It’s not well written. Meant only to offer insight. Nothing more. I wrote this nearly two and half years ago and had barely researched the matter legally. This was what I ALREADY recognized at that time. I’d soon discover that my problem was much more involved. Here’s one of six completed parts. It’s obviously unedited. I send it the way I originally wrote it. Didn’t think too many people would ever see it regardless. Didn’t have a destination originally.
It’s in portions. Hopefully the first two get read though.
It’s unlikely that anyone reading about this experience will be an attorney or even a concerned doctor. Methadone maintenance patients may not recognize how medically and legally it’s important to understand that everyone is afforded the right to acceptable care. Doctors are supposed to behave professionally. That includes the manner in which they treat you medically.
I’ll be as straightforward as I can be. Everyone should arm themselves with at least some of this information.
**”TREATMENT DOESN’T = CURE”
Not all occupations were created equal. Being a doctor is considered prestigious and society respects any person who has chosen to heal others for a living. What profession could possibly be more important than treating sick people? And when a doctor has successfully done her job, she’s even able to save lives. That’s why they earn our admiration as well as earn impressive amounts of money.
However there’s a reason why they earn trust and respect. Not just anyone who feels like it can suddenly decide to be a doctor. For example, waitresses.
Naturally they don’t have the medical knowledge that doctors possess. While waitressing is not easy or particularly glamorous. Being a physician requires a person to pledge an oath that promises to DO NO HARM while practicing medicine. Obviously waitresses aren’t required to make that same promise. And truthfully when a waitress makes an error or a mistake it’s very unlikely that anyone will actually die from her oversights. Unless she’s poisoning the food.
There’s consequences for misbehaving. That’s true for anyone and doctors are no exception. There are legal sanctions, including fines and penalties. There are medical boards that can suspend or revoke a medical license altogether if a doctor neglects her duties. And most importantly, there are laws meant to protect the welfare of the public. When a doctor is found to be in violation of those laws she can even be found criminally responsible. She may be ordered to pay the “DAMAGES” if a court decides she has injured someone. Or an injunction can halt risky medical procedures or treatments until a judge can decide.
In other words, a judge can declare a doctor responsible or “LIABLE” which is a legal term basically meaning that when doctors and nurses fail to live up to their professional duties and patients are harmed. Patients can file a suit and may be awarded damages. Or monetary settlements can occur. Mediations can take place when both sides wish to avoid further action.
Most physicians to the best of my knowledge, perform their duties with integrity. Even doctors who assessments might not be embraced by their patients usually appear to behave professionally. At least from what I’ve personally experienced. Thankfully.
Now “Malpractice” has a very specific criteria. Hopefully no one is likely to experience all four points. If so than that is legally defined as malpractice. Malpractice has ruined my life. If I had realized that physicians were obligated to not HARM me than perhaps I could have gone to court much sooner. By the time I recognized all the harms I had endured, all the damages it cost me. Basically statues of limitations had run out. But it was moot, or so I thought so. My life couldn’t ever be restored. I sacrificed my own well being and I’m still in distress, twenty years later. I also never realized to what extent the damages were until many years into my treatment. There’s nothing I’ve not lost to substandard care. Every single possession. All of my hopes and dreams. Even my future achievements. Gone now. I’d even argue that I also lost my soul. Maybe some one will read what I’m writing and then I can ask them honestly if they disagree.(?)
And cruelest of all were the innocent victims that didn’t get a choice in the matter. My beautiful babies. Nobody told me that by simply trusting the wrong healthcare provider, my children would also be harmed too. Surprisingly physical harm occured to them as well. I wish sincerely I had been the only one hurt.
If only someone had explained a few critical items to me. Maybe I could have made an informed choice instead of simply trusting that no possible harm could occur to me by following my doctor’s suggestions.
This is what I’ve learned on the fly. I’ll warn you, on FLY
1. Misdiagnosis can be considered malpractice. Did they miss something even unintentionally? If so did, due to a lack of treatment did the condition worsen?
2. Negligence can occur with substandard care is the cause of injury. If a capable physician didn’t prevent an obvious blunder or condition than he’s neglectful.
