Finding Normal The Truth About Methadone

Methadone....In The Eye Of The Beholder.

noreply@blogger.com (Kristina) — Mon, 15 Dec 2008 10:14:00 +0000

Of course, I had to find an excuse to post a picture of this little darling...my new Grandson! So I thought instead of a news article I would just ramble. It has been an incredibly painful night but for whatever reason I finally got some peace so I thought I would write. I have had a lot on my mind lately. I think anytime someone is facing something like this you tend to review your life & perhaps things you would have written off easily before make more of an impact than they would or should. There is so much hate between the anti methadone groups and the pro methadone groups (at least on the internet) that I believe all of us have lost site of reality. The more I think about it the more I think it is all based on your personal journey. I can't help but believe if some of the addicts who have overdosed had lived and found the kind of help I did at a Methadone clinic they would have been right there with us along with there families. Vice Versa...If my son (God forbid) ever died from an overdose and the coroner said it was unequivocally Methadone that killed him I can't say I wouldn't have founded next HARMD. After all, I was passionate enough for this so what is to say I wouldn't have been 3 times more passionate about something tragic like that? I honestly have tried to put myself in the other sides shoes in my advocacy work. No one but myself and my family knows that was never more apparent than during the NIMBY Video crisis where I was being accused of deliberately using the pictures to trample on the memory of dead family members. I went back and forth, I prayed and meditated for hours. What do you want me to do Lord? Tell me, I asked. Every time I went to remove them I received a note or an e mail of some horrible threat or demeaning name. This should not prevent me from removing the pictures because that would mean I was all they said I was but it was enough to make me question removing them. The intention was to show thing people had seen and heard and read that IMO lead them to believe all of the things they used as reasons to prevent a clinic from opening. Then I received a heartbreaking letter from a man who had lost his daughter to a Heroin overdose while waiting for a clinic to open. He had told me how he read the stories of the mothers, fathers, sisters, etc. who said Methadone had taken their loved ones life but no one spoke of those like his daughter. QUOTE "Nobody said, Heroin killed my baby...they said she killed herself. He continued to say No one says she had the right to live because if that meant MMT then she didn't. My Baby is forgotten, he said. There is no HARMD space for her picture. There is no march for her mother and I to go to and carry her beautiful picture. There is no Heroin dealer in jail for murder. Can you imagine if we had tried to have someone charged with murder for our daughters Heroin overdose? Much less several people like in some of the cases of Methadone overdoses. No, we could not take it a step farther and say the lack of methadone clinics available killed her and blame all of those we believe are responsible for keeping the clinics out of our area. We have had to face a reality that organizations like HARMD have shielded many of their members from. We were forced to face that there is no one to blame for our daughters death. Yet,Do I think if there had been more clinics she would have lived? Yes, we believe Methadone could have saved her. Do we believe there are people to blame for their being a lack of clinics? Absolutely. However, living in blame would get us where? Thank You for taking the time to read this & doing the work you do." End QUOTE So, after this I couldn't help but leave it as is. I must say though I have changed my tune about HARMD lately as they appear to be making more of an effort towards education of methadone diversion and that I am all for! Maybe I have changed not them or quite possibly it is the strongly stigmatized view MAMA.org has taken with their WE WANT METHADONE BANNED campaign. I wonder if they knew it would only lessen the popularity of their website? Usually HATE driven people either reach understanding or continue to think they can win others over to their point of view (Remember Hitler?...LOL) Their were more members in his party than Nancy's (the creator of MAMA).

So, here's to new ideas, understanding, hope, and new life!! Until next time...God Bless! .

