Methadone replacement therapy cuts HIV-infection rates, but…

Methadone replacement therapy cuts HIV-infection rates, but…

Yet another study (there have been many) shows that methadone replacement therapy for opioid addicts can lower HIV and hepatitis infection rates. The latest study, published in the British medical journal The Lancet, was carried out in Vancouver, British Columbia, Canada, where methadone maintenance therapy (MMT) has been in use for decades. By connecting methadone programs with a reduction in needle sharing (and therefore a reduction in HIV infections – facts which are already common knowledge world-wide) thestudy’s authors wanted to encourage the British Columbia government to expand its financial commitment to MMT in the province. Between 1996 and 2013, the Canadian researchers followed 1,639 HIV-negative injection drug users. Most of the 138 people who became infected with HIV during those years were not taking methadone, the study said. MMT requires addicts to attend a pharmacy or clinic every day and consume a small quantity of liquid methadone, itself an addictive opioid. The once-a-day dose of methadone relieves the opioid withdrawal symptoms that drive addicts to need a “fix” every few hours around the clock. Some patients, usually after years on the drug, are allowed to take a week’s worth of doses home with them. MMT proponents defend it because people on MMT are less likely to continue to use syringes and share them with others. As the study says, “they may be less likely to engage in risky behaviors associated with spreading the virus.” And MMT also can help some addicts “get off the street” – reduce illegal activity – andresume at least some normal activities such as a job and family life.

But…there’s a dark side

Not all addiction specialists in Vancouver – and elsewhere in the world – share such enthusiasm for MMT. In the US, only 10 percent of opioid addicts are currently treated using drugs such as methadone. The problem is that too many patients find themselves on methadone treatment for years – getting off it is worse than getting off heroin would have been. One local treatment specialist in Vancouver compares methadone to WWII Nazi concentration camps. Jim O’Rourke, executive director of several treatment centers in the province, recently showed a reporter a picture of “hollow-eyed prisoners of Nazi concentration camps” and asked him to compare the images to the men and women standing in line at any methadone clinic. O’Rourke says the provincial government, which pays for the methadone programs, thinks of heroin users in the same way as the “terminally ill.” When a doctor puts a patient on methadone maintenance treatment, he ignores the addict’s“problematic relationship to heroin – itcondemns them to death.” Another local treatment specialistwho manages three homes, also refuses methadone clients. “If you’re using methadone you’re stoned,”Susan Sanderson said. “How can you possibly do a program? We tried it. We had some residents who were here on methadone. They just sat in the corner and drooled.”

A negative public view doesn’t help

Reports have appeared in the local media recently exposing kickbacks from methadone dispensing pharmacies and clinics to treatment centers if they send addicts for MMT. One pharmacy offered $100 per patient. And the public also gets to express its own views on MMT in the media. Comments under several current and recent articles on the province’s MMT programs were unanimously negative, with not a single positive comment – and many were from current or former methadone treatment patients. Here at Novus, we’re not politically or financially motivated towards one or another approach to treatment – we’re pragmatic and simply choose the best. Our medical opioid detox protocols are state-of-the-art, setting patients up for the best possible results from their subsequent rehab program. And best of all, we also offer methadone patients a way out of the “methadone prison” – an innovative, safe, effective and comfortable methadone detox, regardless of the daily dose. Don’t hesitate to call Novus if you or someone you love is trapped by opioids or methadone.

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