3. As a result of treatment was HARM created? Treatment doesn’t have to be raving success in terms of improvement. But it isn’t supposed to cause a more severe debilitating condition than the one you arrived with.
4. You were engaged in a Patient-Doctor relationship at the time.
I guess it might seem unnecessary to define what a horrible medical experience will look like. Especially since when you begin to suffer, trust me you won’t need a law book to confirm that treatment has damaged you. Still I pray no one’s ever going to hurt as long as I have already.
Now if a waitress is performing your surgery, assuming she’s got your permission. You can’t reasonably expect her to not HARM. Just because she’s playing doctor doesn’t mean that you’re engaged in a “Doctor-patient” relationship. She can’t be held legally liable. However a professional, like your doctor can be held liable. A doctor-patient relationship is established once a doctor has officially seen you or treated you. The two of you have entered an unwritten contract. He cannot breach that contract. He’s responsible if you are injured simply by virtue of him being the ONLY one who can be responsible. He’s the one who attended medical school, not you. That’s why doctors are punished for overwriting prescriptions. It’s automatically his duty and his sanction and most importantly he should not write a prescription for anything other than what it’s intended for. NEVER forget that part. Even if he examines you inside a circus tent. He’s acting as your medical provider. And he’s obligated to live up to his professional duties. You might not realize it but included in your role as the patient. You have an obligation to speak up when treatment goes awry.
Doctors tend to underestimate the intelligence of their patients sometimes. If you feel like your doctor is not quite interested in hearing about your issues than start paying closer attention at that point. It’s a red flag.
Last bit of knowledge that might arise. Ideological influences! It’s not really that complicated but it is used to manipulate patients occasionally and it’s a major influence even without realizing that it’s being used. Patients would be wise to remain on the lookout for ideology that doesn’t respect their needs and attempts to convey messages. It’s not always present but you should try to recognize it whenever it is used.
My least favorite part of being admitted into treatment is all the boring paperwork and pamphlets. I used to never read any of it. I’d sign documents regarding my healthcare after a mere glance. Trust me, I’ll NEVER let one signature of mine wind up on anything that I’ve not carefully read! For example, the word “Client” is sometimes used in instead of the word “Patient”. In my own case it’s meant to imply that I’m not exactly entitled to the same rights as a full blown legitimate PATIENT. It’s used to subtly remind me that I’m merely a consumer paying for treatment and medication. The term “Client” is sometimes used by prostitutes and by drug dealers during all kinds of exchanges where you are ONLY a paying customer. But here’s the catch legally speaking, medically speaking. They are both exactly the same in terms of rights to adequate care. There’s no difference. It doesn’t matter what a provider chooses to refer to you as. You are entitled to proper care and he’s supposed to live up to his professional duties. The “contract” is the same. Remember either at an upscale practice or being examined inside a circus tent. You have entered into a PATIENT DOCTOR relationship/ contract the minute you’re treated by a physician and that relationship is sacred. Period.
Unfortunately, there are doctors, nurses, hospitals, facilities etc. that are widely accepted by the medical community even though they harm people when delivering sub-standard care. Recognizing when care is not just unsatisfactory but being able to identify potentially harmful care is how a person can take personal responsibility to make sure that treatment doesn’t rob a person’s health, life and their future. Most medical scenarios can include an advocate who’s job it is to explain the full consequences of your treatment. They ideally should not be paid by the same clinic or hospital where services are rendered. So how do you even know if you’re in need of further explaining at the Doctor’s office? I can’t provide a list of everything that I’m unaware I don’t need. Unless an advocate climbs out beneath the doctor’s desk and introduces herself. I’m completely oblivious. I’m also going to recommend that recovery coaches be the type of advocate who’s truly qualified to explain what in the hell methadone maintenance clinics are going to be like. Remember- treatment is not the same as a cure. They’re not interchangeable.
“WHO’S THE DOCTOR??”
I had been in a horrific car accident my senior year of high school. I ended up breaking my jaw bone, crushing four of my fingers on my left hand as well as various other cuts and bruises. After being escorted to an Indianapolis community hospital I was told that I would need extensive work. Including having my jaws wired shut for about six weeks. The procedure was very painful. My jaw hurt so much I thought I’d probably loose my mind! To make matters worse I was nine weeks pregnant with my first child. Initially I didn’t even ask for painkillers since I was concerned about my baby’s development. But after an agonizing sleepless night. I called the emergency room sobbing and was told Vicodin would not hurt my unborn child. Thankfully they called me in a script of Vicodin and I immediately got relief.
