Methadone Treatment 1

Methadone for the Treatment of Heroin

Jennifer Sweeney
College of Charleston
Methadone Treatment 2
Abstract
The treatment of heroin is a controversial topic and people have various views regarding
the ethics of using a drug for treating another drug !n this essay ! will attempt to argue
for the use of methadone in the treatment of heroin dependence Methadone use over a
short period of time may help people trying to recover from opiate abuse because it
ma"es withdrawal tolerable The most appropriate course of action is to have methadone
administered to patients in the smallest efficient dose to ease pain# and then over the
course of a few wee"s time wean them off until they can function without it
Methadone Treatment $
Methadone for the treatment of heroin addiction
The withdrawal of heroin can be a very painful e%perience for heroin users
&ithdrawal can include craving# cold flashes# anhedonia# flu'li"e symptoms and although
they are typically not life'threatening# they may cause a user trying to get clean severe
distress !n the H() documentary *Methadonia+ one of the addicts in the video brings up
a good point that# *heroin treatment has changed a lot in the past forty years Methadone
has clearly provided more humane treatment than straight,ac"ets and rubber deto%es+ !f
drug abuse is considered a psychological disorder that warrants treatment then drug
addicts deserve to see" help in a way that causes them the least amount of physical and
psychological discomfort !t may be argued that it isn-t humane to throw a first time
offender who has used heroin in ,ail to allow them to suffer from withdrawal !t isn-t a
method conducive to psychological wellbeing and may not prevent relapse in many
cases &ithin the appropriate environment .such as within methadone clinics/ methadone
may provide some relieve to heroin users &ith the combination of other therapies li"e
cognitive'behavior therapy# methadone may be an effective treatment &hether or not
methadone will be an effective therapy has a lot to with the patient-s cessation of other
drugs and ability to wean off the methadone gradually Most methadone related deaths
involve polydrug use# especially ben0odia0epines in combination with methadone
Sometimes patients can end up on multiple prescriptions for ben0odia0epines along with
opiates Heath 1edger allegedly died from a combination of prescription opiates and
ben0odia0epine depressants .Many celebrities have had similar deaths# perhaps because
they li"ely have very easy access to any and every drug/
2!3A has done research on methadone as a treatment for heroin and found that it
Methadone Treatment 4
can be a safe# effective therapy Methadone may prevent a user from craving# because the
methadone prevents heroin from producing the same euphoria as it once did.1/ ! do wish
to point out that it is disturbing to me that 2!3A-s site claims that methadone is
medically safe even when used for over ten years .1/ ! am advocating methadone as a
short-term treatment of heroin addiction# not as a permanent drug alternative Methadone
dosages should be carefully administered and monitored !t should be a last resort
treatment# used to relieve severe pain that has not been relieved by other pain"illers.2/
Methadone vs. Heroin
Heroin
Heroin is a highly'addictive and illegal street drug that is "nown for being deadly
The drug is derived from morphine and obtained from the opium poppy and is used
because of its pronounced pain'relieving effects Slang terms include brown sugar# blac"
tar and smac" among others and these street names come from the fact that the substance
is a powdery tar'li"e substance .$/ !t is most commonly in,ected intravenously or
smo"ed# though some newer users may use the drug subcutaneously and according to
5rowid .4/# some users may try to wean themselves off by ta"ing oral doses# though this
is not the preferred method when *chasing the dragon+ Heroin has an e%tremely high
potential for abuse partially due to the fact that tolerance develops 6uite rapidly to the
euphoric and numbing effects .though unfortunately barely at all to other negative side
effects# such as gastrointestinal effects li"e constipation/ 7sers will often continue to
search for the same high that they got the first time that they used8 this is what it means
Methadone Treatment 9
to *chase the dragon+ Heroin is a central nervous system suppressant that causes a range
of physiological reactions# including noticeably constricted pupils# vomiting# clouded
mental functioning and slow or slurred speech 1ong term use can cause respiratory
problems# pulmonary complications such as pneumonia and death Some problems
arising from heroin use may be largely due to the fact that street drugs are often *cut+
with various other dangerous substances .$/
Methadone
Methadone is a form of opiate replacement therapy that has a longer duration of
action than heroin and is not considered to produce the euphoric effects that are
commonly associated with heroin use 2!3A claims that users can e%perience real
emotions on the drug :: Heroin has about the same potency as morphine but the duration
of action for methadone is considerably longer# where heroin lasts an average of three or
four hours# methadone can last twelve to twenty four hours .p24; te%t boo"/ A patient in
a methadone clinic would thus only need to ta"e the drug once or twice over the course of
a day
!n the 7nited States methadone is a schedule two drug# which means that there is
a high potential for abuse but the drug is still considered to have a currently accepted
medical use with severe restrictions .heroin is a schedule one drug# which is not
surprising considering it is "nown for it-s high potential for abuse and the drug is illegal/