Does Giving Drugs Of Choice To Addicts Help Or Hinder

noreply@blogger.com (Kristina) — Mon, 24 Nov 2008 07:39:00 +0000

I have been struggling with my POV regarding the NAOMI project Results. First of all here is an overview of what I am referring to in case you didn't know... The NAOMI study tested whether heroin-assisted therapy or methadone therapy is better for improving the health and quality of life of long-time opiate users. Eligible participants were randomly assigned to receive a 12-15-month course of medically prescribed injection opioids (heroin or hydromorphone) or oral methadone therapies. Following a slow, but steady recruitment of volunteers who met the study’s rigorous inclusion criteria, NAOMI fully enrolled 251 participants (192 in Vancouver and 59 in Montreal) by March of 2007. The treatment phase of the study was completed in June 2008. Researchers will continue to gather and analyze data until NAOMI’s expected closure date in mid-2009. Funded by the Canadian Institutes of Health Research, and approved by Health Canada, NAOMI enrolled and treated participants in Vancouver and Montreal since 2005. Individuals were considered eligible for the NAOMI study if they: • Had been addicted to heroin, dilaudid or another opiate for five years; • Had been injecting heroin for the past year; • Had tried addiction treatment twice in the past including methadone maintenance; • Were 25 or older; and, • In the case of the Vancouver site, were a member of the Downtown Vancouver community and had been for an extended period of time. Results show that North America’s first heroin therapy study keeps patients in treatment, improves their health and reduces illegal activity. VANCOUVER, BC, October 17, 2008 – Researchers from the North American Opiate Medication Initiative (NAOMI Study) today released final data on the primary outcomes from the three-year randomized controlled clinical trial. “Our data show remarkable retention rates and significant improvements in illicit heroin use, illegal activity and health for participants receiving injection assisted therapy, as well as those assigned to optimized methadone maintenance,” says Dr. Martin Schechter, NAOMI’s Principal Investigator, Center for Health Evaluation and Outcome Sciences and Professor and Director, University of British Columbia School of Population and Public Health. “Prior to NAOMI, all of the study participants had not benefited from repeated standard addiction treatments. Society had basically written them off as impossible to treat.” The data, which was collected from 251 participants at sites in Vancouver and Montreal, demonstrate that a combination of optimized methadone maintenance therapy (MMT) and heroin assisted treatment (HAT) can attract and retain the most difficult-to-reach and the hardest-to-treat individuals who have not been well served by the existing treatment system. Key findings at the 12-month point of the treatment-phase of the study showed that HAT and MMT achieved high retention rates: 88 per cent and 54 per cent respectively. Illicit heroin use fell by almost 70 per cent. The proportion of participants involved in illegal activity fell by almost half from just over 70 per cent to approximately 36 per cent. Similarly, the number of days of illegal activity and the amount spent on drugs both decreased by almost half. In fact, participants once spending on average $1,500 per month on drugs reported spending between $300-$500 per month by the end of the treatment phase. Marked improvements were also seen in participants’ medical status with scores improving by 27 per cent. Of particular note amongst the findings, participants receiving hydromorphone (DilaudidTM) instead of heroin on a double-blind basis (neither they nor the researchers knew) did not distinguish this drug from heroin. Moreover, hydromorphone – an opiate licensed for the relief of pain - appeared to be equally effective as heroin, although the study was not designed to test this conclusively. According to the NAOMI Study Investigators, further research could help to confirm these observations, allowing hydromorphone assisted therapy to be made more widely available. While a comprehensive health economics study is pending, researchers have already determined that the cost of continued treatment is much less than that of relapse. “We now have evidence to show that heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatments. A combination of optimal therapies – as delivered in the NAOMI clinics - can attract those most severely addicted to heroin, keep them in treatment and more importantly, help to improve their social and medical conditions,” explains Schechter. A summary report of the findings and background information on the study are available at: www.naomistudy.ca. OK, So we have an $8 million study conducted that shows treatment is successful. At first I thought , "Wonderful, another treatment option for addicts." After all, I had always said, Methadone is not for everyone and we only want people to have as many options available as possible. I have supported all forms of treatment including Ibogaine which is a hallucinogenic illegal in the US. Certainly not for me but it has worked for some so I would support it. However, the more I thought about this the more I disagreed with it. Here is why... I was addicted to Oxycontin. I would take other opiates but only if I could not find OC's or couldn't afford them. If someone had come to me before I was in recovery and said, "We are conducting a study to treat your drug addiction which will involve the administration of Oxycontin (or whatever your drug of choice is) at a level to prevent withdrawal. Then we will be studying you to see how you do." I would have jumped at the chance. Don't you think the outcome would have been a decrease or elimination in the amount of money I was spending on the street, a decrease or elimination in any illegal activity I had to commit in order to get money, and an increase in my health due to clean surroundings to inject in, sterile equipment, more money to use for food so I could eat etc? Also, they even remarked that a decrease (Not an elimination) of buying additional drugs off the street as a success. IMO the decrease from $1500/month to between $300-$500/month was because most of the cost was being absorbed by the study. I mean doesn't it make sense that if you spend $1500/month on heroin and then join a study where they GIVE you heroin it may help the cost? OK, now I know someone is going to question how I can have this attitude when I defend the fact that Methadone is not trading drugs. So how can I say this is just keeping them addicted but MMT isn't? Yet, when someone says they are addicted to Methadone I have never heard anyone tell them to go to a Methadone clinic! In the case of MMT patients we are not being treated with our drug of choice. Does that make any sense? So, while I am all for clean needle exchanges, even clean injection sites I believe those programs come with a responsibility to educate and offer treatment (of their choice) to anyone using these programs. I still believe a variety of programs need to be available because what works for one won't work for all but the programs shouldn't offer drugs of choice as treatment either. I would like to know what others think about this including other addicts.

My Journeys End

noreply@blogger.com (Kristina) — Mon, 10 Nov 2008 04:53:00 +0000

Yes, I realize this is depressing but maybe when I have finished you won't find it so bad. I have been putting this off for some time now but according to my doctor now is the time to do it. I have ignored the doctors warnings until now (like when they told me last year would be my last Christmas) but my body is finally starting to agree with what they are telling me. By no means does this mean I will be signing off for good. I will still be here as a source of info for some and a pain in the rear for others...LOL No doubt the latter will be glad to see me go. This only means the time is drawing nearer for my journey to end so I wanted to leave some thoughts now because it may be too difficult to do as my health deteriorates further. Many of you know I contracted Hepatitis C years ago as a nurse at the VA Medical Center. The genotype I received is most common in Asians which is where my patient had been stationed for years. This was the only way the doctors would believe it wasn't connected to my IV drug use. I learned in time that it didn't make a bit of difference How anyone contracted it only that they had it. Anyway, I advanced rather quickly to cirrhosis then to cancer. This song reminded me so much of how I felt after they told me I had a tumor on my liver. I did not want anyone to talk about my prognosis because ... well as the song says "Don't tell me that I'm Dyin cause I don't wanna know." LOL I knew that a transplant was the only real option available but I had just watched a friend die after receiving her liver and they had refused her pain meds because of her addictive history. I also knew the statistics were very clear that new livers become reinfected with Hep C within 5yrs. of transplant. When you are diagnosed with HCV it is a lose/lose situation if you advance to terminal conditions because you feel as though you have poison coursing through your veins. This poison will reinfect any new organ it comes into contact with and you have to start all over. I wanted the time I had left to be as quality as possible so I chose what is known as the "non invasive" route. Well, I have done great. I have lived a year longer than anyone expected and have maintained a fairly high level of independence throughout. That is until a few weeks ago. I went to the oncologist and got a fairly routine check but I knew the results would be anything but routine. I had been experiencing signs that the cancer had spread. I don't want to discuss the personal details but lets just say I had what appeared to be advanced cancer in several areas of my body. For the first time I was truly scared. A few days later I got a phone call for me to come in and we would "talk". I told the nurse (who I had developed a fairly close relationship with) to tell me yes or no..."Has it spread?" Well, after much coaxing my suspicions were confirmed. My cancer has indeed infiltrated several major organs and they are shutting down. I was told to prepare for severe pain and to get a doctor nearby that can be called at anytime to come to the house when it gets bad. I found a sweetheart of a doctor who is so understanding. He offered to put me on additional Methadone until I had a pain management doctor but I refused. The time will come for the strong meds again and I will know it. Not before then. I am determined to fight it as long as possible. Of course I find this funny because I received a comment from Nancy Garvin today about how I thrive off of this drug and am addicted to methadone not just dependent. Then she told me to Stop a day or so and watch what happens. My favorite comment was this, " You have no intention of becoming drug free and running scared that methadone may no longer be labeled the wonder drug you and so many claim." I bet the doctor who told me how stubborn I was being by "holding on" would find her comments pretty funny. Regardless, I want to thank all of you who have supported me & encouraged me. Those who know me via the Hepatitis C, Cirrhosis, and Cancer support groups continue to write your legislators for funding so there may one day be a cure for this horrible disease.To those who have been saved by Methadone keep fighting for your right to treatment as well as for the elimination of diversion. We must find a balance through measures that will allow the right people to get treatment while keeping the wrong people from getting it on the streets. We also must educate others that Methadone is not dangerous when used correctly but used incorrectly it can be lethal. Someone once told me my legacy would be Finding Normal which is why I have worked so hard to build on it by adding a website, etc. but the time will come when I will either have to pass on my website to someone else or close it down. I am leaving my son in charge of contacting John, Bayla, and Zenith when I pass so I don't leave anyone wondering. These people know all of my contacts to spread the word. I know some have asked about services, etc. and Brenton will have that info also. I do not want flowers though. In liue of flowers please donate to The American Liver Foundation or NAMA. Believe me I know how gross this is HaHa... which is why I have put it off but like i said the sooner I have it out of the way the sooner I can stop worrying about it. So, I love you all, I have mad respect for you (you know who you are). Remember... Dance like no one is watching, love like you'll never be hurt, work like you don't need the money, live like it's heaven on earth.