During those long six weeks my wired jaw needed maintenance and that meant tightening screws into the bones that were broken. Each visit I received another refill. Bear in mind that 25 years ago doctors wrote painkillers pretty liberally. Back then pill mills weren’t in the headlines and the DEA weren’t out to sanction doctors for over-prescribing narcotics. Of course that would quickly change. The Opioid epidemic caused many patients concern. Particularly chronic pain patients.* But there’s more than one group of patients that suffered reprecussions due to the nation’s opioid crisis.
Believe it or not certain substance use disorder patients also felt the reprecussions first hand!
I began to use my Vicodin to relax after work or for a headache. Largely it was simply an opportunity that allowed me to use the Vicodin I already had at my disposal. I just happened to have them on hand sometimes.
My teeth were in poor shape after those wires. I suffered tooth aches and Vicodin helped a lot. As I look back and ask myself where did I go wrong? What could I have done to avoid abusing them? When did it happen I wonder? I certainly never made a conscience choice to abuse hydrocodone. I never needed more than two or three pills which was within the prescription guidelines, that is until the day it wasn’t.
It didn’t take that long for me to go from relieving pain to feeling pretty warm and fuzzy all over. I started requesting Vicodin at almost every medical visit. For awhile, perhaps a year. It wasn’t difficult to be accommodated. That didn’t mean I always had Vicodin handy. But of course I was able to make them last back in those days.
Naturally it finally stopped being easy. I would be questioned suspiciously about my pain issues and the quantity was decreasing. I didn’t want to go without them more than a week or two at a time so that’s when I begin buying from friends and family. I began to supplement them. Sometimes I just callously raided my dear friends medicine cabinets. I would mainly rely on luck as far as supplies go. I was never was able to have them all of the time. I wouldn’t like it if I had none to take after work or for a headache. Waitressing is physically quite demanding.
However it certainly wasn’t overly difficult to obtain more. It was frustrating to go without them. It wasn’t physically painful though. I didn’t experience physical withdraw from not being able to find any. Only a desire to use more.
At one point I didn’t have luck locating any so I told myself that I’d make an appointment and attempt to reason with my doctor. Although it didn’t impose on me physically to wait a few a days or longer while I was looking for more. It was inconvenient at best. And truthfully I was a bit spoiled.
Surely I could just persuade him to assist..
To my great disappointment he flat out refused and then informed me he wouldn’t be writing them again. At one point he made a suggestion. He hands over a pamphlet and says I’m addicted to Vicodin. Dependant on opioids. He says if I need an opiate narcotic that this same community hospital also included a methadone outpatient clinic. He explained that every twenty four hours I’d have to drive into downtown Indianapolis in order to drink an opioid narcotic called methadone. It must be taken in full view of the nurse so no prescriptions available. He says that it can be addictive (cough, cough) but I’d never need Vicodin again and once I was stable.
I could simply ween myself off at any point in time. Whenever circumstances were right I could get off of the medicine.
Then adds that I’ll be required to pay for it every week. Payable only with a money order. The cost was fifty dollars back in 1999.
Over the years inflation etc meant the weekly fees grew more and more expensive. And virtually no insurance would provide coverage. Least of all Medicaid. That meant my coverage under the hospital’s managed health care program wouldn’t cover it either. It was called the Wishard Advantage plan, later renamed Eskenazi Advantage of course.
I was very trusting of my doctors back then. I can still hear myself thinking that a physician wouldn’t possibly hurt me or recommend I take medicine that’s too addictive or even difficult to ween off from.
But at the same time I was also apprehensive.
This entire process sounded like a huge commitment for a single mom working as a waitress. Plus I wasn’t collecting any child support. How was a doctor who was supposed to be helping me recommend that I pay for medicine I couldn’t afford? And honestly didn’t need? Then only to become hopelessly (and it was so very hopeless) addicted to it?
