zenith

One other thing, Mr Frost--you say there are drugs that are not mood altering to replace endorphins. That makes very little sense even if it were true. One of the primary functions of endorphins/enkephalins IS to regulate mood. They are the chemicals that make it possible for us to experience pleasure and happiness, feel joy, etc. With these chemicals depleted, the person is in an anhedonic state--unable to experience joy and pleasure, with nothing to fill their opiate receptors. Therefore , any medication that repairs this system and re-regulates the brain chemistry is going to, by definition, be "mood altering". There is no crime in taking a "mood altering" medication if you have a brain chemistry malfunction that affects your MOOD.

Mr Frost, it is interesting that you feel that anyone who agrees with me must therefore BE me. Many people in the methadone community know me as I monitor many support boards and attend conferences and educational seminars with them, and they know that I am a female. I assure you that I do not post to back up my own posts. In addition to my CMA training, I also have a degree in nursing (an RN degree) and have completed schooling and practicum for chemical dependency counseling. I make it my business to keep abreast of everything that is going on in opioid addiction therapy, I read reams of scientific papers, and I think for myself instead of believing rumors, stigma and prejudice. You are WAY off the mark with your assesments about how many patients pay for their treatment--the majority of clinics in the US are private pay clinics. You are also way off on your assesment of how many patients are drug free on MMT. Statistics show that 65-90% of patients test drug free depending on the clinic. Some people do need counseling, usually due to the havoc that addiction has brought about in their lives. However, not all do--the face of addiction is changing, and not everyone is a street person, homeless, jobless and strung out on heroin. Many people come from very functional backgrouns and need minimal counseling and assistance to put their lives back together if their primary problem is dysfunctional brain chemistry. Just as people with depression, bipolar disorder, etc may initially benefit from some counseling but if the medication works to repair their brain chemistry, likely do not need long term intensive counseling every week forevermore, the same is true of many addiction patients. The proof is in the pudding. At any clinic you can see long term patients who have put their lives back together and have been living perfectly normal law abiding, happy lives for decades without benefit of intensive counseling or support groups. While I DO think the coffee shop idea is a very good one--and I probably should have made that more clear in my firts post--I can assure you that my opinion on this matter did not come simply from my own ideas but from the studies and findings of much greater scientific minds than mine, such as Dr Vincent Dole, Dr Marie Nyswander, Dr Mary Jane Kreek, Dr Thomas Payte, Dr Benny Primm, Dr Edwin Salsitz, Dr. Robert Newman and other giants in the field of addiction treatment.

While this is an excellent idea, I do take issue with one thing stated. It is insinuated that methadone is simply a substitution therapy and that the "real" treatment is the counseling received. This is untrue. Many long term opiate addicts have sustained permanent damage to the endorphin system in the brain--the natural opiates we all have. Even long term abstinence, group therapy, counseling, meetings, etc will not repair this damage when it is permanent, as it sometimes is. Methadone is a substitution therapy, yes--but not for the heroin or other opiates. It is a substitute for the natural endorphins no longer being produced, in the same way that insulin replaces the chemicals no longer produced in the pancreas of the diabetic. Though some addicts may need counseling due to lifestyle issues, and it should always be offered, methadone is a very important part of the treatment and should not be relegated to the realm of unimportance next to the often questionable "counseling" that occurs at clinics. In fact, many long term patients have long since resolved their social and other issues they had when entering treatment and no longer require counseling of any kind--they are stable, compliant, functional, and should be able to see their physicians on a monthly basis for their medications instead of clogging up needed slots at a clinic.