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Recovery in the News
Addictions & Answers: Dr. Dave and Bill on methadone maintenance
Bill Manville and Dr. Dave Moore
NY Daily News
September 24, 2010
BILL : "Drugs are part of human nature," writes Methadone Mac. "The two constants we find in every society, no matter how primitive, are intoxicants and fire. The ancient Peruvians didn't have the wheel, but they chewed on cocoa leaves."
DR. DAVE: Is he defending his drug use?
BILL: He says that methadone treatment helps him keep not only a steady job, but also a stable marriage. "But if I ever mention methadone maintenance at an AA meeting, people shun me as if I'm a drunk." Dave, no less than AA founder Bill W. himself once asked Dr. Vincent Dole, the methadone pioneer, and a non-alcoholic trustee of AA, if he would invent a methadone treatment for alcoholics. How does it work?
DR.DAVE: Methadone can be used as a gradual detoxification replacement for heroin, Oxycontin, morphine, et al. More controversially, as a way to maintain a physical opiate addiction without the intoxicating euphoria.
BILL: Stanford Professor Dr. Keith Humphreys has advised both the US and British governments about methadone maintenance -- and believes it to be a valuable tool. "In the US, where over half the population takes at least one prescription drug," he recently told me, "I find it absurd to stigmatize people who need prescribed methadone to recover from heroin addiction. Let he who is without Nexium or Prozac or Zocor or Lunesta cast the first stone."
DR.DAVE: Very timely observation. We're currently going through an ex-ploding addiction to opiate pain medication in our country-- with 1 in 10 high school seniors using Vicodin or Oxycontin without a prescription to get high last year .
BILL: And they're going to need some form of methadone maintenance to get off the stuff?
DR. DAVE: An important point that Methadone Mac makes is how little support he gets from adults in AA. From that, you can guess that young adults have even less of a community of recovery.
BILL: Kids tend to think of AA and NA as something for "the old folks." I can imagine how tough it would be for a teen going through a six-month Methadone gradual detox without some peer community support.
DR. DAVE: Working with New York's Albert Einstein College of Medicine, Walter Ginter of the Bronx-based MARS project, leads a peer recovery support network for people on methadone maintenance. In fact, there's now an opiate replacement medication that can be dispensed right out of a physi-cian's office. It's called Suboxone. Anyone suffering from opiate addiction can learn more about it at www.suboxone.com.
BILL: But, doc, you aren't encouraging a prescription treatment for addic-tion, are you? That little "just you and your doctor" recovery dance has failed countless times.
DR. DAVE: Of course not. And neither are the researchers out of the federal government who pioneered Suboxone. As for any other addiction, the person needs licensed chemical dependency therapy. But, chances for recovery are enhanced by building a MARS model peer support network. A recovery community that supports members who attend AA, NA and the other 12 Step Groups—but doesn't force immediate change on any of those older groups.
BILL: I can remember back when adult 12 Step members were confused and anxious about sitting next to their neighbor's kid at a meeting.
DR. DAVE: Let's also remember that peer support networks can be much more than just meetings. I would encourage any community coalition, public health group or prevention-intervention group to go to the MARS website and explore their programming—www.marsproject.com.
BILL: Since you're too modest to mention it, let me add here that both you and Walter Ginter were just published on this topic in the August edition of the Journal of Alcohol Studies. But let's close with a final word from another author in that special peer recovery edition -- the old guru of recovery advo-cacy himself, Bill White, who famously declares "There is no wrong door into recovery."
DR. DAVE: I'll give you a research "Amen" to that!