Currently in Ontario there are approximately 30,000 people, between the ages of 15 and 49, using illicit opioids on a regular basis. (Hart 2007) Opioid use is a costly and dangerous social problem and is the fastest growing drug problem in the country. The good news is that there is a treatment that has been proven by research and evidence to be effective. Methadone Maintenance Treatment (MMT) is a long term treatment program used to treat opioid dependence and addiction.(Source) MMT works by preventing withdrawal symptoms in opiate users. It also prevents the euphoria the user is seeking from other opiates. MMT uses the drug of Methadone to do this. Methadone is a synthetic opioid commonly used to treat opioid dependence.(Source) Methadone is different from other opioids because it is created synthetically and does not produce a euphoric feeling or a ‘high’ in the user. MMT is a cheaper, more effective and a safer way to treat opioid addiction and due to these reasons it should become the national standard for treating opioid addiction and dependence in Canada.
Prior to examining the opposing arguments about MMT let’s take a look at some of the background information. MMT was first researched in the state of Florida in the 1960’s. (source) Clinics both private and non-profit began to spring up in the USA in the 1970’s. In the 1960’s Methadone began to appear in Canada, as a detoxification treatment. (Source) The original studies of MMT shared 6 conclusions. Those 6 conclusions stated; that methadone normalized patient behaviours, with a high enough dose (about 80-120mg) euphoric effects from other opioids would be blocked, a patient's tolerance to methadone didn’t increase over time, oral dosage eliminated the need for needles, ...
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The methadone program at Rosthern Hospital is a very active and intense program. Boast over 20 patients that are regular methadone users, the involvement of the physicians, pharmacists, nurses, and addiction counselors are key (Melle, 2016). Dr. Melle is the coordinator of the methadone program at Rosthern Hospital. His roles include, patient recruitment, patient care management, follow up care, and most importantly prescription and dosage of the methadone (Melle, 2016). Pharmacist’s role in methadone treatment is providing the methadone to the hospital, as well as in Warman pharmacy they monitor and dispense some methadone to some of the patients in the methadone program. Addiction counselors are an outside resource that the staff at Rosthern hospital can utilize. There are not social workers or counselors at Rosthern, but Dr. Melle and the nurses prefer if their patients are regularly seeing an addiction counselor while in the methadone program. Finally, the nurses role in the methadone program is early treatment and monitoring of patients during detox, the continued monitoring or patients when methadone doses change, dispensing methadone and monitoring our patients in the recovery program, and observation of patient’s success during the program. Together the interprofessional team has successfully treated dozens of patients, and the methadone program address the needs of both the patients and the addiction issues that are plaguing the surrounding communities (Melle,
Before the mid 1900’s the Harrison Narcotics Tax Act was formed to tax those making, importing or selling any derivative of opium or coca leaves. In the 1920s, doctors became aware of the highly addictive nature of opioids and started to avoid treating patients with them (Center, 2004). In 1924 heroin became illegal. However according to a history published in the Journal of the American Medical Association in 2003, anesthesiologists opened "nerve block clinics" in the 1950s and 1960s to manage pain without having to resort to surgery (Meldrum, 2003). This push for treating pain without surgery was a major factor in the opioid epidemic we see today. In 2008 the overdose death rate was almost four times the rate in 1999, and the sales of prescription pain relievers in 2010 were four times higher than in 1999 (Paulozzi et al, 2011). The substance use disorder treatment admission rate is also greater than in 1999, with it having been six times higher in 2009. Chasing Heroin’s claims surrounding the fear of prescribing pain medications is accurate as you see an increase in public policies surrounding opiate use in the early 1900’s. The climbing rates of overdose deaths and the increased amount of people seeking addiction treatment suggests that the fear of prescription opiates was
With the growing number of individuals addicted to these narcotics, the need for better therapies and treatments to end these addictions has grown exponentially. Of these therapies and treatments prescribed to these patients, the newest and seemingly most celebrated is a treatment known as Suboxone therapy. This therapy is for those individuals who have opiate addictions and are seeking help toward a more speedy recovery (Thompson-Gargano, 2004).
National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment
Falcone, Timothy J. "Alcoholism and Drug Addiction FAQ's Saint Jude Retreat House. 19 April 2004. Online. Internet. 19 April 2004. Available: http://www.soberforever.net/FAQ1.cfm.
This leads to the second school of thought on medically assisted treatment. There has been a great deal of debate about the medication used to treat Opiate addiction, methadone. Many feel that the drug methadone is simply trading one drug in for another, as the addiction to methadone is quick and almost more powerful than an opiate addiction (Nelson, 1994). The withdrawals effects are far more intense with methadone and for this reason it is a lifetime maintenance medication. Some suggest that more rehabilitative programs are needed that would address the social problems the users have to help them recover, instead of the methadone program that is viewed...
McGovern, M. P., Xie, H., Segal, S. R., Siembab, L., & Drake, R. E. (2006). Addiction treatment
National Institute on Drug Abuse. (2013, Septemeber). Methamphetamine: Abuse and Addiction. Retrieved February 6, 2014, from National Institute on Drug Abuse: http://www.drugabuse.gov/sites/default/files/methrrs_web.pdf
New treatments must be made by realizing drug dependence coexists with habits that must be changed. This must, and can happen with long term supportive health with both clinical practices, and new-evidence based treatments such as Buprenorphine/naloxone rather than Methadone. This type of intervention will work in an extraordinary way with addicts and their sobriety. Intervention of both the physicians and addicts practices of opioid misuse would change the course of a deadly prescription.
Capuzzi, D., & Stauffer, M. D. (2008). Foundations of addictions counseling. Boston, M.A: Pearson Education.
In previous years, the government has not made great efforts toward stopping opioid addiction (Global). With the vast amount of deaths, over 183,000 since 1999, and dependencies, it would be foolish for the government to not address this (Jones).
Opioid dependent individuals who are in inpatient treatment have a 60% chance of relapsing; another estimate suggests that less than 25% of addicts will remain abstinent post methadone maintenance therapy (Veilleux et al., 2010). Opioid addiction is not just harmful for the individual, but also causes a large financial burden on the nation. In 1996, the United States dispersed roughly $21.9 billion dollars across the nation due to heroin addiction expenditures (Mark et al., 2001). Treatments which are able to address comorbid issues that affect retention rate, longer-abstinence post-treatment completion, and decreased economic impact would be very beneficial on a national and global
To begin with, in order for a facility to be successful in treating people with addictions whether it be alcohol, or drugs the facility must have a treatment plan to use and guide both counselors and the client alike to be successful in the program.
“The number of people receiving methadone maintenance treatment in Ontario has increased sharply in recent years, from 6,000 in 2000 to 38,000 in 2012” (CAMH). Though this number seems threatening, it is a sign that Canada’s effective methadone treatments are reaching more people. Methadone is a synthetic opioid; it has a different chemical structure but similar effects on the body to other opiates such as morphine, heroin, codeine and OxyContin (Harvard Health Publications). Methadone is not used to cure, but rather treat addictions that individuals have to more dangerous opioids. Critics of the maintenance treatment say these rising numbers is proof of addicts getting high with Canadian’s tax money. A more accurate statement would be that
Smith, Melinda, Segal, Jeanne, and Robinson, Lawrence. "Overcoming Drug Addiction." : Drug or Substance Abuse Treatment, Recovery, Help. Help Guide, Apr. 2013. Web. 23 May 2013. http://www.helpguide.org/mental/drug_abuse_addiction_rehab_treatment.htm