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Voices: Clinical Addiction 

Methadone is no quick fix for most heroin addicts

This is a story from 110º: Tucson’s Youth Tell Tucson’s Stories, an annual publication that features the best work by the youth participating in VOICES Community Stories Past and Present Inc. For more information, visit www.voicesinc.org.

For nearly eight years, my mom has been going to methadone clinics in different locations around Tucson. About four years ago, my siblings and I started going with her. I was only 10 years old.

One day, we were sitting at the bus stop on our way to the clinic, and she started having withdrawals from methadone, a drug that blocks the high she might otherwise get from heroin. At the time, I didn't know what withdrawal was, but I remember the look on her face: It was as if she had just eaten a bowl of rotten mayonnaise and was about to throw up. Seeing her in agonizing pain because of these withdrawals, and watching her struggle with hepatitis (which came from re-using needles) have been far more effective in stopping me from taking drugs than any lecture.

According to my mom, Lauren "Princezzz" Franklin, methadone has been just as hard to kick as her lengthy heroin addiction.

"I loved that heroin," she says. "It caused me a lot of problems, but it made me function. I'd chip at it and then detox myself and chip again."

My mom has been on methadone for so long that it makes me wonder if this form of treatment is doing anything at all, except keeping her addicted. I did my own research to find out why methadone clinics have such a strong hold on their clients' lives.

According to the Office of National Drug Control Policy, methadone treatments allow those who have been addicted to opiate drugs, like heroin, the ability to eliminate withdrawal symptoms. Methadone is used in detoxification programs, because it can stay in the user's system for more than 24 hours and relieve the craving for opiates while not creating a high. Methadone also renders heroin less desirable by blocking its expected euphoric rush. It can either be injected or ingested and is only legal when administered through methadone clinics.

While hanging out at the methadone clinic, I've listened to many stories from clients—some much worse off than my mom—about what it's like to deal with the behavioral-health system. Although many of the clients are interesting and smart, some of them told me they felt mistreated and labeled by people at the clinics who treat them as "ex-junkies."

"I feel like an employee, and they're my boss, and if I don't do exactly what they say, my well-being is in danger," says Lori Smith, one of the clients my mom and I know.

Ilaann White, a nurse at the clinic, says that many of the patients have a hard time staying clean once they get off methadone, the timing of which is determined by the counselors and clinicians on staff.

"Some people may get off, and it seems like they succeeded in getting off, but a year or two later, they're back in the doors again," White says. "So it can be a merry-go-round."

Many patients stay on methadone for a long time, like my mom. She tells me that it takes a long time to detox from heroin using methadone, and her dosages are determined by the counselors at the clinic.

If a client wants to change a dosage, for example, there are specified procedures that she must go through. According to James Bissell, a therapist with CODAC Behavioral Health Services, Inc., the organization that oversees my mom's clinic, "a member can request a change in their dose level, but they can't just go up because they want to go up. There are specific criteria ... That's part of our training, to monitor them and ask the right questions to find out if they really need to. It's not just like, 'Oh yeah, I want to go up, and now I don't want to go down today.' It's not quite that simplistic."

Being a methadone patient means being tied to the clinic, because the drug must be administered under supervision, usually on a daily basis. If a client wants to go on a vacation, for example, she must either find a clinic in the city where they're going (to get a "courtesy dose"), or she has to qualify for "take home" medication.

In my opinion, the small chance that a client might take a dose wrong, or not take a dose at all, is much less risky than that client getting frustrated and returning to their opiate of choice.

"I think the methadone clinic has a hold on us, because they are the ones that make and break us. What we get, what we don't get, what we can do, when we can't do," says Smith.

Dawn Crawford-Rogers is the program coordinator for methadone services at the clinic my mom attends. In cases like these, Crawford-Rogers says, patients "have to make a choice of walking off of treatment or not going." To my mom and me, this feels like house arrest. Some people might think that "ex-junkies" should have a short leash and be kept close to home, but this doesn't seem fair in light of how long so many patients stay on methadone. Instead, methadone patients would be healthier, and their addiction counseling more helpful, if they weren't in a position of having to choose between taking their medication and traveling.

Referring to methadone as a "treatment" when clients have experienced just the opposite seems hypocritical to me: Treatment should help someone. But instead, people like my mom are not any closer to kicking their addiction than when they started.

My mom currently goes to the clinic every Friday before 11 a.m., and stays for about a half an hour. She's one of the lucky ones. She's gotten to this point, because the staff at the clinic trusts her enough to give her take-home doses. Many of the clients go to the clinic six days a week.

It makes me wonder if the methadone is really getting them off drugs. It's true that if they quit methadone, or tried another kind of therapy, they might go back to their original drug of choice. But in my opinion, they're locked into a system that feeds and masks their real problems—just legally.

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