Pubdate: Mon, 14 Jul 2008
Source: Post and Courier, The (Charleston, SC)
Copyright: 2008 Evening Post Publishing Co.
Note: Rarely prints LTEs received from outside its circulation area
Author: Diane Knich
Bookmark: (Methadone)


State's Only Public Treatment System Says 93% Of Patients Aren't 
Using Other Opiates

When he tried to quit using OxyContin, heroin and other opiates cold 
turkey, Ken S. said the pain was so great he felt it in the marrow of 
his bones.

Ken, 40, who chose not to give his last name so he could remain 
anonymous, said that about a year ago he landed on the doorstep of 
the Charleston Center of Charleston County, a drug and alcohol 
treatment program that runs the state's only public methadone program.

He had been abusing opiates since he chugged a bottle of codeine 
cough syrup at 10 years old. And he was at the end of a two-year 
spree of heavy abuse of prescription opiates and heroin that left him 
in fear of losing his job and his family.

He was so out of control, Ken said, that he physically and verbally 
abused his wife as his child watched. "My 9-year-old son was scared 
of me," he said.

Ken was so ashamed of what he'd done that he tried to stop using the 
drugs, but the withdrawal symptoms were unbearable. He found himself 
doubled over and vomiting in the shower as nearly scalding water 
washed over him.

"It was disgusting," he said. He knew then that he desperately needed help.

He remembered hearing that a former girlfriend, who also was an 
opiate addict, had participated in a methadone program and was 
successful getting off the drugs.

So, Ken showed up at the Charleston Center. It was his last hope, he 
said, "the last house on the block."

Ken said he hasn't abused drugs in about a year. And he takes the 
methadone only as prescribed.

He's rebuilding his life with the help of the methadone program, 
which includes counseling and regular drug screening. He also is part 
of a 12-step recovery program. For the first time in many years, Ken 
said, he can think about doing things to help others instead of 
simply thinking about himself and planning to get more drugs.

He's aware of the stigma surrounding methadone programs, how they 
conjure images of homeless junkies injecting themselves with heroin.

Ken is employed, middle class, married and has never used a needle. 
He thinks the negative stereotype keeps other addicts from seeking 
the help they need.

Methadone, a long-acting synthetic opiate, has been used to treat 
heroin and other opiate addicts since the 1960s. Some addicts treated 
with methadone gradually decrease their dosage until they are 
drug-free while others stay on it for decades. They don't get high 
from methadone, and are able to function normally, including holding jobs.

According to the White House Office of National Drug Control Policy, 
methadone is a rigorously well-tested medication that is safe and 
efficacious for the treatment of narcotic withdrawal and dependence.

Still, it remains controversial with the public and among some 
alcohol and drug treatment professionals who believe that only 
abstinence-based programs are effective.

Dr. Jack Emmel, medical director of the Charleston Center, winces 
when people ask him whether treating heroin and other opiate addicts 
with methadone is simply trading one drug for another.

When it comes to opiate addiction, he said, "you'll find no program 
that has the success rate of a good methadone program."

Addiction to shorter-acting opiates, which include heroin, OxyContin, 
Lortab and Vicodin, severely alters a person's brain chemistry, he 
said, while methadone stabilizes it.

Methadone, however, doesn't work quickly. It takes many months, even 
a year in some cases, for an addict's brain chemistry to return to 
normal, Emmel said.

Addicts who attempt to stop using opiates too quickly experience 
severe withdrawal symptoms and are likely to return to abusing the 
drugs, he said. Ninety percent of such addicts who stop cold turkey, 
even those whose withdrawal is medically supervised, relapse, he said.

Ed Johnson, program administrator for the center's opiate treatment 
program, said patients who use methadone fare better.

The center's random drug tests have found that 93 percent of patients 
who are using methadone aren't using any other opiates. And 65 
percent aren't using any other drugs. Those rates indicate that the 
methadone program is more successful than most drug treatment 
programs, not just programs for opiate addiction, he said.

Johnson said the stigma surrounding methadone programs has worsened 
after some recent highly publicized drug overdose deaths involving 
methadone and other drugs.

Methadone also is used as a painkiller, he said, so it ends up on the 
street. But most addicts use it only when no other opiates are 
available. It doesn't give them a good high, but it holds off painful 
withdrawal symptoms, he said.

Johnson and Emmel said the center's staff thinks gradually decreasing 
the dosage of methadone and becoming drug-free or staying on the drug 
long-term are both viable options.

"A person whose methadone dose is adjusted properly is 100 percent 
functional," Emmel said. And some people can't get off it, just as 
some people with diabetes can't eliminate the need for insulin by 
changing their diets and exercising.

The center serves about 250 patients in the methadone program, 
Johnson said. They are all different ages and come from all walks of 
life. Fewer than half use needles. Most abuse prescription drugs.

The state has 10 private methadone programs, including one in Charleston.

The Center's program is self-supporting, and patients pay about $13 
per day, Johnson said. That includes methadone and counseling. 
Without counseling, most patients would likely relapse, he said.

Ken says that's true for him. In the year he's been on methadone, 
he's been "working full-throttle on recovery," he said. He's been 
decreasing his dosage of methadone over the past several months, and 
expects to be off of it and completely drug-free by mid-August.
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