METHADONE (MTD)
Originally manufactured for pain management, it was first introduced as Dolophinel as an analgesic for pain management. In 1947 it hit the United States intended for use in narcotic addiction. Since its effects can last for upwards of 24 hours, it is commonly needed only once a day. It blocks most of the major effects of drugs like Heroin. The thought being that continued use of MTD would discourage the continued use of Heroin. It can be taken either orally or injected as Schedule II formulations with both methods having similar results. As with any narcotic, prolonged use or abuse is where the problems begin.
Methadone clinics, once prominent in major cities only, have begun to appear in small towns as well. Their appearance has mirrored the growth in illicit drug use in what was also once a problem for major metropolitan areas. Concurrently, a similar growth in methadone addiction has blossomed. Increased dependence on MTD has developed its own following and as a result the societal ills that typically accompany drug addiction have followed suit. MTD addicts, like others, do whatever it takes to feed their habits including burglary, robbery, and acts of violence and so called “victimless crimes” like prostitution. A chronic use of MTD develops a level of tolerance and bodily dependence. An addict’s need to “score” or “fix” is so engrained their brain that they receive false signals of pain and anguish that they believe their only chance of survival is to use. The withdrawal symptoms associated with MTD addiction are less severe then those of other addicts and develop at a slower rate.
As stated before, MTD was developed in the United States to assist with people trying to get out from under a Heroin addiction. Unfortunately, MTD addiction has become a problem in and of itself. MTD was intended as a maintenance treatment whose ultimate goal was eventual non use of Heroin for users. It is intended for people who can not seek more traditional forms of treatment such as a stay at an inpatient facility. A “crash” detoxification (detox) in which the user is given medications in larger doses to overcome the addiction in a mere 48-72 hours has not been perfected nor have they met with the desired results in drugs like cocaine or morphine. The “euphoric” effects of MTD on the brains sensory receptors have caused a backlash of abuse of the drug itself. The patients are off of the Heroin. Now they are addicted to the MTD.
As with any other opiate addiction, the problems associated with MTD addiction include inability to maintain acceptable job performance or build lasting and meaningful relationships. Unfortunately, now that the patient has become addicted to the medication that was trying to cure them of their original addiction, the main avenue to take is a rapid detox of the MTD.
GENERAL ANESTHESIA ASSISTED OPIATE DETOXIFICATION
(GAAOD)
For rapid detox of a MTD addict, the patient must pass a battery of tests to initiate the process. Unfortunately this is many times the result of a court ordered plea due to the person’s involvement in a drug induced crime. The process begins with the patient having several physical and psychological evaluations. This includes extensive blood tests, Electro Cardio Grams (EKG) to measure the heart’s efficiency and liver enzymes. During this time the patient also receives initial psychological counseling. After the initial criteria are met, the second stage of the detox begins. The patient is given general anesthesia to begin the procedure. While the patient is monitored, they are given an opiate antagonist to remove any remaining narcotics from the brain while simultaneously filling the brain receptors with additional anti-opiate medicine. This process takes approximately an hour. Once the procedure is completed the patient is monitored in an area compatible to a post operative surgical suite. Nurses trained in GAAOD recovery are assisted by equipment that monitors breathing and brain activity. When the patient completely awakens, it is at this point that they are fully detoxified.
After discharge, the patient is given follow up treatments with a psychotherapist as well as oral opiate blocker medicines. It is perhaps the ultimate irony in that people become addicted to that which is intended to cure them from an existing addiction. Addiction is a disease regardless of the substance the person is addicted to. It doesn’t even have to be drug. It can be a food a place or a person. The fact of the matter is becoming addicted to a drug that is supposed to cure you is truly a double edged sword.
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