Tennesee Methadone Clinic Needs Help Opening & Fighting A Lying Self Proclaimed Expert

noreply@blogger.com (Kristina) — Mon, 15 Sep 2008 07:19:00 +0000

Sunday, Sep 14, 2008

AROUND THE TOWN: Methadone clinic may come to Monterey

By Jan Boston Sellers / Chronicle columnist I was talking with my friend Steve Stone on the phone earlier this week about the possibility of a methadone clinic being located in nearby Monterey. Steve has done a lot of research on the proposed clinic and is very knowledgeable about the drug that is used to treat heroin addicts. Steve Stone works for the family owned business ...TAPS which is basically an advertising agency that places ads for planes, construction equipment, etc. One could see the expertise this would lend to someone in the field of addiction. LOL Check out their website and look at all the addiction info...NOT! http://www.tappublishing.com/index.html "Jan," Steve said, "we have to get word out about this clinic so that locals know what may be coming into their community." Absolutely, and don't forget to bolt the doors and lock up the kiddies because The Druggies are Coming...The Druggies Are Coming! I suggested he compose an article for me this week based on research surrounding the proposed methadone clinic since he has more information than I do about it. I would hate to see how little she knows then. The following was written by Stone, a partner at TAP Publishing here in Crossville and a large supporter of nonprofit organizations in the community, including the TAD Center. By Steve Stone One might think that is good news for our area that a new clinic could be opening next year just about 20 miles west of Crossville on Hwy. 70. To the contrary, this is not good news. It's an extremely serious development that carries life and death consequences. Methadone is a drug that was legalized to replace heroin and other opiates. The key word here is "replace," not arrest or cure. Drug replacement therapy supposes that it is better to replace a legally prescribed drug with one that is not legally obtained. In the brains of addicts, methadone prevents heroin or morphine from interacting with receptors for natural painkillers called endorphins, blocking the effects of the addictive drugs and reducing the physical cravings. In controlled doses, it creates its own effects of euphoria and drowsiness, but lasts much longer. Methadone is one of the most physically dependant medications invented in the 20th century. And, like methamphetamine, it is also a Nazi invention. First of all in controlled doses it produces NO euphoria. Controlled doses are what the goal is for those in treatment. Secondly, the statement that it is one of the most dependent meds of the 20th century is false. Please back that one up with research because I would love to see it. Last, the fact that methadone originated in Germany has nothing to do with its effectiveness. Many drugs were created in Nazi Germany that were important such as the first antibiotic, (Salvarasan) the first drug to treat Syphilis, and many many more. Since this therapy began in the 1960s, methadone has spread worldwide. Today, in our area, one of the closest clinics is in Rossville, GA, just south of Chattanooga. Private Clinic North is applying to locate a new, for profit, facility in Monterey to treat up to 650 addicts a day. Addicts must go to the clinic every day for 90 days before they are given a 30-day take home supply. Abuse and street use of methadone is exploding and young people are dying. Federal regulations only allow 30 days of take home meds to be given after 2 years of treatment. Check the federal regulations. http://www.methadone.org/library/42CRF_part8_code.html The number two cause of death today from accidental drug overdose is methadone. I have explained many times how this is skewed. That is behind only cocaine. Methadone is an extremely dangerous drug and in the wrong hands, it kills all too often. Sheriff Burgess told me last week about two brothers and a cousin from Cumberland County that died from methadone overdose last year. According to the CDC, the methadone rate in Tennessee went from 12 in 1999 to 134 in 2005. Addicts who begin methadone replacement therapy rarely ever stop to experience living a drug-free life. Success on MMT is not measured by whether or not you continue taking methadone. It is inconvenient for an addict to drive 90 miles to the nearest clinic. Putting a clinic just down the road is going to make it easy for addicts to continue using drugs and not learn how to live drug-free. No, Putting a clinic just down the road is going to make it easy for addicts to get the help they need. We are very fortunate to have a strong recovery influence in our community. Making this all too often deadly drug easy to obtain will surely kill people. The introduction of a drug treatment facility including Methadone has never coorelated to an increase in death rates. Most diversion is occuring from Pain clinics. Methadone is a terrible failure and is spreading like fire across our country. Research to prove that statement? We can stop this clinic from locating here. Yes, and you can also cost many lives in the process. There will be a public hearing in Nashville Oct. 22 and hopefully one in Monterey approximately two weeks prior. Please contact your local and state representatives and say no to this for profit venture. If you know someone in Putnam County, contact them and ask them to say no to methadone. Private Clinic must obtain a certificate of need before they can begin dispensing methadone. Contact the Tennessee Department of Health Services and Development at 500 Deadrick St., Ste. 850, Nashville, TN 37243, or e-mail melanie.hill@state.tn.us. *** This is one of the most bias pieces of crap I have ever read regarding MMT. NIMBY at its worst. Lots of work needs to be done in Tennessee. The man that wrote this article has no qualifications to be discussing addiction on either side. He is just one of the most wealthy and come from one of the most prominent families in the area. WOW. Please contact the agencies mentioned and fight this or don't complain when the clinic doesn't open.