Behavioral mental health disorders should be evaluated from a socioeconomic perspective as well as from a clinical point of view.
Not just from one person’s subjective opinion. Addiction is a complicated disease and there’s many considerations, causes and treatment options available. Methadone maintenance isn’t always the most appropriate treatment for every type of Opioid addiction. It’s essential to closely monitor patients when they first arrive. Close supervision will reveal if that person is regularly exposed to opiates. Blood work is probably a critical determination. Not that I would ever get the chance to benefit.
I was skeptical but thought I’d try it for a month. After all it was written there in black and white right in the pamphlet. I could always stop going if it became inconvenient. Or once I was stable(?? Mention problem with that later)*
After all it’s an evidence based form of treatment according to the handout I was reading.
Of course it didn’t say under what circu ofmstances it was an evidence based forms of treatment! I didn’t know it back then but I was about to make my descent into Hell. Into madness.
*”Methadone is a powerful opiate based narcotic. After ONLY fourteen days, your brain begins to change and starts to become starved for it’s fix. The rewiring of your brain will alter it forever. Brain damage in two weeks.”
I didn’t know what the word opioid dependant meant. Didn’t know what OPIOID addiction was from a medical standpoint. I barely had a clue how addictions worked or realized that dependency on opioids is a physical response. Everyone gets dependant on it who takes it on a long enough time line. It behaves much like heroin. Oh well, ok ok not exactly like heroin. It is legal and methadone is four times the strength of street heroin.(Terrifying & completely true) Growing more and more opioid seeking receptors with time. Building a tolerance and your body will NEVER have enough. You’ll grow receptors for the entire time. You’ll eventually need the $50 weekly fix more than food or family. (How’s this is not a drug deal disguised as some type of medical treatment is beyond me). Unless a person IS ALREADY DEPENDANT or severely addicted methadone will only harm you.
Of course nobody told me that.
I wanted to question my doctor further but he seemed to have all the answers. I didn’t realize that since this little outpatient methadone clinic was part of the community hospital’s network, that meant the profits are all going straight back into the main hospital. I can’t believe I didn’t recognize what his incentive probably was by referring me over to the methadone clinic.
The community hospital’s outpatient clinic was sitting on a cash cow. In retrospect I was probably more recruited than I was referred. And of course avoiding possible sanctions for overwriting opioid prescriptions was probably a factor. I would give any amount of money to go back and beg him to tell me what methadone withdraw is like. Or even deny me access to any narcotic medication altogether.
I had no idea what I was getting into. But without an advocate who’s job it is to see that I fully comprehend what I was signing, how in the hell would I know that my life was getting ready to seriously go down hill and I would pay $125,000 for almost twenty years? Monetary loss might appear to be a nightmare for some folks but I was only getting warmed up in the “loss” department.
ASSESSMENT! ADMITTING DAY:
Generally most methadone clinics share the same criteria for admission.
1. Must be dependant on an opiate. That means you’re incapable of going without it. No one who’s truly dependant will skip a day or neglect to feed those screaming receptors. Trust me.
2. EACH PROSPECTIVE “CLIENT” MUST PROVIDE A URINE SAMPLE ON ARRIVAL AND IT MUST BE POSITIVE FOR OPIOIDS. NOW PERSONALLY I DON’T GET HOW ONE URINE SAMPLE ON ONE PARTICULAR DAY is PROOF POSITIVE of ANYTHING OTHER THAN YOU WERE POSITIVE FOR OPIATES ON THAT ONE OCCASION.
But hey I didn’t go to MEDICAL school.
3. And a start up fee of about $150 in addition to a picture ID. (1999) That’s the remainder of the requirements. After a brief assessment you are welcome to begin serving your sentence! Or rather, you are now a client.
What also adds to my frustration is that I’m trying to figure out how a qualified specialist is content with preforming an assessment as opposed to a thorough exam. A proper exam makes it far more likely to receive a diagnosis. And a proper diagnosis makes the likely hood of receiving effective treatment a reality. Not to mention makes it less likely a person will suffer.
