal drug, that many people abuse. The disease of addiction is a powerful illness, that is difficult to recover from. Many wonder if there will ever be a cure. Addicts go through many stages of recovery, and many do not make it through treatment, and unfortunately relapse. Now that it is a common issue in the United States, healthcare workers face many issues regarding caring for patients with addiction, whether it may be in a hospital or rehabilitation setting, or a mental institution. It is a nurse’s responsibility to be aware and knowledgable about this serious disease and how to care for patients who are withdrawing from the drug.

This causes a broad range of heroin seeking behavior. It has become evident that users who are dependent on prescribed opiates may have a lifetime of addiction. Prescribed opioids are plentiful in many communities. Heroin is generally injected or snorted, but prescribed opiates are administered orally. According to Michelle Peavy, “Prescription opioid abuse presents a unique set of challenges for health educators, outreach workers, treatment providers, and others whose mission it is to disseminate substance use of prevention and risk reduction information”

Methadone is a synthetic opioid used medically as an analgesic; also it can use for the treatment of opioid dependence, because it has cross-tolerance with other opioids including morphine and heroin. However, unlike heroin, methadone is long acting, usually preventing the beginning of withdrawal symptoms for 24-36 hours, longer duration of effects. Different level methadone doses can produce different results; small amount of methadone dose can stabilise patients by mitigating opioid withdrawal syndrome, higher amount of methadone can block the euphoric effects of heroin, morphine and similar drugs. Methadone is approved for different indications in different countries. Common is approval as an analgesic and approval for the treatment of opioid dependence. As a results, methadone is a very successful drug used in the treatment of opiate addiction. At the same time, methadone should be used with caution in patients with hepatic or renal impairment, hypothyroidism, Addison's disease, prostatic hypertrophy or urethral stricture. In this case, Cisco’s methadone dose has been legally prescribed, which mean that methadone dose act as a medicine for Cisco. A medication or medicine is a drug