Letter from Canadian MMT Patient Praises Treatment

noreply@blogger.com (Kristina) — Mon, 15 Sep 2008 07:12:00 +0000

Another Canadian Praises The MMT Program

Sunday, Sep 14, 2008

Methadone program gave me a second chance at life

The Province

Published: Friday, September 12, 2008

Any system designed to help people always has a couple of bad apples to ruin it for everyone.

As an ex-heroin addict I wouldn't have had the chance for a second start in life without the methadone program.

I'm now working full time. I don't rely on the government to pick up the tab on my medicine, nor do I receive any sort of incentive, cash or otherwise, for my prescription.

Leslie Tannen of the Downtown Surrey Business Improvement Association should do her homework before she puts down a great program.

There are biweekly and random urine tests to make sure patients are not misusing the program, but you can't monitor anything 100 per cent of the time.

If anything, these ma and pa pharmacies should have more screening to determine who dispenses the methadone and if they follow correct procedures.

Tannen's comments were insulting -- only a very few abuse the program.

Michael Smith,

Vancouver

NY Times Article on Methadone

noreply@blogger.com (Kristina) — Mon, 18 Aug 2008 00:50:00 +0000

I debated whether or not to add this article with my comments included. After all they are pretty harsh. Then I recalled all the people who have been hurt by the anti methadone groups and how nobody comes to their defense. Because they survived addiction and feel as though they are fighting for their life (yet are told they are fighting to maintain a legal high) they are seen as not worthy. Every single story of Methadone overdose I have ever seen has another side to it that is never told. Maybe because I am terminally ill and have too little time left to spend afraid of these people or maybe it is because I was raised that if something is right you fight for it with all you have. Whatever the reason, I am printing my thoughts. Without fear, shame or worry about the consequences. The latter is due to one of the anti methadone members who has been known to call a patients clinic or doctor and make false allegations when someone gets in a heated debate with her or say...prints something she doesn't want others to know in a blog...LOL Thats OK I have God and truth on my side. I'm not ascared!

*Comments in red are my own and do not reflect the original article.

Methadone Rises as a Painkiller With Big Risks

Stephen Morton for The New York Times

IN MEMORY Nancy Garvin with a photo of her son Robby at a garden she had made for him in Beaufort, S.C. Robby, who had severe back pain, died at 24. Nancy is the founder of MAMA.org. She did not mention in this interview nor in the video that her goal is to ban Methadone completely from both pain patients and addicts. This is the opposite from the group HARMD who states their goal is to place srticter regulations on the drug. This difference in opinion led to Nancy stepping down as the vice president of HARMD. I believe that Mellisa Zuppardi (founder of HARMD) has the same goal in mind but ids a little smarter than her counterpart and is going about it in a more tactful or decieving manner. Instead of declaring war on the drug Methadone she states she wants stricter regulations. However, she has been told and I am sure is fully aware that the restrictions she is requesting would lead to the ultimate closing of addiction clinics as well as being a detourant for pain specialists who prescribe it. One of the proposals is the restriction of 30 clients per clinic and the ban on driving. This would close most clinics within 6months. In addition, the red tape doctors would be required to go through in order to prescribe the medication for pain goes above and beyond educating the patient and would force most doctors to resort back to more dangerous drug such as Oxycontin (which uninsured clients cannot afford) or it will leave patients in pain. This is the first picture of Nancy to date and the first video. I could say, "I can see why" whoops I just did...LOL

Bill Crandall for The New York Times

Dr. Howard Heit is a leader in pain management and tightly controls methadone use of patients. Checking pain sensitivity of patient Alexandra Sherman.

By ERIK ECKHOLM and OLGA PIERCE

Published: August 16, 2008

Suffering from excruciating spinal deterioration, Robby Garvin, 24, of South Carolina, tried many painkillers before his doctor prescribed methadone in June 2006, just before Mr. Garvin and his friend Joey Sutton set off for a weekend at an amusement park.

On Saturday night Mr. Garvin called his mother to say, “Mama, this is the first time I have been pain free, this medicine just might really help me.” The next day, though, he felt bad. As directed, he took two more tablets and then he lay down for a nap. It was after 2 p.m. that Joey said he heard a strange sound that must have been Robby’s last breath.

Methadone, once used mainly in addiction treatment centers to replace heroin, is today being given out by family doctors, osteopaths and nurse practitioners for throbbing backs, joint injuries and a host of other severe pains.

A synthetic form of opium, it is cheap and long lasting, a powerful pain reliever that has helped millions. But because it is also abused by thrill seekers and badly prescribed by doctors unfamiliar with its risks, methadone is now the fastest growing cause of narcotic deaths. It is implicated in more than twice as many deaths as heroin, and is rivaling or surpassing the tolls of painkillers like OxyContin and Vicodin.

“This is a wonderful medicine used appropriately, but an unforgiving medicine used inappropriately,” said Dr. Howard A. Heit, a pain specialist at Georgetown University. “Many legitimate patients, following the direction of the doctor, have run into trouble with methadone, including death.”

Federal regulators acknowledge that they were slow to recognize the dangers of newly widespread methadone prescribing and to confront physician ignorance about the drug. They blame “imperfect” systems for monitoring such problems.

In fact, a dangerously high dosage recommendation remained in the Food and Drug Administration-approved package insert until late 2006. The agency has adjusted the label and is now considering requiring doctors to take special classes on prescribing narcotics.

Between 1999 and 2005, deaths that had methadone listed as a contributor increased nearly fivefold, to 4,462, a number that federal statisticians say is understated since states do not always specify the drugs in overdoses. Florida alone, which keeps detailed data, listed methadone as a cause in 785 deaths in 2007, up from 367 in 2003. In most cases it was mixed with other drugs like sedatives that increased the risks.

The rise of methadone is in part because of a major change in medical attitudes in the 1990s, as doctors accepted that debilitating pain was often undertreated. Insurance plans embraced methadone as a generic, cheaper alternative to other long-lasting painkillers like OxyContin, and many doctors switched to prescribing it because it seemed less controversial and perhaps less prone to abuse than OxyContin.

From 1998 to 2006, the number of methadone prescriptions increased by 700 percent, according to Drug Enforcement Administration figures, flooding parts of the country where it had rarely been seen.

