At least, that’s what a lot of people say, right? Stop shooting dope or taking prescription painkillers and start taking methadone or Suboxone as a form of maintenance and people still shake their heads at you like you’re doing something wrong. We talked the other day about stereotypes of opiate addicts. It comes from those in the medical profession, people in government who make laws regulating opiate prescriptions and opiate addiction treatment, the average guy on the street.

But unfortunately, these bad attitudes toward opiate addicts and opiate addiction are not necessarily restricted to those who have never been strung out before. Even within the recovery community, some look down on people who undergo opiate detox as part of a long-term maintenance program. What’s that all about?

Why Are Opiate Addicts So Judgmental?

There seems to be this attitude among those who managed to get clean after a short detox and without methadone or Suboxone that that’s the only way it can be done. Or that if one thing worked for them, then nothing will work for anyone else. Some 12 step groups, for example, are notorious for telling people who are on methadone or Suboxone that they’re not clean and sober. What’s the point of this? Does it serve anyone to denigrate the detox choices of others?

What’s the Alternative to Methadone Maintenance and Suboxone Treatment?

These people who tell you that you’re not clean when you’re on either of these medications have a very definite idea of what you ‘should’ be doing. They would recommend that you do a short detox, either cold turkey or under medical supervision with a constant tapering off of any opiate medication you’re prescribed to keep the withdrawal symptoms at bay. After that, if you get cravings, you’re supposed to ‘tough it out.’ Go to meetings. Call your sober friends. Work the steps. Not that any of these things are bad ideas. In fact, they’re all great ideas. But there’s no reason why you can’t do those in addition to taking your methadone or Suboxone prescription if it’s keeping you from getting loaded.

Why Suboxone and Methadone are Legitimate Forms of Opiate Detox

When you’re on maintenance, you can choose to be at a blocking dose of methadone and on Suboxone, one of the nice characteristics of the drug is that it won’t let you get high off other opiates. So if you’re feeling like getting loaded, you know that it would be a waste of time and money because you won’t feel it anyway. Do you know that one of the biggest risks of overdose is getting high after a period of sobriety? People take too much without realizing how low their tolerance has gotten and end up with severe respiratory depression, having a seizure, ending up in a coma or dead. There are a number of reasons why maintenance programs are a good idea when you feel more comfortable, but to me, that’s the most important. If you’re dead, what constitutes clean and sober isn’t much of an issue, is it?
What do you say to people who tell you that you should get off methadone or Suboxone? How do you deal with the prejudice you face from other addicts in recovery?

When you’re undergoing an outpatient treatment using Suboxone or methadone, it’s important that you find your resources for support wherever you can. One of the most common ways people choose to do that is to take advantage of the many 12-step support groups like Narcotics Anonymous. Free of charge with meetings every day of the week and, in many towns, many times a day, there really isn’t a more convenient or cheaper way to get the help you need.

Unfortunately, it’s not the most exciting way to spend your time. A friend of mine recently told me:

“Look, I hate meetings. I can’t stand the whining, the gossip and the fact that I lose hours of my life with my ass falling asleep in a metal chair. But I go and I’m going to keep going, because it’s keeping me clean.”

It’s true: meetings are not fun. Newcomers and chronic relapsers can get on your nerves as can the superiority of those who have been clean for years. The coffee is bad, and the snacks are cheap. Metal folding chairs will become the bane of your existence as will the sleazy 13th steppers.

So how do you save yourself from an NA or AA meeting when you really just have to go?

1. Bring your hobby. For many, just spending time in the meeting is the important thing, and you don’t have to have idle hands to listen to the speaker. I’ve seen people in meetings do everything from knit to carve clay figurines. Drawing, hand sewing, artist trading cards…whatever it takes to keep you from clawing your (or someone else’s) eyes out as long as it doesn’t smell, make a mess or take up a ton of space.
2. Get involved. What’s the opposite of dropping out of NA? Taking over. Speak up in meetings, introduce yourself to newcomers, talk to people after the meeting. Volunteer to clean up after the meeting or get yourself voted into a position of authority. Maybe if you have a larger hand in your regular meetings, you’ll be able to choose topics that interest you.
3. Change meetings. If you live in a city or any metropolitan area, you have a large schedule of meetings to choose from. Though you most likely choose according to the time of the meeting or where it’s located, it could be worth it for you to get up a little bit earlier, stay out later or drive a little bit further in order to explore the different meetings available. If you live in a smaller town and don’t have a ton of meetings to choose from, then start your own. Why not? That’s the beauty of NA. Pick a name, find a location, choose the first topic and advertise. Keep showing up and so will more and more people.

