From my work with injecting drug users about a decade ago: None prefers methadone, they only take it because, when in a treatment program, they get it for free and unadulterated. When it comes to actually ceasing consumption, at least on the mindvox drug users list, the consensus seemed to be, that is is easier when first switching back to heroin.
Ask your friends whether it is the methadone as a substance that helped them or the decriminalization and steady supply they don't have to worry about. From experience, I bet on the latter.
This is not what a solution should look like.
I'm not necessarily a supporter of suboxone / methadone / whatever , but this NIMBY rhetoric isn't helpful, either.
It's rare for the down-turn of an area to have one extraordinary cause.
I guess that the suggestion is that methadone clinics create crime where there otherwise wasn't -- but I don't see it that way in my community.
What I see these clinics provide is a centralization of potentially bad actors for authorities to keep tabs on while they seek guidance or pay court-ordered time to the system otherwise.
What's the alternative here? Cease these communal style clinics? If one believes in these treatment options whatsoever then it must be realized that cessation of these clinics would take that care option away from many people who may find legitimate use.
I don't have alternatives to the clinics , but I do have insight into what one should pay attention to when an area begins to struggle:
Income, education, and general upward mobility within society.
no it's not. he's talking about a single store. in my town it's the homeless shelter and halfway house that causes a 5 block radius around it to be a terrible place to live.
we're not talking about building more housing, or zoning for high density commercial/residential mixes, or building public transit, or eliminating cars from downtown cores, or building more bus routes, or bikeshares, or uber, or any number of things that people actually want. we're talking about methadone clinics and halfway houses next to where affluent people live.
if you pretend like it's hard to understand why people don't want those things in their residential/shopping neighborhoods, you're just going to alienate everyone you communicate with. you can't just invoke the magic 'nimby' and get people to change their minds. __they don't want these things next to where they live__.
Which is the precise definition of Not In My Back Yard...
here's another turn of phrase you might find handy: choose your battles.
the junkers have basically turned the nearest subway into hamsterdam.
Man On Stoop: Got to. This America, man
The answer is: never.
Only if they get into a program that guarantees they will be detoxified in 6 months(or so). This is rare unfortunately because it needs the addict's consent, which is rarely given. They usually choose the "open-ended" program because it's easier.
They only use methadone because it's a legal(but controlled) drug. It's not that much better than heroin.
But I am just stating facts.
> at some point methadone might get de-prioritised
But that is wishful thinking, not reality. Open-ended programs do not work. Period.
By far most people in such programs relapse multiple times. You can't expect from the addict to kick the drug off out of sheer will and good intentions.
> took intelligent pro-active steps to move their lives forward
You don't understand addiction and how it works. It has nothing to with intelligence or logic. When someone chooses an open-ended program is because the people around them force them to take some action and they choose the easiest one.
Again, no one is judging and no one said those people do not need love, quite the opposite. But open-ended programs destroy their lives.
"For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question — including the World Health Organization, the Institute of Medicine, the National Institute on Drug Abuse and the Office of National Drug Control Policy."
https://fivethirtyeight.com/features/what-science-says-to-do...
One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs.
Are these the same scientists that think prescribing Vicodin, as if it's aspirin, is a good thing?
Who cares? Nobody talks this way about a person who has to take heart medicine every day to survive, and not that many talk this way about me when I take Lexapro every day to not get depressed. What makes methadone so different?
You can survive without it for starters. Not the case with heart medicine I guess?
If you saw people, with the same condition as yours, having a good quality of life without medicine wouldn't you not wonder if that could apply to you too?
In the case of drug addiction, I've seen many people successfully kicking off the habit in months and living a perfectly healthy life, as if almost nothing happened.
Life-long methadone users? Not so much. I can tell that people really think it's different from heroin but it's not really. It's just regulated. Think about it ;)
Experience is valuable but for driving systematic changes, unreliable. Its too easy to color personal experience with bias of many kinds. That's the entire point of science, to eliminate those biases and document the underlying evidence to support a claim like: "Methadone does not work."
Challenge accepted :D
Scientific fact 1: methadone doesn't alleviate the addiction. It actually feeds it to the point that it increases the patient's tolerance at which point you have to increase the dosage.
Scientific fact 2: methadone doesn't provide the "high". Totally true. That's why the vast majority of patients seek it elsewhere(alcohol, cannabis, etc).
Scientific fact 3: Life-long methadone users have relapses more than once. Most clinics/doctors supporting methadone brush it off as "it's quite normal and logical".
Scientific fact 4: innumerable people have been able to kick off opioid addiction by following long-term(but not life-long) therapies.
General fact: You'd be hard pressed to find a drug, other than methadone, that has been so controversial in its usage.
More facts: these panels of "experts" don't provide evidence that long-term recovery doesn't work, but they opine that "hey, methadone is the best, true story.". Show me data, show me science ;)
Isn't it way too convenient for the drug industry? Has it ever happened before, I wonder?
Isn't it weird that heroin addiction in US has increased because of the gratuitous opioid prescriptions?
https://www.theguardian.com/society/2017/mar/29/us-heroin-us...
"Detoxifications and drug free modalities, although appealing to an understandable desire for recovery without medications, produces only 5-10% success rate. Methadone maintenance is associated with success rates ranging from 60 - 90%. The longer the people are in this modality the greater their chances are of achieving stable long-term abstinence."
http://www.csam-asam.org/methadone-treatment-issues