Question about methadone addiction?
Written on July 11, 2009 – 1:44 pm | by Drug Abuse Help
How difficult is it to cease a methadone habit? My brother is 21 years old and he is destroying our family. He is enrolled in an outpatient methadone maintenance program, and has been for 5 years now. He abuses the program, and has begun to steal from our family including myself. He claims there is no way he can quit taking methadone, let alone quit using drugs altogether. He acts as if he were to not dose at the clinic one day that he would land in the ER. We come from a very wealthy family, and none of us understand him. What is the best way to help him. How do you save someone that does not want to be saved. If you say anything to him he gives you a big speech about how "you don’t understand." Why he chose to use drugs is beyond me, he has everything but my family’s patience is wearing very thin. He lives in a 2 million dollar home that he purchased with the families money. Something has got to change, and I love my brother and want to help him. He uses mixes his methadone with alprazolam, and from what I hear that can kill you.
AskAndYouShallReceive said:
Jul 11, 09 at 11:45 amNeither you or your family can save him. Only he can, you and the family have done the best as far as seeing he was in a program to help. But seems he does not want to quit, he has not hit his rock bottom yet. It differs for each individual, some it can be simple as losing a job, or marriage in trouble, others, their very lives are in danger (as was and still is with my brother-going on over 20 yrs, in and out of rehabs, methadone programs, stealing $, stealing medications, to contracting hepatitis due to needle usage, to infections that almost cost him his life, and he still is not ready to see the damage that is done.) This is where tough love comes into play. I hope none of the family is enabling him, ie. they can be very cunning portraying themselves the victim, or entering in to programs to make you think they have finally ’seen the light’, to have food, a place to sleep. All goes well for maybe 2 wks, and you notice the same patterns over and over. If he was truly serious about quitting, he would be in NA with a sponsor who can’t be conned by lies and deceit. Methadone programs are nowhere near designed for a 5 year period, and yes, your brother is badly addicted that things are getting worse, methadone is not enough, he is supplementing with other drugs, and the behavior is uncontrollable. You as a family can attend support groups of families with addictions, much like Al-Anon, where you cut off all communication with them, and state you will not permit to see them slowly killing themselves. It is extremely painful to have to cut ties, and it is not being rude, non compassionate towards them, but it is in their best interest. When he cannot depend on anyone but himself for support, a roof over his head, food in his mouth, anything. Perhaps he will then realize he has hit rock bottom. I can very much relate with your situation and that of the family.
J.R. Neuberger said:
Jul 12, 09 at 10:19 amSome of what “Ask” above has said rings true, and some does not. It is true that noone can save your brother–he must want that for himself before any real recovery can begin. But please don’t judge the problem by the length of time in the methadone program. They are NOT related. For most chronic abusers long-term opiate abuse creates permanent changes in brain chemistry that do not heal with abstinance. Methadone is the treatment for this endorphin deficiency and is, in essence and in its workings on the patient, endorphin replacement therapy. So the fact that your brother is still in a program after five years could be a good, and NOT a bad, thing. Addiction is a “chronic, relapsing condition,” and like any chronic condition, requires constant medical attention. An untreated addiction frequently leads to death. So pressure to discontinue treatment should not be exerted in any way, and it is hoped that this is not occuring in your brother’s case. That would only be an obstical to his continued good health.
I ask, how do you know he is still abusing?? For length of time in a methadone program is no indicator here, as explained.
Also, NA is not for everyone, and not being in NA or having a sponsor, again, is an indicator of nothing. One size does not fit all and there are many paths to recovery.
And your brothers assertions as to the need for daily methadone dosing are also not an indicator of anything negative. Like many medications, a person taking methadone becomes dependent on that medication for normal functioning. If one stopped taking their blood pressure medications that condition would be exacerbated and no longer under control. The same applies here and there is no double standard–it is the same for methadone as with any other treatment–it needs to be ongoing to be effective. So your brother’s assertions in this area are nothing more than him realizing the nature of his disease. Family should be supportive of that and, again, not an obstical to his condition’s needs.
The hope here is that there is not a prejudice at play here against the treatment with methadone. It is the “gold standard” for the treatment of opiod addiction, as declared by our National Institutes of Health and has been in safe and effective usage since the 60’s. It is one of the most studied medications in medicine and, when used properly, is effective and safe, even for lifetime usage.
Does your brother have the permanent changes in brain chemistry alluded to earlier?? Only he can determine that. But if that be so, it should be greeted by the family with compassion and support, not judgement and criticism. Do not judge negatively on the basis of the treatment alone. For the results of an untreated addiction are too often death, so maintenance in treatment should be celebrated and not criticized. If his opiod abuse lasted five years or longer, then the permanancy of damage is more likely.
You can access the science behind this treatment at the National Institutes of Health websites, and also at http://www.methadone.org and http://www.lindesmith.org.
As to why your brother chose drugs in the first place, that question has no place in today. It is over and done and cannot be reversed. So saying it to him serves no constructive purpose and becomes another obstical for him to deal with. Living with an addiction, like living with any chronic condition, is no walk in the park for the person concerned. And real support does not have criticism of the past as one of its constant components. So energy spent on that serves no good purpose for either you or your brother and should be tempered.
And you need to be open to the possiblity of your really NOT understanding the full import of his disease. It is NOT a common cold, and it will NOT go away with wanting it to. That is no more good treatment than wishing high blood pressure to go away is good treatment for that condition. He is the one that is saddled with this now–maybe paying a lifelong cost in the need for constant treatment for some bad decisions in his past. Can you imagine with that must be like?? Unless you’ve walked in those shoes, as I have, you cannot fully understand the full import of that. He needs your support, not criticism for past actions. Nor does he need criticism of his present treatment–for that treatment is the best available for his condition.
I wish you, your family and, most of all, your brother the best of luck in dealing with this disorder. But, again, please do not judge by the treatment. That is what is most positive in the words you’ve posted concerning your brother.
Kind regards,
J.R. Neuberger
JRNeuberger@gmail.com
National Alliance for Medication Assisted Recovery
J.R. Neuberger said:
Jul 12, 09 at 10:31 amOne last item that I had missed. Your choice of words for your heading betrays a prejudice. For your brother is NOT addicted to methadone. He is dependent on it. The two are very, very different. For addiction has with it a very specific set of behaviors that dependence do not. Methadone is treatment, not addiction. It is NOT “trading one drug for another,” but is rather a medical treatment for a medical condition. It is endorphin replacement therapy for the former opiod abuser. But it is NOT abuse and he is not addicted to it, but dependent on it for normal functioning. We would not label the diabetic as having an addiction to insulin. It is no different with methadone treatment. Addiction and dependence are very different concepts.
Kind regards,
J.R. Neuberger
Wilmington, Delaware
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