3octors should use caution when prescribing doses of methadone and heavily consider
the patients history of abuse !t should be used in the conte%t of a harm'reduction
approach# with the intention of "eeping a user from relapsing to heroin over the course of
Methadone Treatment ;
the few wee"s or months proceeding *6uitting+ when a user is most vulnerable to drug
and environmental cues that may promote relapse !n the video *Methadonia+ some of the
users too" methadone in ways that are not intended8 many used as a way to circumvent
prosecution because of heroin )ne of the users in the video "ept *nodding off+ in a way
that suggested he was abusing methadone as an alternative to heroin Methadone should
only be administered in a safe# clinical setting and it seems that it is perhaps too easily
available with seemingly little limitation for former heroin users <eople should not be on
methadone for years
! read a personal account entitled *&hat has two years of it gotten me=+ on
5rowid of a guy who had been on a one hundred and fifty milligram dosage of
methadone for two and a half years He claimed that he felt stuc" and foresaw that he
would be on methadone for the rest of his life# because he had been on it for so long that
he could see no other way to function Methadone was the only way he felt cured from all
the loneliness and emptiness he felt and without it he fiends for it and goes through
miserable withdrawals# laying in bed tossing around and e%periencing what he deemed
punishment for the high he got from methadone .he said that he doesn-t believe the hype
that methadone patients don-t e%perience a high# he says he does# it is simply a little bit
less of one than when he was in,ecting/ <erhaps the anonymous male who wrote that
article on 5rowid would be better off if he had been prescribed methadone for a shorter
length of time and had another form of therapy# such as cognitive'behavior therapy to
deal with other apparent issues# li"e his despair and de,ectedness ::Acceptable practice
is for methadone doses to be tapered off over the course of a few wee"s until the user is
no longer physically dependent on morphine or heroin anymore .p291/
Methadone Treatment >
&hen a user is not abusing methadone and is actually trying to get off of drugs#
the treatment can have a very positive impact on several domains in their life &hen a
patient begins to get methadone treatment at a clinic their overall health will improve#
even if they are H!? positive addicts They will li"ely have less interpersonal problems
and won-t have to "eep creating more ugly scars from in,ecting intravenously# which !
can see easing the minds of their loved ones and perhaps even opening up new
employment opportunities Also# a more serious reason for not in,ecting is H!? among
intravenous drug users# which is a big public health concern !f heroin users stop in,ecting
heroin and start ta"ing a methadone pill instead# the rates of H!? might decline Also#
the statistics show that criminal activity is very much decreased once someone admits
themselves for methadone treatment .9/
Conclusion
!t is easier to find information li"e statistics about how many people are passing
away from methadone and how obviously dangerous it is &hat is downplayed is the fact
that these people would have li"ely continued to use heroin and possibly died from that if
methadone were not available Many patients abuse various other drugs or ta"e too much
of their medication <erhaps doctors are prescribing 6uantities of methadone that are too
liberal and for too long# as ! have already previously emphasi0ed ! would li"e to see
more scientific research about methadone and its application in drug treatment ! thin" it
is fair to say that the medical community should "now more about the drug# as well as the
patients who are being prescribed it
@ortunately the prevalence of heroin use is fairly low# but among those who use# a
disproportionate portion will inevitably die as a result Among those who have used
Methadone Treatment A
heroin# over half will become dependent on it .;/ My father-s friend used heroin for only
a few wee"s and overdosed and died &ith heroin addiction# treatment is more urgent
than with most other drugs# because their life is very much at sta"e Heroin users have a
death rate that is roughly fifteen times greater than non'users They are also at an
e%tremely high ris" for suicide# and many heroin related deaths are suicides .;/ !t is
costing our society too much The &isconsin Medical society show statistics that the
yearly cost of heroin addicts# due to their criminal activity# lac" of social productivity
among users and medical care costs# etc was twenty one point nine billion dollars8 and
that is an outdated statistic from 1BB;# but ! only presume that it is far beyond that now
.;/
2ew Cor" has 29D#DDD heroin addicts and only enough capacity in their
methadone programs to hold $$#DDD .9/ Some clinics refuse methadone treatment# and
the statistics show that the relapse rates are even higher among those not being treated
with methadone and the patients are less li"ely to return to treatment The heroin
epidemic is a serious problem and getting users to deto% on methadone is a start There
are many addicts who aren-t getting the help that they need

Methadone Treatment B
::E5M)?5 F7)TAT!)2S8 <AEA<HEAS5 A23 C!T5 S)7EC5S .correctly/
Please do not overuse headings. It is perfectly acceptable just to have a few major
headings and zero minor headings. In this paper, I use headings uite a bit just to
illustrate their use. If you find that every other paragraph is a different heading,
you are overusing them! "his becomes uite distracting and I will deduct points.
