Methadone Maintenance Treatment: A Case Study

Almost half of all Americans know someone addicted to the pain pills they are prescribed to. Heather VanderSloot knows the thoughts an addict has because four years ago she was an addict.

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

The use of opioids and other drugs continues to gradually increase in the United State. According to Centers for Disease Control and Prevention (CDC), the number of overdose deaths involving opioids has quadrupled since 1999” (CDC website). Individuals are abusing prescription opioids such as oxycodone, hydrocodone, and methadone. Prescriptions opioids that are supposed to be used as pain relievers, cough suppressants and for withdrawal symptoms are being use by individuals in order to feel relaxed or for the overwhelming effect of euphoria. These types of drugs are to be taken orally, but people are snorting, smoking, and injecting them in order to get a better high. I have personal encounters with opioid drugs and opioid abuser on a regular

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5, opioid use disorder (OUD) is characterized by patterns of opioid use that are problematic and persist for at least one year (American Psychiatric Association, 2013). Evidence of problematic use of opioid is demonstrated through the presence of at least 2 symptoms which include withdrawal, craving, and continued use of opioids despite the disruptions it causes in personal and professional life. The substances used by persons with OUD are heroin and nonmedical pain relievers ([NMPR]; i.e. nonmedical use of opioid pain relievers), and estimates for DSM-5-defined OUD tend to combine the prevalence of use for each of these substances to determine overall

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)

The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.

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.

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

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.

“In 1949, Isbell and Vogel, working at the U.S. Public Health Hospital in Lexington, Kentucky, showed methadone to be the most effective medication for withdrawing addicts from heroin (Joseph, Stancliff, & Landgord, 2000, p. 347). Further studies revealed that administering methadone to an addict for seven to ten days had a relapse rate of more than 90% when treatment ceased. “By 1998, the number of methadone patients in the United States had increased from the original six research patients in 1964 to about 44,000 patients in New York Stated and 179,000 patients worldwide” (Joseph, Stancliff, & Landgord, 2000, p. 347). The number of individuals enrolled in MMT continues to increase as the methadone clinics and the overall effectiveness of MMT gains

Post World War II New York City was faced with a major heroin epidemic with over 151,000 names listed in the Narcotics Register (Herman). As a medical response, methadone was developed to treat heroin addiction (Herman). Today methadone maintenance treatment has grown to become a popular therapy for drug addiction as well as pain management. Methadone has helped many people to create new lives for themselves, yet there is still debate over the success of this program. Methadone assisted treatment should be seen as an effective program in combating opioid addiction due to its health and social benefits for both users and the community.

Methadone is a synthetic opioid drug which was first used in World War II for the treatment of pain. Since then, methadone has become a popular choice for treating those addicted to other opioid drugs such as heroin, oxycodone, morphine, and hydrocodone. It is used to reduce dependency and the treatment should help them become clean. Even though, the policy of giving methadone to drug addicts is not a cure, it is a good one. Fortunately, the Methadone Maintenance Treatment (MMT) is a reliable way for those with an opioid addiction to stop and not restart the use of opioids. For many, methadone treatment provides an opportunity to regain balance in both lifestyle and priorities. (“Opiate Addiction and Treatment Resource”). Everyone deserves

69,000 patients in substance abuse treatment revealed that methadone was fourth for risk of abuse out of 11 opiate based prescription drugs. Worse, after adjustment for prescriptions, methadone advanced to the number one position for abused compounds. Even more startling was a simple random population sample, surveyed by telephone, which reported methadone as the second most used drug. However, Butler et al. cite a major limitation in that the data examined came from subjects who had entered treatment for substance use disorders. Like Plater et al. (2012) aside from the telephone survey, they were unable to examine data for abusers not in treatment (2011).

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.

D-The patient arrived on time for her appointment. Reported stable on her new current dose. Deny craving and withdrawals. According to the patient, her weekend was good and again, happy to have her take home bottles. Then the patient reported, she continues to keep all appointments with her mental health provider and its going very well. This writer then discussed with the patient about the next step to her recovery. The patient reported, she wants to continue with her methadone until she's ready to start tapering off on the methadone. The patient has some fears to tapering off on her methadone because she does not want to experience any craving and have a relapse.