News from Portland's Overdose Prevention Project

Q: Why is methadone prescribed if it is addictive?
A: Prescription methadone is a viable treatment option for some people addicted to opioids. While there are people who do abuse methadone, the vast majority of methadone patients do not. Unfortunately, these successes aren't the stories we hear about in the media. Additionally, most of the diverted methadone comes from prescriptions written by under-informed doctors, not from methadone clinics. There is current action being considered by the FDA to better educate doctors about methadone.
Q: Can you use methadone if you're pregnant?
A: Yes. Methadone is the 'gold standard' of treatment for pregnant, opioid-addicted women. Despite the many myths, methadone (and sometimes Subutex) is an option for pregnant women and is much safer for the baby than to quit using 'cold turkey.' Look for the Portland Women's Task Force educational materials about treatment options for pregnant women coming Spring '09!
Q: Why do the clinics allow pills to be released to some clients?
A: Take-home prescription methadone is a privilege earned by patients, who meet Federal and State criteria, as it is a means to support people who are looking to get on with their lives. "Program staff members use discretion in customizing medication schedules for each patient, according to that patient's best interests. Physicians and staff members...consider public health issues in approving take-home medication (e.g., preventing diversion, ensuring safe storage and security of medication, preventing overdoses). Staff...ensure that policies for approval of take-home medication do not create barriers to patients' continuing in treatment." Source: CSAT/SAMHSA Guidelines for the Accreditation of Opioid Treatment Guidelines
Q: What is the process for getting into the clinic?
A: Once a person has decided to explore methadone treatment for their opioid addiction, a phone call to a clinic starts the process. After the initial contact has been made, a screening, an assessment and intake process will follow. While each clinic's intake process varies, it is important to note that pregnant women are priority clients. Each clinic offers similar services that include "...integrated medical and counseling approaches grounded in an individualized recovery oriented philosophy that treats addiction as a biopsychosocial disease."
Q: Is coming off methadone harder than heroin?
A: "Because it is long-acting, withdrawal from methadone does last much longer than withdrawal from short-acting opioids. Therefore, a person who has experienced "cold turkey" withdrawal separately from heroin and methadone might say that "kicking" methadone was worse - because it lasted longer. This is one way the myth might have started and it ignores the fact that methadone withdrawal should never be done "cold turkey" to begin with."
Q: Isn't it just trading one drug for another?
A: "Methadone Maintenance Treatment (MMT) is a form of" medication assisted treatment that uses "...a medication (methadone) to overcome the compulsive need for other opioid drugs (such as heroin or other abused opioids). While the person is, indeed, physiologically dependent on methadone, the pharmacologic actions of methadone are quite different from addictive opioid agents - methadone is not a mere substitute."