Minor Heading
The number of ma,or headings that you use# of course# depends on your research
topic !t is possible to get a perfect score on this paper using only ma,or headings That
is# divide your research paper into logical sections 5ach section could be a ma,or
heading !f it ma"es sense to divide a ma,or topic into several smaller ones# then minor
Methadone Treatment 1D
headings are appropriate As a general rule# if you are going to divide a ma,or section of
your paper using minor headings# be sure to have at least two minor headings !t ma"es
little sense to have a ma,or heading and then only one minor heading
Major Heading
2ote that this section of the paper has no minor headings That is perfectly fine
2ow ! want to discuss how to provide in'te%t citations in A<A style !n the body of the
paper# articles and boo"s are cited by the last name.s/ of the author.s/ and the year of
publication <lease do not cite the author-s first nameG @or e%ample# you might writeH
Mowrer .1B4>/ originally proposed two'factor theory and it has received renewed
attention .Eescorla I Simon# 1B;>/ 2otice that when an entire reference is enclosed
within parentheses# the ampersand is used rather than the word *and+ !n citing more
than one paper by the same e%act author.s/# put them in order of date .earliest first/ @or
e%ampleH 5arly studies by Smith .1B>9# 1BA2# 1BA4/ have shown support for the
e%pectancy theory# while studies by Jreen and (ernard .1BAA/ have not supported the
theory 2ote here that *and+ is spelled out in the Jreen and (ernard reference because it
is cited nonparenthetically Compare this with the Eescorla and Simon reference above
which uses the ampersand because the entire reference is parenthetical An astute student
might wonder why ! did not type the dates the second time ! referenced the Jreen and
(ernard# and Eescorla and Simon studies The first time that you reference a wor"#
provide the date !f you reference the same wor" again in the same paragraph# omit the
date The first time that you reference the same wor" in subse6uent paragraph.s/#
however# you must provide the date again
Methadone Treatment 11
!f different authors are cited simultaneously at the same point in the te%t# the
citations are arranged alphabetically by the authors- surnames# separated by a semicolon#
and enclosed in parentheses @or e%ampleH Some studies .Adam# 1BBBK Smith# 1BA$K
Smith I Jones# 1BA4K Smith I Martin# 1BA2K Smith# Thomas# I Jones# 1BBBK &alterman#
2DD4/ dispute the behaviorist position 2ote that you should only space once after a
semicolon 2ote that each set of authors is in alphabetical order# but within each set# the
authors are in the order as they appear on the boo" or ,ournal article @or e%ample# the
authors of your te%tboo" are Maisto# Jali0io# and Connors .2D11/ Cou would never
alphabeti0e these !f a study is mentioned more than once and it has more than two
authors# cite all authors the first time For all future in-text citations# only cite the first
author and replace the other authors with *et al+ @or e%ampleH Maisto et al .2D11/
describes the dangers of commonly abused drugs
!f you are citing a wor" previously cited in a prior paragraph# you must include
the date @or e%ampleH Although they claimed to refute e%pectancy theory# criti6ues point
out that the research by Jreen and (ernard .1BAA/ is flawed .Huggins I Stewart# 1BB$K
Smith et al# 1BBB/ Also note the use of *et al+ in the previous e%ample because it has
three authors and all authors were cited the first time in a previous paragraph Also note
that the citations are in alphabetical order according to the first authors- last names
Sometimes you have no recourse but to rely on secondary sources .that is#
someone else-s interpretation of a piece of wor"/ Then you might want to use a
secondary source Here is an e%ampleH Maisto et al .2D11/ reported that (lum .1BA4/
concluded that opium was used as early as 9DDD ( C !n the reference section# list
Maisto et al and not (lum in spite of the fact that the (lum study is of interest to you
Methadone Treatment 12
(ut try to avoid this &here possible# find the original sources of information that you
