This is a guest post by Elizabeth A. Clark, a lady in long-term recovery on methadone. She is sharing her story in the hopes of educating about medication assisted treatment and to try to break down the unfair stigma attached to it. We are in the midst of an epidemic that is killing thousands of people each year. We can help by getting educated on ALL the available treatment options and by supporting whatever works for each individual. Let the STIGMA stop with you!
In active addiction, I was neither unique nor remarkable. I experimented lightly with alcohol and pot in high school. After graduation, I began using pharmaceuticals and eventually found myself addicted to Dilaudid. As my use increased, I became involved in ever increasing levels of crime and was soon arrested for this.
I was convicted and court mandated into rehab where I was detoxed off Dilaudid, counseled and went to classes and meetings. I was released after 30 days with no clue how to recover and maintain recovery. I really didn't want to stop using Dilaudid. If anything, without it my life was just more painful. I didn't want to give up the only thing that ever made me feel normal and good, but I also didn't want to go to prison for breaking the law.
At meetings, many of my fellow AA/NA members were still using and drinking, which meant that I couldn't even find sober friends at a 12 step meeting. Since I had let go of my old friends, I became isolated, lonely and miserable. I "white knuckled" abstinence as long as I could stand it. Finally, I told my poor mother that I hoped God would grant her the serenity to accept the fact that I was going back out to rejoin my old friends. Obviously, that did not work out well. I was soon re-addicted and breaking the law. Mom gave me the option of either moving out or going back to rehab. I chose rehab.
I spit out and injected all the Dilaudids used for detox and left this time with a bad attitude and a bigger habit than I had when I went in. I continued to use after this. I was very depressed and hopeless. Because I was lousy at crime, I was arrested again in no time. I went back to rehab again as I awaited my court date. This time the judge mandated me to a program over a thousand miles from home. I went to a 12 step abstinence based program. I was more appreciative of the precarious position I had gotten myself into, so I gave it my very best effort. I abstained, made friends, had sponsors, sponsored people, led meetings, did my inventory, went to sober activities, worked, and lived on my own. In spite of all this, something was still missing and I was miserable. I lost my sobriety after 9 1/2 months, and was addicted to Dilaudid again within a couple weeks.
During this period of active addiction, I met people who were on methadone maintenance treatment (MMT). After talking to them, I decided that if I was incapable of giving up opiate addiction, I'd be much better off taking something that was legal. I knew MMT was a serious step, but I was desperate at this point. I got on the program in 1981. I drank my dose daily, got counseling, worked full time, met my first husband, went back to college at night, got married and slowly tapered off methadone after about two years.
I felt great after tapering, but within a week, the devil brought an old friend to my door at 1:00 a.m. When I saw the friend's constricted pupils and her state of relaxation and normalcy, I felt cravings like I'd never before experienced. I knew in my heart that a relapse was rapidly approaching so I decided to get back in MMT before it happened. I have remained on methadone since that time.
I was on methadone and my life was better, but because I was so very much indoctrinated in 12 step ideology, I still viewed myself as a hopeless addict who couldn't make it without a replacement drug.
At this time I went to a low dose clinic and because my dose was much too low, I began taking Valium with it in order to enhance its strength. Over time, this grew into one of the worst periods of my life. Valium led to Xanax, which led to losing most of what was dear to me. I eventually elevated my dose, but because of my abuse of methadone and dual addiction to Valium/Xanax, I had no idea whether or not it was a stable dose for me. Methadone combined with Xanax became my drug of choice.
I lost my job, marriage, home, car, phone, cable TV and anything resembling a normal life. I depleted my bank account and ruined my credit. I was spending all my time with my new boyfriend, who was a methadone abuser. I was getting no counseling and faking negative urinalyses. I had no positive friends and no support from anyone but my mother, who was many miles away and not totally aware of my downward spiral. I was a functioning addict who worked while my boyfriend, who later became my second husband, stayed home and sold Xanax and methadone. We were eking our way through life in poverty and misery, high 2/3 of the time and dope sick the other 1/3. I knew I needed to make some drastic changes but was so down and out that I didn't know where to begin. I also knew that I could never have a better life if my husband and I stayed together. I loved him, but it was killing me.
