Experience with methadone and detox

by Nancy R. (Roseville)

I have been on methadone since 1975, straight through to the present. During my first 10 years on methadone (1975 to 1985), I continued to use heroin, then Dilaudids. Before I became addicted, I graduated from high school in 1971 then worked as a secretary for several years. Within one year of using heroin, my life fell apart. I quit my job, sold my car (the last material possession I had left), broke up with my boyfriend of seven years, and moved into the Cass Corridor (for those not familiar with Detroit, in the 1970's, the Cass Corridor was a section in downtown Detroit considered the ghetto, full of street addicts, drugs, poverty, and prostitution. Today, over 20 years later, the area has been considerably "cleaned up"). Anyway, for the next four years, I lived "in the streets". . .staying at cheap hotels and shooting galleries or crashing at friends' apartments, selling myself, cheating and stealing for the next "fix." Yes, I was on methadone during that time, but I was not quite ready to give up the drugs yet (although I believe my use of illicit drugs would have been greater without the methadone). Besides, the city-run methadone clinic I belonged to would only give up to a maximum dose of 30mg. That wasn't enough to keep me from feeling withdrawal symptoms or to take away drug cravings.

Shooting heroin ruined my health very quickly; I had seizures, caught Hepatitis B, and got several abscesses. Then, someone introduced Dilaudids to me. Dilaudid pills could be crushed, added to water, then injected, and they worked like heroin. With Dilaudid, at least addicts knew what they were getting; in other words, the pills could not be "cut" with who-knows-what, like heroin is. But, buying Dilaudid illegally on the street was extremely expensive, just like buying heroin. I finally got tired of chasing money, chasing drugs, shooting up, taking a chance of getting arrested, and of "living the life."

Luckily, I found a privately-owned clinic where doses were individualized. I was able to go as high in dose as I needed (150mg) in order to feel comfortable and end any drug cravings. So, since January 1985, I have never again used an illicit drug, but I continued taking methadone at the methadone clinic. My life turned around dramatically! I went back to work full-time as a secretary and enrolled in college part-time in the evenings. I worked nine years at a local hospital, eventually getting promoted to Executive Secretary to the Medical Director. I am halfway through my junior year at Wayne State University, working toward a bachelors degree. I got married, and we bought a house in Detroit. Yes, METHADONE SAVED MY LIFE!

A little over a year ago, I was laid off from the hospital. I had started attending Narcotic Anonymous (N.A.) meetings the previous year. When I lost my job, I decided to take advantage of the break from my grueling schedule of work and school to see if I could possibly detox from methadone. A little background history here: Since 1985, I had been taking between 100mg and 150mg of methadone daily (some of you may remember reading my previous articles in Methadone Today--"Take Home Med Policies, What is Fair?" in the August 1995 issue and "Narcotics Anonymous" in the February 1996 issue). I felt most comfortable at 150mg but would try periodically to detox down to 100mg in order to get once-a-week take homes. I would achieve this then find I just couldn't function as well and go back up in dose to 150mg (but then have to go to the clinic every day).

I began my detox: From October 1995 to March 1996, I dropped from 150mg to 130mg. Then, within three months (April to June 1996), I detoxed from 130mg to 45mg! Well, it sounds great, but the physical withdrawal symptoms suddenly hit me as if I had run into a brick wall. I had bad stomach cramping, nausea, diarrhea, sleep disturbances, aches and pains, and worst of all was that jittery, internal restlessness where you can't stand being in your own body--you just want to shake your arms and legs right off. I didn't expect detoxing to be a breeze, especially after taking methadone for over 21 years and at high doses, but it was hard to persevere day after day with severe withdrawals. The clinic doctor pointed out that I had dropped much too fast and suggested stopping or slowing down the detox, or even going back up in dose slightly until my body had time to readjust, then continuing the detox at a much slower pace. I followed his advice. I backed up to 65mg for a few weeks (I felt much better), and now I have just begun my detox again, only going down a few milligrams a week. For those interested, I will write again to keep you updated on my progress!

I must add this: I am strongly in favor of Methadone Maintenance Treatment (MMT). I understand many of us patients may need to take methadone for the rest of our lives, and we need not feel guilty about this! It has to do with brain chemistry (in fact, if you are interested, contact Beth Francisco, Editor of this newsletter, and she will be happy to pass on articles on brain chemistry and addiction. An excellent article appears in the Ombudsman, Fall/Winter 1994 issue, by Joycelyn Woods, Executive Vice President of the National Alliance of Methadone Advocates [NAMA], called "A Matter of Degree", which explains in medical and biological terms about how long-term use of opiates can cause damage to our brain chemistry, sometimes permanently).

I decided to try to detox after the past 11 years of successful MMT for several reasons. First, I am 43 years old, and I thought, "If I don't at least try to see if I can detox now, the older I get, the harder it will be to do it." Secondly, I am scared! It really scares me how the government is treating addicts in general, and methadone patients in particular--as criminals, rather than persons with a disease. Last year, the DEA raided a Detroit methadone clinic as if it were a "dope house", going in with guns drawn! Appalling! Addiction is considered a disease, and MMT is recognized as a viable treatment option by medical professionals. But, for persons with an addiction, Medicaid funding is in danger of being cut, SSI has been cut, and the government is considering making all methadone clinics 7-day-a-week operations (in other words, No take homes for anyone regardless of your personal history!).

A third reason I am trying to detox is that I would like to see if I can live life methadone-free. Narcotics Anonymous gave me many tools for learning how to cope with life and be happy without drugs. NA has helped put me on a path of personal and spiritual growth. Plus, I have met many people in NA who have successfully detoxed from long-term methadone treatment. They gave me hope. I want to see if I can do it!

One last note: "Total abstinence" does not have to be the only definition of "successful recovery." To paraphrase something our editor said recently--to only count complete abstinence as successful treatment dooms many addicts to total failure! MMT is success for many addicts when you consider "success" to mean an addict who turns his or her life around, stopping illicit drug use and stopping criminal activity, going back to work, paying taxes, raising families, and voting--just like everyone else!