cite ! do not want to read a paper that does nothing but cite a te%tboo" repeatedly
Sometimes the source that you are citing is an organi0ation Here is an e%ample of
how to cite it correctlyH According to the 2ational Survey on 3rug 7se and Health#
AD2#DDD Americans used 1S3 in 2DDA .2S37H# 2DDA/ 7sing this as an e%ample# you
should now be able to cite things off of 2!3A-s or 2!AAA website accurately Also see
the reference section for how to cite these things accurately there
Major Heading
Minor Heading
Jenerally# try to avoid direct 6uotations That sentence is important enough to
repeat Avoid 6uotations ! want to read your writing# not the writing of somebody else
<art of learning how to write scholarly involves the ability to summari0e the wor" of
others in your own words )f course you will cite the sources for all of the information
that you use )therwise you will be guilty of plagiarism (ut you will summari0e this
information in your own words )therwise you again will be guilty of plagiarism# even if
you cite the source <lease see my comments on plagiarism on the other handout
Earely# it is necessary to provide a direct 6uotation from another source @or
e%ample# perhaps you want to provide a definition of a term that is uni6ue# highly
technical# and impossible to summari0e in your own words .This is actually rarely
necessary Many definitions are common enough that you can define them in your own
words and if your definition is very close to another-s definition it still would not
constitute plagiarism because the term only can be defined in one way/ (ut if you are
providing a word'for'word definition from another source# it should be in 6uotes &hen
Methadone Treatment 1$
you provide a direct 6uote# be sure to include the page number @or e%ampleH Tardive
dys"inesia can be defined as *an e%trapyramidal complication characteri0ed by
involuntary movements of the mouth and tongue# trun"# and e%tremitiesK a side effect of
long'term .two or more years/ use of antipsychotic drugs+ .Maisto et al# 2D11# p $1>/
2ote that ! use *et al+ because ! have already cited this source .and all of the authors/
earlier in the paper
Another case where it might be appropriate to provide a direct 6uotation is for the
psychologicalLliterary punch that it pac"s @or e%ample# if you are arguing for the
legali0ation of mari,uana# you might be interested in what a popular introductory
psychology te%tboo" says about the matter !n their discussion of mari,uana use in an
introductory psychology te%tboo"# Schacter# Jilbert# and &egner .2DDB/ stated that *the
greatest danger of mari,uana is that it is illegal+ .p $2;/ 2otice how in the first 6uotation
! put the entire reference at the end of the 6uotation !n the second# ! put the authors and
year first and the page number following the 6uotation 5ither is acceptable
Sometimes# when you are 6uoting from on'line material# page numbers may not
be available Sometimes authors are not even available Try to give enough information
for the reader to find the 6uote !f titles# headings# or paragraphs are visible# use them
Here is an e%ample of how to handle this situationH )ne user of "etamine# identified by
the screen name Jesusgreen# describes his e%perience on the website erowidorg as suchH
*)nce ! was in the MN HoleM# everything lost its meaning ! was no longer a person# ,ust an
entity# and everything ! saw was meaningless+ .Journey into the !nfinite# para ;/ 2otice
here that ! provided the author-s screen name# website# the title of the essay# and the
paragraph number
Methadone Treatment 14
@or the purposes of this paper# you should rarely .if ever/ need to directly 6uote
material from another source Eather# summari0e the literature in your own words and
then cite the source ! want to read your writing# not what someone else has written
"herefore, I am imposing a limit of two direct uotations for this paper. <lease note
that you can get a perfect score on this assignment with 0ero direct 6uotations (ut if you
must 6uote directly# do so sparingly Points will be lost if your paper has more than
three direct uotations.