Sometimes a tragedy can lead to redemption. On April 5, 2004, my husband went to sleep and did not awaken. In the period immediately following his death, I was all alone and still taking Xanax along with my methadone. For the first time in a long time, I was afraid. I realized just how vulnerable I was when all alone and intoxicated. I was scared of what might happen if I had a seizure from Xanax withdrawal while alone. I had no job, car, phone or family in the area. What would I do if I ever feared for my life, since I had no phone?
With the death of my husband, there were no longer any ties keeping me where I was at. I packed a few boxes and suitcases, gave away or abandoned the rest of my belongings and rode a Greyhound bus back home. I was unwilling to cause any more pain in my elderly Mom's life, so I took my last Xanax on that bus. I was finally at a point where I really wanted to end all the drama and danger of a life of poverty and misery that revolved around drug abuse. I wanted stability, productivity, health, enrichment, and positive relationships with family and friends. I wanted to prove myself as an honest and trustworthy person. I wanted redemption and a fresh start. I also knew it was impossible to have these things while engaging in drug abuse.
At this point in my life, I still believed the things I was taught by 12 step programs. I didn't think sobriety was possible while I was still on methadone. However, I knew a better life was possible if I took my methadone properly and abused no other drugs. After 23 years of MMT, I felt as if I had "slipped through the cracks" at the clinic and was a loser because I was still on methadone. I had much to learn.
I have had a series of good counselors at my current clinic, but the greatest aid to my recovery came from membership and participation in Facebook methadone support groups. In them I found other long term MMT patients, some on methadone even longer than my 33 years. I met and developed close relationships with many of the group members. I know I can rely on and give support to all of them.
The most important thing I learned from the groups was that being on methadone does not disqualify me for sobriety. I simply take it as a maintenance medication in order to lead a normal life and avoid relapse. I learned to stop using stigmatizing language such as "clean" or "dirty" to describe urinalysis results, "addict" instead of person with a substance use disorder, "detox" instead of taper, and derogatory terms like "liquid handcuffs" and "junkie." I learned that abstinence is not possible or even recommended for some people and it is ok for me to stay on methadone for the rest of my life if I want to do that.
I want all people addicted to opiates and their families to be aware that methadone is a good option for people who repeatedly fail at abstinence. I want them to know that MMT can work for anyone who wants to recover and can greatly reduce the harm involved in the drug abusing lifestyle while they are deciding. I spent many years in MMT before I chose recovery and now have over ten years of sobriety. I want parents to stop having to bury their children from overdoses after they have been released from abstinence based rehabs with low tolerances and unprepared to deal with life without medication. I want people to stop being afraid of methadone. I want them to know that the methadone myths are untrue. I never again want to hear methadone called "meth." This confuses ignorant people, causing some to think we receive doses of methamphetamine at a methadone clinic.
I'd love to see an end to the battle between NA and people on MMT. I want people to know that there are different ways of treating addiction for different individuals and sometimes MMT works when NA fails. I want people to accept methadone as a valid treatment. It reduces the incidence of future crime and allows people to be better parents. I want people to view methadone in the same way that they view insulin dependence, dialysis and the taking of hormones, blood pressure, cholesterol and mental health meds. I never want anyone to not be hired or lose a job because they are on MMT.
This sounds like a tall order, but I believe that most of the things I want are possible if we continue to advocate and if people who are thriving while in methadone are willing to "come out of the methadone closet" and stand as examples of what is possible when a formerly hopeless addict decides to work hard and achieve sobriety through MMT. I hope that sharing my story will help in some small way to tear down the stigma by showing what can be accomplished by one person in recovery on methadone.
Expert opinions on Methadone from a few of the leaders in health:
World Health Organization: “New WHO guidelines confirm that, even after 40 years, substitution therapies such as methadone are still the most promising method of reducing drug dependence.” http://www.who.int/bulletin/volumes/86/3/08-010308/en/
Centre for Addiction and Mental Health: “Methadone maintenance is a long-term treatment. Length of treatment varies, from a year or two to 20 years or more. This prolonged treatment with proper doses of methadone is medically safe and is one of the most effective treatments currently available for opioid addiction.” http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/methadone/Pages/methadone_dyk.aspx
Center for Disease Control: “Methadone maintenance is the most effective treatment for opiate addiction.” http://www.cdc.gov/idu/facts/MethadoneFin.pdf