But too few doctors, experts say, understand how slowly methadone is metabolized and how greatly patients differ in their responses. Some prescribe too much too fast, allowing methadone to build to dangerous levels; some fail to warn patients of the potential dangers of mixing methadone with alcohol or sedatives, or do not keep in contact during the perilous initial week on the drug. And some patients do not follow the doctor’s orders.

“Those problems were not soon recognized,” said Dr. Bob Rappaport, a division director at the Food and Drug Administration. He added: “Methadone is an extremely difficult drug to use, even for specialists. People were using it rather blithely for several years.”

Dr. James Finch, an addiction specialist in Durham, N.C., said, “In the clinical and regulatory communities, everyone is trying to run and catch up with and deal with the causes of methadone overdoses.”

This year the federal government started sponsoring voluntary classes that teach doctors the elaborate precautions they should take with methadone, like inching upward from low starting doses and screening patients for addictive behavior. (While Robby Garvin’s doctor could argue that the dosage he was taking was reasonable — one to two 10-mg tablets, three times a day — and he was cleared by his state medical board, many specialists would have started him on a lower dose.) This is the first time it has ever been released how much Methadone N.G.'s son was prescribed. In the past she had always used the fact that he had taken his Methadone exactly as prescribed and it killed him leading others to believe he was prescribed an appropriate dose of Methadone (5-10mg). Whenever asked what amount he was prescribed she never answered. Now we know why. The doctor killed her son not the medication. Furthermore, I am curious as to what was in the other prescription bottle beside the bed in the video. Supposedly her son wasn't on anything other than the Methadone. Yet, the video clearly shows 2 prescription bottles on the table in the motel. BTW, I was unable to download the video but have no doubt it will be plastered all over YouTube soon (unless she knows the discrepancies exist and don't want it seen) at which time I will post it). Until then it can be viewed at...

http://video.on.nytimes.com/?fr_story=db64ec8d5d24c60a889157b34b368603664be207.

In what critics call a stunning oversight, the F.D.A-approved package insert for methadone for decades recommended starting doses for pain at up to 80 mg per day. “This could unequivocally cause death in patients who have not recently been using narcotics,” said Dr. Robert G. Newman, former president of Beth Israel Medical Center in New York and an expert in addiction.

The F.D.A. says that in the absence of reports of problems by doctors or surveillance systems, “we would have no reason to suspect that the dosing regimen” might need to be adjusted.

In November 2006, after reports of overdoses and deaths among pain patients multiplied and The Charleston Gazette reported on the dangerous package instructions, the F.D.A. cut the recommended starting limit to no more than 30 mg per day. “As soon as we became aware of deaths due to misprescribing for pain patients, we began the process of instituting label changes,” Dr. Rappaport said.

Methadone, which is made by Roxane Laboratories Inc. of Columbus, Ohio, and Covidien-Mallinckrodt Pharmaceuticals of Hazelwood, Mo., creates dependency and is sometimes sought by abusers who say they experience a special buzz when mixing it with Xanax. This is what causes most of the deaths.

Bill Crandall for The New York Times

A NEW START Alexandra Sherman suffered for years from hip and shoulder pain that “felt like somebody stabbing me with a knife.”

While the greatest numbers of methadone-related deaths have occurred among the middle-aged, the fastest growth — an elevenfold jump between 1999 and 2005, to 615 — occurred among those age 14 to 24, which experts say may be mainly a result of pill abuse.

Pain experts say the country is seeing a reprise of the abuse and tragedies that followed the introduction of OxyContin, a time-release form of oxycodone that was heavily marketed in the late 1990s. It became a factor in hundreds of deaths and a focus of law enforcement.

OxyContin is still widely prescribed, but a survey of Medicare plans in 2008, by the research firm Avalere Health LLC, found that many did not even include OxyContin on the list of reimbursable drugs. Critics like Dr. June Dahl, professor of pharmacology at the University of Wisconsin, fault the insurance companies for favoring methadone simply because of its monetary cost. “I don’t think a drug that requires such a level of sophistication to use is what I’d call cheap, because of the risks,” Dr. Dahl added.

Yet for the right patients, methadone can be a godsend. Alexandra Sherman, a patient of Dr. Heit’s at his Fairfax, Va., clinic, suffered for years from hip and shoulder pain that “felt like somebody stabbing me with a knife,” she said. Pain began to rule and ruin her days.

Dr. Heit gave her OxyContin and later, because it seemed to work better and because of the expense, switched her to methadone. Her insurance at one point covered only $500 in prescriptions, which paid for just one month’s worth of OxyContin, compared with methadone’s cost of $35 a month.

Methadone “has given me my life back,” Ms. Sherman said. And if Nancy Garvin has her way you will lose it!

But Dr. Heit did not just throw drugs at her problem. He told her that she would also have to try physical therapy as well. They signed a contract listing mutual obligations — she would follow directions, he would be on call. He starts patients at low doses, makes them bring in their pill bottles so he can count how many are left, and may give urine tests to deter mixing drugs.

Some doctors, like Dr. Theodore Parran of Case Western Reserve University, also require methadone patients to give them the names of relatives or friends they can call from time to time.

But not all doctors have taken such precautions. Tony Davis, a contractor in Victorville, Calif., had just turned 38 in 2004 when, after years of migraines and back pain, he saw a new pain doctor in his Kaiser Foundation Health Plan. The doctor, who had already given him the sedative Xanax, prescribed methadone because of his continued pain.

The second day on the two medications, Mr. Davis said, “I’m feeling really weird,’ ” recalled his wife, Pebbles Davis. The two lay down for a nap and when she woke up, her husband was dead.

Ms. Davis recalled that the coroner had told her, “Given the medicines he was on, his brain forgot to tell his heart to beat and his lungs to pump.” The case went to an arbitrator, who ruled that although Mr. Davis had overused his drugs in the past, the doctor had failed to warn him about the new risks of starting methadone together with Xanax and that the care was substandard. Ms. Davis was awarded more than $500,000. “I never had any idea of the risk nor did my husband,” she said.

Another source of danger has been the conversion tables that doctors use when switching patients from one opioid to another — telling, for example, how many milligrams of methadone would be equivalent to the level of morphine a patient had been taking. These charts, until recently, indicated dangerously high doses for methadone. Newer ones suggest lower levels but many experts say these may be useless because methadone affects patients so variably.