Minor Heading
Here are some miscellaneous tips &rite with clarity and do not use flowery
language @or e%ample# *The eminent American <sychologist 3r Jeorge Nelly# is
credited with the first portrayal of man as a scientist- would be better stated as *Nelly
.1B99/ was the first to portray man as a scientist+ This is not a creative writing class
Scientific writing should be clear and to the point
Avoid citing redundantly This is a common mista"e that students ma"e Here is
an e%ampleH 3allery .1BAA/ reported that attractive students were more li"ely to earn
higher grades He also found that that this effect was especially pronounced if the teacher
was the opposite se% of the student .3allery# 1BAA/ 2ote that this second reference is
completely redundant given that it follows immediately from the prior sentence and there
can be no confusion as to who *he+ refers !f there could be confusion .for e%ample# if
you are discussing multiple studies in the same paragraph/# then it would be appropriate
to provide the citation again (ut here# you already told me that this material came from
3allery So the second citation is not needed (y the way# that e%ample is completely
fictional .as are most of these references/
Methadone Treatment 19
Major Heading
2ote that this handout is largely a formatting guide !t says very little about how
to actually organi0e your paper !t is up to you to present your research topic in a logical
se6uence Most of the topics involve whether or not a drug should be legali0ed )ne
way to organi0e the material would be first to provide some bac"ground material on the
drug Then provide a history of the legal history associated with the drug 2e%t provide
arguments for legali0ation# arguments against legali0ation# and conclude with your
opinion Ma,or headings could be devoted to each of these topics 2ote that this is only
one possible way to organi0e your paper There are many
Methadone Treatment 1;
#eferences
The reference section begins on a new page $ote that the header is
%#eferences& and not %'or(s Cited.& There are many online sources for how to format
your references in A<A style A few of these websites are provided on the other handout
! have# however# provided a few references to use as a model 2ote that many of these
references do not correspond to the references in the te%t They are simply to be used as
a model Also note that this paragraph provides information about the Eeference section
)bviously# in your papers# you would omit this paragraph and ,ust list the references The
references would correspond e%actly with what was cited in the te%t @inally# most online
,ournal articles and some boo"s have doi numbers !f it does# include it in the reference !f
not# omit it
Adams# J 5 I Arronson# H 1 .1B>1/ Jroup dynamics in the prison
community Journal of Experimental Social Psychology# 42# 1>'21
doiH %%%%%%%%%%%% )$ote* +,ample of a journal article.-
(rody# J 5 .2DD># 3ecember 11/ Mental reserves "eep brain agile The ew !or"
Times Eetrieved from httpHLLwwwnytimescom )$ote* .nline newspaper
article.-
Clay# E .2DDA# June/ Science vs ideologyH <sychologists fight bac" about the misuse of
research #onitor on Psychology$ %&.;/ Eetrieved from
httpHLLwwwapaorgLmonitorL )$ote* .nline magazine article.-
History Channel .<roducer/ .2DDD/ 'oo"ed( )llegal drugs and how they got that way*
+ocaine$ the third scourge O3?3P )$ote* %/0/& is part of the reference.-
Methadone Treatment 1>
Jesusgreen .2D1D# @ebruary 4/ Journey into the infinite O)nline forum commentP
Eetrieved from httpHLLwwwerowidorgLe%periencesLe%pphp=!3Q>B9>B )$ote*
"his provides an e,ample of how to properly cite a user e,perience from
+rowid, or any online forum comment for that matter.-
Eissen# A 5 .1B;;/ Sensory deprivation !n 5 Stellar I J ! Sprague .5ds/#
<rogress in Physiological Psychology ,-ol* ./ 2ew Cor"H Academic <ress doiH
%%%%%%%%%%%% )$ote* +,ample of a boo( chapter.-
Stogdill# E 2 .1B>4/ 'andboo" of 0eadership 2ew Cor"H The @ree <ress )$ote*
+,ample of a boo(.-
7S 3epartment of Health and Human Services# 2ational !nstitutes of Health# 2ational
!nstitute on 3rug Abuse .2DDB/ 1esearch 1eport Series( )nhalant abuse
.2ational !nstitute on 3rug Abuse# 2!H <ublication 2o DB'$A1A/ Eetrieved
from httpHLLwwwnidanihgovL<3@LEEinhalantspdf )$ote* "his is an e,ample
of how to cite research reports from $I/1. "here are research reports for
many drugs of abuse on $I/12s website.-
7S 3epartment of Health and Human Services# Substance Abuse and Mental Health
Services Adminstration# )ffice of Applied Studies .2DDA/ 1esults from the 2223
national sur4ey on drug use and health( ational findings .)ffice of Applied
Studies# 2S37H Series H'$;# HHS <ublication 2o SMA DB'44$4/ Eetrieved
from httpHLLwwwoassamhsagovLnsduhL2"AnsduhL2"AEesultscfm )$ote* 3ood
chance that you will be using this reference!-
Methadone Treatment 1A
$ote* 'hen citing an entire website, it is sufficient to give the entire website in the
te,t. It does not need to reappear in the reference section.

1/ httpHLLdrugabusegovLresearchreportsLheroinLheroin9html
2/ httpHLLwwwnlmnihgovLmedlineplusLdruginfoLmedsLa;A21$4html
$/ httpHLLwwwdrugfreeorgLdrug'guideLheroin
4/ 5rowid
9/ httpHLLdrcnetorgLmethadoneL
;/httpHLLwwwwisconsinmedicalsocietyorgLR&MSLpublicationsLwm,LissuesLwm,Rv1D$n
4L(rownpdf