Who wants to head into the operating room based on their own assessment as to what the problem is and what type of surgery your doctor should be performing? Well assuming that it’s not a fellow surgeon who fills out the assessment alright (?)! And would it be of any comfort to realize that it’s not just any surgeon who’s going to perform the operation. It will be a SPECIALIST! What does it matter if he’s not going to perform or treat you using his specialized skills in the operating room.? Does a hospital really need to pay an expert to treat patients based on what they themselves are telling him to go ahead and do? Like I mention constantly. Never went to medical school. Maybe I’m misunderstanding.
I was handed a question-answer based survey to complete asking me to rate or gauge my drug use and symptoms. A questioniarre. It’s probably not surprising to discover that a lot self described opioid addicts will on occasion “lie” in order to ingest a powerful opiate such as methadone. I myself had been advised from friends and coworkers who recommended that I claim my body was dependant on some type of opiate each and every day if asked. And I guarantee you that I wasn’t alone. I didn’t want to leave empty handed. Plus I didn’t fully understand what opiate dependency was. I’d never heard the term opioid dependant before. Waitress, not med student**
I naively assumed that the clinic’s expert would examine me and let me know his professional opinion on what I needed. The only opiate I’d ever had was Vicodin. Vicodin Is a relatively weak narcotic when in comparison to others. And methadone makes Vicodin look like baby aspirin in comparison.
Methadone studies have reported that it’s in fact four times the strength of street heroin. That’s in terms of physical withdraw. And they aren’t wrong. To this very day I can’t feel Vicodin any longer. In fact I’ve not felt Hydrocodone in almost twenty five years.
See, you can’t go back once you cross a threshold. Once your brain and body develop a certain tolerance, you’ll require that exact same amount to even register you’ve taken it. And methadone is no different from any other opiate. Meaning you’ll continue to grow more and more opioid receptors whether it’s methadone, heroin or even Vicodin. You’re eventually going to have to take more. Subuxone is different but that’s another subject.
However at the time I wasn’t even able to obtain Vicodin daily. The night before being admitted I was frantically trying to locate any opiate in order to test positive the next day. I ended up buying half of one Vicodin and took it in the morning before I was admitted.
It’s something I regret every single day of my life. I had a clean system and I risked it all to try out a drug that’s simply not meant to be “sampled” unless you are in serious need. However looking back I can clearly identify myself as engaged in drug seeking behaviors. That’s part of having a substance use disorder. I wasn’t in control. But I wasn’t OPIOID dependant. Not yet anyway.
There are plenty of other ways to verify an addiction to opioids. Check a person’s criminal background, ask them to show you their injection scars. Ask them to sit in a waiting room as the feeling of complete dread and panic begins to slowly creep in. They are very unlikely to be able to continue sitting or standing too long. Plus a runny nose filled with a very thick mucus that never quits. I always run a fever and my blood pressure goes way up. None of these indicators would have been found in my case.
And whose more qualified to determine if I was in physical withdraw than a man who is an Addictionologist? I assume it’s part of his training to determine my level of care using his skills. Not basing it on my recommendations.! I’m not even sure if it’s possible to lie to a doctor in the first place. After all what if a patient honestly believes they know what is plaguing them but they are mistaken? Waitress not med student* remember (?)
I can’t walk into a doctor’s office and announce that I’ve got lung cancer and insist he administer chemotherapy right away! Besides my number of correct/incorrect assumptions ratio isn’t exactly impressive these days.
Only at a methadone clinic can a patient offer up a treatment plan!
I waited patiently for the doctor to examine me in his office. Meanwhile I got so bored I began actually reading the new pamphlet. And here’s exactly what methadone maintenance was supposed to achieve.
Lessening criminal justice system, cases
Less chance of a family court case
Increased Job stability, financial stability.
Improvement of social skills and bonding, strengthening family ties
Less chance of transmitting an infectious disease from dirty needles
I was puzzled wondering why I’d ever have to be worried about those problems any way. I’d never seen or used illicit narcotics before except for weed occasionally. (For the record had I just stuck with weed rather than a fondness for opiates, I’d have a brand new life right about now)!
The doctor entered the room and performed a very brief physical exam. He took my blood pressure, listened to my heart, listened to my lungs and five minutes later he left. I briefly considered attending medical school myself since it looked pretty easy. Huh
Within thirty minutes I was handed my very first dose of methadone. I do recall the doctor asking me if 30 milligrams sounded like enough to me (??)