Now, as the government is making new efforts to teach methadone’s challenges, some officials and doctors would go further, requiring prescribers to take a course before using methadone.

But many physicians and patient groups are wary of any steps that would slow access to pain treatments.

As early as 2003, alarmed by the rise in methadone-related deaths, the Substance Abuse and Mental Health Services Administration made an urgent call for more systematic and detailed state and national reporting about opioid deaths — a call that still goes unanswered.

Misuse by abusers was first seen as the problem, but now, said Dr. H. Westley Clark, director of the Center for Substance Abuse Treatment of SAMHSA, “We know that a significant share of the methadone deaths involve doctors making well-intended prescriptions.”

A majority of victims also used large quantities of alcohol or benzodiazepine sedatives but few would have died without an opioid as the primary culprit. “You can take a lot of benzodiazepines without dying,” said Dr. Charles E. Inturrisi of Weill Cornell Medical Center, who said they strengthen the depressive effect of methadone.

Some doctors prescribe to patients who may be expected to court danger, like Anna Nicole Smith, who died from a drug cocktail including methadone. I had hoped I would never even need to clarify this because it was so prominent in the news but oh well, never assume anything...LOL METHADONE DID NOT KILL ANNA NICOLE! The coroner stated that the Methadone was the least of the concerns with her toxicology report and much to many others dismay he refused to put it on the death certificate as the cause.

Last February, Margaret Moore, 54, who lived alone in South Pasadena, Fla., with a history of alcoholism, depression and chronic back pain from a car accident, was found dead at home. Her doctor had prescribed methadone and valium and, he told investigators, warned her to stop drinking. OK..another mixed drug reaction this time the fault of the doctor. Where are all the single Methadone related deaths?

Her body was surrounded by empty vodka bottles and a host of pills including bottles of methadone tablets and sedatives. Her death was declared an accident from methadone toxicity. Now excuse me but BULLSHIT! To not even say multiple drug related is nonsense. So, remove the Vodka, remove the sedatives, the Methadone in and of itself caused the death? That is the biggest crock of prejudice I have ever seen.

Since April, SAMHSA has sponsored nine voluntary training courses on the safe prescribing of opioids, and many more are planned, though they will only reach a fraction of prescribers. The agency is also contracting with the American Society on Addiction Medicine to set up a mentoring program, through which prescribing physicians can receive expert advice. The State of Utah has a plan to educate every doctor and pain patient in the state about safe use of methadone and other opioids.

Nancy Garvin, Robby’s mother, is one of many relatives of victims who, in the absence of a national registry, have started educational and pressure groups to fight bad prescribing and abuse of the drug. I believe "pressure groups" was the key.

Still, the death rate appears to be rising, raising the question of what more may be necessary, in law enforcement and in doctor training.

“Methadone can be important for patients when other drugs don’t work,” said Dr. Inturrisi, ”but unless the doctor has the training and resources to manage the patient properly, he’s going to get in trouble at a rate that’s unacceptable.”

Another Maine Town in Protest . Methadone Clinic NIMBY Again!

noreply@blogger.com (Kristina) — Mon, 18 Aug 2008 00:47:00 +0000

This week, the Palmyra Board of Selectmen began discussing a temporary moratorium on methadone clinics, as the town of Sanford and city of Lewiston have previously done.

Last month, the Newport Select Board approved a moratorium to allow the town government to update its zoning ordinance to specify where a clinic can be established.

Now, the Bangor City Council is considering whether to limit the size of future methadone clinics in Bangor, which is home to three.

All of this concerns Mike Franklin, clinical supervisor of the Discovery House of Central Maine, a methadone clinic at 21 Airport Road in Waterville. Discovery House serves about 365 people.

Methadone is a synthetic opiate and is used to treat addiction to heroin and other opioid substances. There are an estimated 50,000 people in Maine addicted to opiate drugs, and the state's nine methadone clinics only serve a couple of thousand people, Franklin said.

"To legally limit the capacity or availability of clinics doesn't make a whole lot of sense to me," Franklin said. "You wind up with untreated opiate addicts in your community, and that's certainly not going to reduce your crime rate. There's an undisputed need here in the state of Maine and it is grossly underserved." I wrote Mr. Franklin and commended him on coming out to defend the clients.

Methadone has been available for treatment of opioid addiction in Maine since 1995.

Supporters of opening more methadone clinics say the facilities, which incorporate counseling and close monitoring, are crucial to helping addicts recover and start a new life. Critics say they just encourage more drug users and crime. The chicken and the egg!

"It's a pretty controversial thing," said Herb Brindley, the Palmyra selectman who brought up the issue at this week's board meeting. "My thinking is we ought to get ahead of it all so we don't get clobbered. I am still trying to visualize a town being clobbered by methadone clinics...Hmmm Sounds like a Horror movie I watched once. It's one of those things where we have to sit down and hammer out the wording (of a resolution or ordinance) and then it needs to be approved by town meeting in March."

Brindley has suggested a six-month ban on methadone clinics, Genius! much like other communities have done, so officials can research and see if town restrictions are appropriate.

Brindley says the board's main concern is that "we don't want them near the schools .... crime is a big concern." Absolutely, by all means keep the children away..LOL

The city of Lewiston several years ago imposed a six-month moratorium on methadone clinics in order to have time to devise rules to govern the clinics, said City Administrator Jim Bennett. Although there has been some interest, Lewiston does not have a methadone clinic.

"The moratorium is a very appropriate tool in order to put the brakes on so you can look at what makes sense," Bennett said. So, you don't get clobbered...LOL

But Rockland went too far when it restricted where the Turning Tide methadone clinic could open; its zoning restrictions violated the Americans With Disabilities Act, a federal judge ruled. The Rockland clinic, the ninth in Maine, opened a couple of weeks ago.

During Lewiston's debate, a top concern for city officials was the belief that many people who visit methadone clinics travel from other areas and bring crime and drug problems with them to the community, Bennett said.

"You have a percentage coming into the community that have opiate addiction and based on where we were at, we did not feel we had a opiate problem in the community and the last thing we wanted was ... getting it introduced into the area," Bennett said. And they say addicts are in denial..LOL

Franklin, of the Waterville clinic, says those concerns are exaggerated, if not unfounded. He knows of no studies that show an increase of crime or illegal drug use in area that have methadone clinics.