Whatever you have to do to make meetings more interesting or sufferable, do it. It’s worth it to build a strong support system that will long outlast the buprenorphine or methadone and carry you through a lifetime of sobriety.

What do you do to make it through an NA meeting when you’d rather be anywhere but there?

Part three in our interview series checks in with a  mother who’s on methadone. A heroin-free addict, our methadone mama went through pregnancy on the juice. She talks about what it was like and gives some advice to other methadone mamas.

When did you start taking methadone? How long have you been on it?

1999. I started maintenance in December of 2000, and I’ve been on it ever since.

Were you already taking methadone when you got pregnant?

Yes.

What did the doctors tell you to expect as far as your pregnancy and the effects of methadone on the baby? Did they warn against anything in particular?

I don’t think my doctors ever told me anything about what to expect. They said that the baby was going to have to be in observation for up to three weeks after birth, and that she could suffer from any range of withdrawal symptoms. Like anything that was common with an adult could happen to her, too. They were basically watching out for seizures, low key stuff like tremors.

I was breastfeeding, and they thought that was great because that meant she could get a little bit of methadone through the breast milk.

But really, they didn’t really prepare me for anything. I didn’t know what to expect.

Was your baby born addicted to methadone or have to undergo a detox when she was born?

Yes, but she had a very easy time. They usually hold [babies born on methadone] for 21 days for observation, but they let her go 10 days early. They watched her for 10 days and she was asymptomatic. She started having little weird gagging reflex and sneezing. She was gagging and sneezing and her tremors got a little worse and they gave her a very minute dose of like .02 milligrams or something, it was just like three drops of a dropper of the DTO (diluted tincture of opium), and it was just for a couple days and then she was weaned off. I never went over 130 milligrams in my pregnancy, and I weighed 235 pounds, so it wasn’t considered too high, which is probably why it was so easy for her.

Since the baby was born, have you felt like being on methadone imposed itself at all or gotten in the way of parenting? Do you feel like it has helped you?

I question whether it has any effect on my energy level. I’m on 75 milligrams now. Especially at higher levels, you know, like when I was on 100 milligrams, I was tired all the time, but I found that even when I reduced my dose, I was still tired.

My husband seems to think that methadone is this horrible substance. He says it’s poison, toxic, you know, “What can you expect from something manufactured for Hitler?” He seems to think that my whole life would just turn around if I got off it. You know, my health would improve, I’d have more energy. He thinks it’s just all bad. He doesn’t recognize that there’s any benefits.

And you think there is?

I think I’m stuck right now, because now it’s like, I need to get off, but I can’t just quit today. I can’t say, “I’m tired of taking it,” and not take it anymore. So I have to weigh the benefits.

It did help me get clean, though. I mean, it’s not a miracle drug; I was at the point where I was ready to quit, and [methadone] made it that much easier. And I’m pretty solid on my feet these days; I’m not worried about having a relapse. I just wish there was an easier way to detox off of methadone.

Have you considered Suboxone?

I have, but I’d have to be at a much lower dose to switch over.

I actually was on it a long time ago, long before it was legal. I had a doctor in LA—I was in the music industry, and I had a lot of money—and he would go to Mexico for it and bring it back. It was Buprenex that I used then, intramuscularly, and he ended up going to prison for it. I pretty much abused that, but that wasn’t the one with the naloxone in it. I’ve never tried the sublingual tabs they have now.

Is there anything you want to pass along to women who are expecting and on methadone?

I guess just try to take it easy on yourself. Don’t beat yourself up over it. There’s nothing you can do about it now. At least you can be clean and sober with your child, and take it one day at a time.

I previously interviewed a methadone addict and a buprenorphine study participant. Check it out!