We must kick our methadone habit | Theodore Dalrymple - Times Online
Dalrymple has another go at pushing his line that methadone treatment for heroin addiction is a bad idea. (Or, at the very least, it is a bad idea to provide it indefinitely to addicts.)
I wonder what the situation is in Australia. In the early 1980's, I had a pharmacist friend who I saw dispensing liquid methadone to registered addicts from his pharmacy. This was in Queensland under Joh Bjelke-Petersen: I don't think many people really knew that conservative old Queensland had a methadone program going then. (In fact, I have an idea that Queensland program may have been more "liberal" for many years compared to the ones in the southern states.)
Still, I was under the impression that the Queensland program did not leave patients on it forever. I thought there was an expectation that the patient would move off it within a year or so. But maybe I'm wrong.
Anyway, Dalrymple's article is a fascinating read.
Some need to remain on methadone for the long term due to permanent changes in the brain chemistry, specifically the endorphins, caused by long term opiate abuse. For these people, when they become abstinent, they suffer severe crippling depression, anxiety, exhaustion, and an inability to feel normal happiness and pleasure. It's not unlike the immediate post-detox phase when people get off opiate drugs, except that for this group it never gets better, and leaves them extremely vulnerable to relapse. All the counseling and therapy and job training on earth cannot fix disordered brain chemistry. In fact, it is thought that many addicts, particularly opiate addicts, may have been especially vulnerable due to a deficient endorphin issue even prior to abusing drugs. At any rate, for this sub group of addicts, long term methadone treatment restores the brain chemistry to a near-normal state, and allows them to function. That is why it is wrong to set time limits on treatment.
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