I am a long-time certified counselor in the chemical dependency field. I read with great interest the letter by Dr. Aaron Greenblatt ("Methadone is the most effective therapy for heroin addiction," Dec. 23) and would like to make a couple of comments. First of all, I wonder whether the writer has ever stood in front of a clinic and observed the numb souls who emerged after getting their "medication." Most methadone is dispensed at amazingly high doses (120-180 mg/day). I wonder if he's watched those people drool and stagger as they try to get their bearings, after which they'll lobby for more methadone because it wasn't enough medication.
I will agree that if a methadone program is a good one, clients will undergo rapid random urinalysis tests at least twice per week to ensure that all the clients are taking is their medication. Then they can confront and counsel those individuals who are using other substances and implement sanctions and discharge them if they continue to use other, likely illegal substances.
Benzodiazepine abuse with Xanax (the main culprit) and other related medications are often taken to enhance the methadone high. Also, many of the clients will inject cocaine, especially if they were doing "speedballs" (opiate and cocaine delivered together) before entering treatment. A vast majority of the clients in these programs will exhibit high tolerance, long-term dependence and an inability to understand or comprehend what "enough" is. I believe that society is being extorted. "Let the taxpayers keep me medicated and I won't steal" seems to be the rationale.
The disease of addiction tells these "disenfranchised people" that they have to live out their lives in "liquid chains." I know 10 people personally who went for methadone every day for 20-to-40 years. They are every bit as incarcerated as anybody in jail is today. They are simply being swept under the carpet.
Lots of big grants and bucks are spewing from federal and state coffers. If these publicly funded programs must exist, run them with consistency and compassion and stop enabling addicts to continue with their suffering! Hire counselors to work with these people and stop throwing money and chemicals at the clients for a continuing justified return on investment. These might be disenfranchised people, but they are still human beings.
George Hammerbacher