To be treated at the Waterville clinic, addicts must have a documented history of addiction, a physical exam, a prescribed methadone-dose schedule, regular nursing assessments and counseling. Methadone is typically dispensed at clinics as liquid.

Most addicts are treated at methadone clinics for at least three to four years before their treatment ends, Franklin said.

"We don't want to treat anyone who doesn't need to be treated," Franklin said. "We regard ourselves as stewards of not only the patient safety but also the public safety as well."

People who successfully recover from addiction "become stable, they get jobs, they repair relationships with their family, many go back to school. In other words, they re-establish a normal life." Why is that so hard to accept?

New Methadone Clinic Finally Opens for Maine Residents After Two Years!

noreply@blogger.com (Kristina) — Fri, 15 Aug 2008 03:42:00 +0000

Methadone clinic opens in city

By Shlomit Auciello Courier-Gazette Reporter ROCKLAND (Aug 13): After more than two years of planning and permitting, Turning Tide has opened at 151 New County Road on Route 1 near the Thomaston town line.

Three weeks after opening, the Rockland methadone clinic is treating 40 to 50 patients, some of whom were previously traveling to Portland for treatment.

Dan Mahoney, program director at Turning Tide, stands in the doorway of the methadone clinic on New County Road in Rockland. (Photo by Shlomit Auciello)

The clinic, in the building formerly occupied by Tuttle's Shoe Barn, contains a reception area, waiting room, pharmacy and dosage area, doctor's office, and conference room.

"Since many patients refer themselves for treatment, all first visits comprise insurance and medical screenings and counseling to review biological and psychological conditions to ensure that the therapy is appropriate for them," said Dan Mahoney, Turning Tide's program director.

MaineCare and Aetna cover methadone treatment in Maine, with some patients paying out-of-pocket for the medication. Costs range between $95 per week for self-paying patients and $78 per week plus a $2 co-pay for services covered by MaineCare.

Once medical and administrative staff have cleared patients, they are scheduled for treatment, which usually begins within two to three days.

During the second visit, patients have blood drawn to check for drugs and medical issues such as heart conditions, diabetes and communicable diseases. They may also receive tests that include an electrocardiogram or tuberculosis testing.

For many of Turning Tide's clients, this visit may be the first medical exam in years and clinic staff often refer patients for further testing and consultation with off-site professionals.

After seeing the medical staff, patients go to a waiting room where they will be called when their methadone doses are ready. Methadone, a synthetic narcotic, is therapy for addicts whose habits have exhausted the areas of the brain most sensitive to opiates and who therefore rely on powerful methadone to achieve normalcy in daily life, according to Mahoney.

When their turns come, patients line up in the corridor outside the treatment area. This area is monitored by a video camera that allows pharmacy staff to see the waiting patients.

The nurse admits patients to the treatment area, two at a time. At the pharmacy window each patient is given a dose of liquid methadone appropriate to his or her medical history, which is combined with an orange-flavored drink to make it more palatable. While the patient is taking the dose, the nurse evaluates the patient's mental status. If there are no concerns, the patient leaves the clinic after taking the medication.

About once a month, patients are subject to random urine analysis. These samples, as well as blood samples, are tested off site, although "dip tests" can be performed at the clinic if a patient appears impaired.

Treatment at Turning Tide includes group counseling, starting with sessions designed to educate patients about the medical details of their addiction and treatment. As treatment continues, group sessions focus on what Mahoney calls the "bio-psycho-social-spiritual" aspects of recovery.

For most patients, methadone therapy is a lifelong process. Citing the rise in younger addicts, however, Mahoney suggests that new data need to be gathered. In his five and a half years working in methadone clinics, he has seen patients who were able to "titrate off" or adjust their dosages downward until they could live without the medication.

Methadone therapy is voluntary, by federal law, and neither the courts nor medical personnel can mandate treatment. In a 20-mile radius of Turning Tide, Mahoney estimates there are two or three medical practices that support those undergoing this type of addiction care. "Some doctors are not user-friendly," he said. Mahoney said he continues to work to build relationships with the local medical community.

Security at the clinic is high, with coded locks at the outer doors, the entry to the pharmacy, and on the safe that holds the medications within the pharmacy. Security staff are on site when the clinic is open and all alarms, including a motion detector, are set when the building is closed for the day.

Mahoney stressed that methadone is not safe for non-addicts, saying that it can be fatal for someone who has no history of opiate abuse to take the medication.

Turning Tide is open for patients Monday through Friday from 5:30 to 10 a.m. and Saturday, Sunday and holidays from 7 to 9 a.m. Comments; I wish the staff and patients good luck in their new endevor. It was a long hard road. Congratulations!

Hooray for the UK! Manslaughter Conviction Overturned in Methadone Case.