I had nodded my head up and down in agreement I but didn’t have the slightest clue. I’d never taken anything close to methadone before. I’d never seen heroin. I’d never injected or snorted opiates. The absolute strongest opioid medication I’d ever been prescribed was Vicodin. The low end ones at that.
And I didn’t even have any ongoing scripts of those at that time. Which was probably the motivation for me to consider methadone in the first place. Times were tough…
Forty five minutes afterward I’d be puking my guts up and barely able to stand. I was so lethargic I couldn’t open my eyes all the way and my speech was badly slurred. It was nothing short of a miracle that I managed to drive the twelve miles back to my apartment. I quite literally crawled into my living room where I vomited right on the carpet.
I would eventually get to my phone and call the clinic asking what in the hell was wrong with me. The twenty year old gal answering phones listened to my concerns and then assured me I was still in withdraw without my Vicodin.(??? Ahhhhh ok sure if you say so)*
She then filled out what’s called a “Dose Increase” form that my doctor would sign off on the next day. The next morning I was given a ten milligram dose increase. This routine continued for about a week. Possibly two weeks. It’s been a minute.. so I can’t accurately describe the rate of my increases from twenty years ago. I do remember each additional morning my dose was increased by ten milligrams. I was told to wait it out. I was told my symptoms were fairly normal and would subside once I was stabilized on the correct dose. (?? Or maybe once the clinic managed to overdose and kill me? Maybe that’s the stability stage(?) Death. In reality if I had died as a result of being seriously overmedicated my odds of getting an attorney to represent me in a malpractice suit would be far better! Sad but definitely true) Unfortunately I lived to tell the tale. Death would have been an easier injury to endure than what ends up happening to me.
I finally was dosing at one hundred milligrams in under two weeks time. For the record people have overdosed and died on as little as thirty milligrams. I was a very small person. I still cannot believe that this didn’t kill me back then. Honestly I really wish that it had. And unfortunately I’m completely serious about that part.
I would come inside to be dosed. Once dosed, I’d then jump into my car as soon as I could in order to race back home within forty five minutes time!! Forty-five minutes was the absolutely maximum amount of time I had before the lethargy set in. (Trial and error I’m afraid)!
If I didn’t drive fast enough then I’d simply fall asleep while still on the road. Thankfully I would typically doze off at a red light or a stop sign-usually. Not always though.
God forbid that traffic prevent me from arriving back home before my allotted forty five minutes was up!
A fellow motorist once found me asleep at the wheel on a set of train tracks. He was extremely concerned but too kind hearted to summon the police. Obviously he didn’t realize that regardless of what my condition was or whatever the consequences might have been for me. It wasn’t safe to not summon police or paramedics! I’d have been much better off if a train had arrived before that good Samaritan. Saving me years worth of tragedies and misery. Not to mention thousands of dollars.
Sad but true.
I wasn’t being UNDER medicated. I was quite clearly being OVER medicated. Although since I would not have another meeting with my doctor for nearly a year. It began literally sucking all the life out of me. I was incapable of staying awake. I even began to fall asleep at my waitress job. Customers would be ordering dinner and I’d fall asleep standing up while taking their orders down!
I weighed 89lbs when I first started methadone. Truthfully I had no business taking it and I was being poisoned. Of course without diagnostic tests or even under the supervision of the clinic’s specialist. There was no one to prevent it from happening. Hoping for the best, I trusted my circumstances would soon be improving. I was wrong, AGAIN.
About two months went by with no significant changes. I finally got fed up and decided to leave. When I informed them of my decision they didn’t appear overly surprised
In retrospect it felt like they expected me to leave. No one seemed interested in finding out what my symptoms meant medically.
Instead they told me I would have to slowly decrease the dose until it was very low and then I would have few if any withdraw symptoms (cough..cough).
Stupid ass me is still under the misconception that I was basically receiving sound medical advice. After all they were the experts. Since everyone knows that regardless of what treatment might not accomplish physically, medically. It can’t actually hurt you more.
