Portland's Overdose Prevention Project
  March 2009

Welcome! In this issue you'll find publication links, resources, and a recap of our February workshop as well as helpful information about methadone and medication assisted treatment options.  In our May issue we will highlight the striking overdose data trends that were presented to us at our March OPP meeting with Dr. Marci Sorg.  Keep your fingers crossed for Spring and we'll see you in May!

Amanda, Nancy & Ronni

Portland's Overdose Prevention Project

Advocacy Partnership Exchange
Q & A: Dispelling Methadone Myths

APExOn February 5th, staff from area methadone clinics came to Preble Street Resource Center for our community "Q & A" workshop in the hopes of dispelling some of the common myths about methadone. The discussion was a lively one with close to 100 people in the day shelter tuning in and getting involved. 

Here are some of the questions people submitted anonymously during the workshop...

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?
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?
"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."

THANK YOU Tim (MRMS), John & Sue (CAP Quality Care) and Steve (Discovery House) for taking the time out of their hectic schedules to talk face-to-face with folks about methadone as an effective treatment option for opiate-addicted people and to Preble Street staff & clients for offering space for our workshop!

Our next APEx workshop is scheduled for June '09. We will feature representatives from Portland's Fire Dept/Rescue to discuss EMT perspective when dealing with an overdose situation.
FMI Contact

Faces and Voices of Recovery:
Messaging & Online Book Club Update
New Messaging from Faces and Voices of Recovery:  Talking About Recovery
"Faces & Voices of Recovery is very excited to share with you language that you can use to talk with the public and policymakers about recovery from addiction to alcohol and other drugs. This messaging is a result of in-depth public opinion research with members of the recovery community and the general public. We encourage you to use this "messaging" or language in all of your recovery advocacy - if you are speaking out as a person in recovery or a family member or friend." 
View the Messaging Memo or visit Faces and Voices of Recovery HERE

FAVOR Online Book Club
Faces and Voices of Recovery has "...been hearing from advocates around the country who want to read and discuss books together that are important to the recovery community and our recovery advocacy movement. Through online conversation and the exchange of ideas, we hope that the Book Club will expand our growing advocacy network, strengthening our movement."
Submit a book to be considered as a book club selection!
Reports & Research

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Methadone  Information
(from clinic websites)

Why is Methadone Such a Controversial Treatment?

Is This You?

Heroin/Methadone Comparison Chart

Medication Information

Nat'l Alliance of Methadone Advocates

American Society of Addiction Medicine

Addiction Treatment Forum

NIDA: Neurobiology of Addiction

American Assn for the Tx of Opioid Dependence

Methadone and Pregnancy

OPP Partner Resources:
City of Portland Public Health Division's Minority Health Program

Minority Health Program Website

Nat'l Inhalant Prevention Coalition
(Materials in Spanish)

DHHS Office of Minority Health

Nat'l Latino Addiction Tx Community Network

NIDA: Drug Use Among Racial/Ethnic Minorities

States in Brief:
Prevalence of Illicit Substance & Alcohol Use and Abuse
State of Maine (map image)
View the Report for Maine

Next Meeting
May 6, 2009
2:00 - 3:30

FMI Contact Ronni
(207) 756-8116

Our Partners
CAP Quality Care, Maine Office of Substance Abuse, Preble Street Resource Center, Discovery House, Portland Fire Department, Merrimack River Medical Services, Maine Alliance for Addiction Recovery, Maine General Medical Center and Portland Public Health Division's Behavioral Health Team, India Street Clinic and Minority Health Program.

Portland's Overdose Prevention Project
City of Portland | Health & Human Services Department | Public Health Division
389 Congress Street | Portland | Maine | 04101
(207) 756-8116 | www.substanceabuse.portlandmaine.gov
City of PortlandClick Here for OSA's Website
Portland's Overdose Prevention Project is supported by the Maine Office of Substance Abuse and the
City of Portland Health & Human Services Department, Public Health Division.