noreply@blogger.com (Kristina) — Fri, 15 Aug 2008 03:28:00 +0000

Death conviction quashed by Lords

by KEITH BULL

A RECOVERING Uttoxeter junkie jailed after being found guilty of killing his friend by giving him methadone has had his manslaughter conviction quashed on appeal. Adam James Wilson, formerly of Ellastone, gave Ryan Farnsworth, of Yew Tree Road, Hatton, and his girlfriend, Natalie Tyers, of Hilton, the heroin substitute in July, 2006. Both dangerously mixed alcohol with the drug, resulting in the death of Mr Farnsworth, who had just celebrated his 24th birthday. Ms Tyers endured heart and hearing problems due to oxygen starvation after the incident. On July 28, all three had taken an undisclosed amount of ecstasy before heading to the Hilton Brook pub in the early evening. The night was supposed to be a leaving celebration for Ms Tyers, who was due to go out and work as a representative in Tenerife over the summer months. After several drinks, the trio eventually ended up in a beauty spot in Wootton, near Ashbourne, at around 3am and were said to be in "high spirits". Wilson, who was prescribed methadone to help him overcome a heroin addiction, offered the synthetic drug to his friends as he thought it would ease the effects of the ecstasy. The pair, who had each taken around 50 millilitres of methadone, became comatose due to the effects of mixing alcohol with the drug. They started 'snoring', and Wilson thought they had fallen asleep. However, the noises were being made due to the couple's blocked airways. Wilson lifted the couple into his car and drove to the King's Head pub, in Main Street, Hilton, at around 5.30am. Later in the morning, while the duo were still 'sleeping' in his vehicle in the car park of the pub, Wilson went into the premises for drinks with a friend. When they came out at noon, they realised Mr Farnsworth's lips had turned blue and began to worry. The couple were taken to the Derbyshire Royal Infirmary, in Derby, where Mr Farnsworth was pronounced dead. Wilson, 28, was convicted of manslaughter and supplying methadone at Nottingham Crown Court in March, 2007. However, in a landmark October, 2007, ruling, the nation's highest court - the House of Lords - decided if a toxic substance is supplied to someone and administered by that person to himself, the supplier cannot be held criminally responsible for the death. Andy Easteal, representing Wilson at London's Court of Appeal, told Lord Justice Toulson, Mr Justice Andrew Smith and Judge John Rogers QC that fundamental change in the law should apply to Wilson's case. The appeal judges agreed, overturning the manslaughter conviction. Wilson, now of Hazel Crescent, Kidlington, Oxfordshire, was jailed for four-and-a-half years after his convictions, later reduced by a year on appeal. He has already served that sentence and appeared in court last week in the public gallery. His conviction for supplying methadone still stands. My Opinion: First of all the alcohol and Ecstasy certainly contributed to this young mans death. Yet, as so often happens Methadone is singled out and the person who sold or gave it to the deceased is charged with murder. At least in the UK they are using some good old common sense. If only the U.S. would take such measures. The U.S. is sentencing people under very questionable circumstances to years and even life on Murder charges if there is so much as a mention of Methadone involved in a death. They often hide behind the "Len Bias Law" which was never intended to be used for that purpose. Drug trafficking is a crime and should be punished but it is NOT murder!

Sheriff's Son Gets Slap on the Wrist for Dealing Drugs

noreply@blogger.com (Kristina) — Tue, 12 Aug 2008 23:17:00 +0000

This article was originally posted in the Herald Leader Posted on Tue, Aug. 05, 2008 Son of Ky. sheriff accused of selling drugs PIKEVILLE, Ky. -- The son of an eastern Kentucky sheriff is awaiting trial after being indicted on federal drug charges. Hoy Curtis Witten, the son of Johnson County Sheriff Bill Witten, is accused of selling cocaine and methadone. Hoy Curtis Witten was arraigned in federal court in Pikeville last week and has pleaded not guilty. In a statement, Sheriff Witten says he and his wife are "devastated" by the indictment against their son. The sheriff also says they believe their son is innocent. The indictment was the result of a three-year investigation by several police agencies, including Kentucky State Police and the FBI. Witten has been released under several conditions including that he pass drug tests and continue a substance abuse treatment program. I am sorry but I live one county away from Johnson and I can tell you if the FBI and KSP spent 3 years investigating anyone else they would have the book thrown at them. I used to buy drugs from a cops son in Lawrence county and he was placed under investigation also only to get off. This is not fair and only enforces the belief that the law in this area is predjudice and tainted.

Methadone Clinic Proves Opponents Wrong. Community & Clinic Living in Harmony

noreply@blogger.com (Kristina) — Tue, 15 Jul 2008 22:28:00 +0000

Tuesday, Aug 5, 2008 http://www.tampabay.com/news/humaninterest/article757690.ece Original article from: tampabay.com

Operation PAR proves to be responsible neighbor By Camille C. Spencer, Times Staff Writer In print: Tuesday, August 5, 2008 PORT RICHEY — When residents on Washington Street heard a methadone clinic was opening in their neighborhood last summer, they banded together in opposition. They worried that the clinic, which provides mental health and substance abuse help, would mar the neighborhood's image, lower property values and cause crime to skyrocket. So they signed a petition and crowded a City Council meeting to speak out against the clinic's opening. But a year later, residents say their fears haven't been warranted. Port Richey police say there have been no reports of major incidents at the clinic on 7720 Washington St., which is run by the nonprofit Parental Awareness and Responsibility, better known as Operation PAR. And Operation PAR officials say by using a few safety tactics at the clinic, they've been able to keep neighbors happy while conducting business. "I have to admit, things have been very good," said Judy Parisi, whose home is behind the clinic on Queener Avenue. "There's been no problems, and they keep the place very clean. They've stepped up and kept their word to restrain people from causing problems and hanging around." Gary Wenner, vice president of Operation PAR's Medication Assisted Patient Services, said whenever PAR moves to a new location, officials keep an open dialogue with neighborhood associations and residents. "When one of these programs opens, a certain part of the population gets scared," he said. "They get nervous. But we let them know nothing bad is going to happen." Here's how, Wenner said: Patients are in and out in minutes for their treatments, unless they are seeing a counselor. Patients often tell clinic officials about people they see loitering outside who shouldn't be there. And counselors walk around the building between appointments to make sure nothing inappropriate is going on. Before moving to its current location, Operation PAR was in a strip mall at 6446 Ridge Road for 10 years. Cramped space led clinic officials to move to a 4,800-square-foot building on Washington Street. The clinic serves patients from all over Pasco County. At the four Operation PAR locations in the state that administer methadone treatments, patients addicted to painkillers voluntarily come in to set up appointments with a doctor. Patients return daily for the next three months to drink a small orange methadone cocktail to decrease withdrawal symptoms. They also meet with counselors. When officials decided to move the clinic to Port Richey last June, first-time homeowners like Melanie Virtuoso and her fiance, who live less than a mile from the clinic, worried their property values could be affected. They expected to see people lingering in their neighborhood after methadone treatments, but haven't seen anything like that. "It's not as bad as I expected," Virtuoso said. "It's still a little uncomfortable, but it is what it is. We are making the best of it." Camille C. Spencer can be reached at (727) 869-6229 or e-mail cspencer @sptimes.com.550 Number of patients treated by Operation PAR last summer 480 Number of patients treated by Operation PAR this summer Source: Operation PAR This goes to show that harmony can exist where clinics are. In fact, if communitees didn't know ahead of time they probably would never know a clinic was present. Most clinics close by 2pm yet crimes commited in the middle of the night are sometimes said to be related to clinic patients by neighbors who resist MMT.