“AND THE TRAP IS SET”
What everyone discovers is that gradually decreasing after you’re on a decent amount is painfully slow. Usually one milligram a day. And often it’s recommended to decrease the one milligram every other day. At least until you know how it’s going to affect you.
In theory- if eighty milligrams is far too much. Than decreasing by one at a time means only seventy nine more to go. Assuming you decrease that dose all the way down to one. That’s eighty milligrams in 160 days. Somewhere in the neighborhood of three months, probably longer. Let’s just hope that person doesn’t need to make a speedy exit at that point! Medical experts will usually remind folks that decreasing too fast will cause “uncomfortable” (cough..cough) withdraw symptoms. Best to take the slow and gradual approach here. And for those of us patients who can add under pressure, those eighty days will of course double your detox. Eighty turns into one hundred and sixty days. Bear in mind that the average “higher” end doses are one hundred and twenty days. Especially over time your starting dose won’t medically fill the newborn opioid receptors that continually grow.
All the while your brain’s chemistry has been changing and adapting. With new receptors popping up, you’re going to start to feel a strong need to fill them.
One ungodly early morning while I was standing outside freezing. Waiting in line on the outside of the building in order to get in a line on the inside of the building. I noticed something. I began to realize that as the seasons changed, the years passed, jobs are lost, etc.
The same faces were always there. As unobservant as this may sound. I guess I’d never really acknowledged it before. Nobody leaves a methadone clinic. Usually anyone who does manage to make an exit isn’t doing so voluntarily. The doctors moved on. The nurses were rotated out. Even the clinicians would never stay too long. It’s kind of like serving time in prison. Everyone else makes some type of significant life progress. Everyone that is with the exception of the paying consumers. The majority of patients had been “consuming” for years. However I began to wonder how much life progress any of us were truly making. I pushed the thought out of my mind that recalled without evolution, all life would be extinct! Change. If only I had listened to my intuition all the years ago. I’m still haunted by thoughts of what my life might have been without the role of methadone in it.
“IT’S A MATTER OF WILL POWER! MIND OVER MATTER!’
Now the next ignorant son of bitch who informs me that getting off of methadone after ten, fifteen or twenty plus years is largely a matter of will power, may be swallowing some of their own teeth!! I can’t even begin to explain how this simply isn’t the case where methadone is concerned. And God knows that I’ve tried! Over the years I was desperate to depart. Occasionally someone in the methadone line would announce that they were in the process of tapering off and were going to leave the clinic for good! Of course all the veterans knew better since time and time again we had also made this VERY same announcement. Not that we wanted anyone else to fail. On the contrary, we’d wish them luck and we knew better than to mention how terribly difficult it would be. And as the weeks passed we’d watch them decreasing their dose and eventually attempt to leave. On average it took about five to 12 days before their return. They always looked awful. But no one dared critized their honest efforts. We knew all too well that methadone maintenance was more or less a life sentence.
And whenever a family member would let me know that if I had really wanted to get off the methadone, anybody could. It was simply mind over matter!
And in nearly twenty years of being a methadone maintenance patient I am unable to provide even one name belonging to someone who successfully managed to get off methadone using nothing more than their mind and their fierce will!
Not even one.
I suppose that’s because everyone I’ve known was just weak, right? Maybe everyone I knew personally just screwed up the recipe where methadone withdraw was concerned?
Who continues paying outrageous fees and driving miles out of their way every twenty four hours? Seven days a week? Even Christmas day unless they knew that they were going to suffer immensely if not? Does that sound like the ability to choose even exists?
No one’s involved just for kicks. No one that I know asks to suffer.
It’s worth mentioning that I didn’t know a single person who’s employment wasn’t adversely affected by the constant inconvenience of the clinic. And what made matters worse, (besides poverty, evictions, loss of employment and broken down automobiles) was the cardinal rule that every methadone “client” knows by heart.
NEVER ever tell ANYONE that you’re a methadone patient. Never. Not under any circumstances will it not be risky business!
The consequences of being honest are most certainly too devastating to bear. Unfortunately I was going to get my first of many lessons. And what follows next is almost too hard to write about. Turns out that an invisible entity better known as STIGMA is the methadone “client’s” worse enemy. And nobody cares.
That’s the first-I