Brief History
Controversies regarding the use of methadone have been existent over the past three decades. The use of the drug has received praise and condemnation in equal measure. The controversies have been persistent especially due to misinformation on the part of the various parties concerned; the addicts and their families, sponsors, physicians and ethnic leaders. Staff who are meant to guide addicts need to get the right information on the level of safety.
The recent past has seen an increase in the number of methadone-related deaths. This is especially so in the use of the drug in combination with other drugs. Methadone aids in treatment of other addictions such as opiate addiction. However, the significant increase in the number of death is sufficient to raise concern over the safety of use of the drug as a solution to addiction conditions. There is need to look into the extent of the problem, the risks involved and possible alternatives. Methadone is a synthetically manufactured opiod. Over and above the treatment of opiod addictions, the drug can also find use in treatment of extremely chronic pain.
The drug is available in liquid and tablet form and its availability has seen an increase in the last decade. Methadone related deaths mainly result from poisoning and the use of various combinations of drugs, such as alcohol and cocaine. However, these statistics do not mean that the drug is completely dangerous. In fact, when used appropriately it is very effective in attaining the intended purpose. Concerns of the use of methadone arise from poor use and the influence of politics, morality and economics. Opiates have been used for pain control since the 19th century. Methadone does not require intravenous injection and instead it is administered orally. Counselors ought to get the right information on methadone to determine, which aspects are mythical.
Current Trends or Issues
Research shows that methadone does function as a one-time cure for addiction. It merely reduces the withdrawal symptoms that arise when one tries to quit. This is why any methadone treatment plan ought to incorporate a counseling routine. Low doses of methadone act more effectively than higher doses. A single dose is usually sufficient to reduce a craving for an addictive drug such as cocaine. However, the problem arises from the fact that methadone’s half-life is longer than that of normal drugs such as heroin. This means that addiction to this drug is far worse than that of any other drug. Successful withdrawal from methadone is normally coupled with deep anxiety and long withdrawal symptoms. In some instances, such patients result to abuse of the drugs for which they were under treatment. Methadone addiction may also arise whereby pregnant mothers take the drug. In such a case, the chances of the baby becoming addicted are very high. Such babies may show withdrawal symptoms from methadone upon delivery. However, heroin addicted expectant women give birth to healthier babies when they are on methadone treatment (Meyer, 2007).
The drug is meant to treat addictions. However, use of the target drug together with methadone has a synergetic effect. This is so since the two drugs may not be lethal when used individually, but they become catastrophic and fatal when combined. Such drugs include heroin, marijuana and cocaine. Abuse of multiple substances may result in respiratory problems, depression of the central nervous system, and too much sleepiness (in some instances).
Societal Concerns or Issues Related to the Topic
Methadone raises concerns, especially among physicians, about its toxicity. This is especially because the drug has a long half-life. The drug remains in the human body for long periods after which it is redistributed back to the blood. Accumulation of the drug in the body causes depressed levels of oxygen in the blood and CNS difficulties. This condition may result in fatalism among drug addicts seeking treatment. This serves to discourage drug addicts from seeking any form of medical assistance. They prefer to remain in their addictions as opposed to risking their lives. This means that he use of the drug undermines the effort of reducing drug abuse. Most deaths induced by methadone occur due to overestimation of the tolerance level of an addict to the drug. Failure to educate patients on the effective of use of methadone without a prescription or adequate administration is a serious concern in the control of addictions. This is because the use of the drug alongside abuse of illicit drugs causes medical complications.
Significance of Topic to Counseling Profession
Teamwork is one of the most crucial points in the treatment of patients using methadone. Counselors comprise of this team together with other health professionals. Communication among all parties involved goes a long way to avert catastrophic consequences to the addict’s life. Otherwise, many of methadone-related treatments have been unsuccessful due to individuality and supremacy battles between counselors and the medical fraternity.
Patients under treatment for addiction mostly contact the nurse administering the doses and the counselors, in an ideal situation. These two people have the most significant effect on the patient’s recovery. The counselor is a very important party since he or she is tasked with the responsibility of securing the addict’s trust and confidence. This means that the patient can trust him or her with the challenges being faced at any one time. Furthermore, the counselor also serves to address the best interests of the patient. This is whereby he ensures the patient’s treatment plan by the physician and nurses take into consideration the patient’s interests. This reduces the incidences of patients quitting these treatment programs due to harshness or sternness (Austin, 2011).
The counselor also avails the patient with the various options available for his consideration. This is in terms of the rehabilitation goals (expected time of completion and strategic goals to be reached at various stages of the rehabilitation process). The counselor also encourages the patient during times of desperation or during periods when the patient feels like quitting the treatment plan. The counselor does not have the mandate to confront the patient at any one time. This is the biggest mistake that counselors make. They assume that confrontation is a form of therapy especially where the patient is unresponsive to dialogue. However, this usually causes the patient to drop out of the whole program and return to the former self.
A balance between active and passive mode of operation of the counselors is thus necessary. It should be sufficient to push the patient over status quo while retaining him within the treatment plan. Counselors normally use a directive approach in the treatment program. This means that they are the ones who guide the patient on the way forward. This is the best approach since patients enter the program with feelings of confusion, demotivation and sometimes hopelessness. The only thing that counselors need to maintain is a sense of mutual respect between themselves and their patients. They ought to be helpful and optimistic of the patient’s recovery. This is the best alternative as opposed to use of non-directive or confrontational techniques of counseling. There is a lot of concern over handling drug addicts. One need not be a recovering or recovered addict for him or her to understand the patients’ situation. However, it is very important to remain non-judgmental over the abuse of illegal drugs or membership to addiction cultures. The counselor also serves too act as a mentor and role model. Addicts can easily picture what a straight life (free from drugs) would encompass (McMurrow, 1981).
The counselor should also understand the challenges (physical and psychological) that addicts face in order to develop patience. Recovery addicts make very good counselors since the addicts see the actual possibility of being rid of the drug addiction. Counselors may find it difficult to remain positive and motivated in their job of helping addicts since these are people who are normally unruly, carefree and disinterested in the program that is meant to help them. However, this calls for a sense of self- motivation on the part of the counselor since he or she is delivering a very critical service to society. The counselor ought not to let the various challenges overwhelm him and discourage him from his cause. Neither should the counselor allow personal feelings of anger lead him to give orders, directions or injunctions (Dole and Joseph, 1978). This may increase the level of opposition from patients. Eventually, the patient will fail in his bid to recover and this of failure will fuel the vicious cycle of self-contempt.
The use of methadone treatment to break addictions from drugs, such as alcohol, requires well-guided procedures. Such a system with preset rules may fail to function when applied by a person who does not follow the norms of society. Some addicts feel that the counseling sessions are an infringement of their rights and they even refuse to open up and share on their challenges or even progress. Counselors of methadone treatment programs ought to take advisory of the considerations of the patient. Counselors help reaffirm the patients of the importance of following the recommended doses of methadone in the treatment program (Barry et.al, 2009). This is a very sensitive area since most addicts feel vulnerable when they allow others to dictate their dosage.
The role of the counselor in patient education of the treatment plan while using methadone to break addictions from illicit drugs is extremely crucial. This requires that the counselors familiarize themselves with the non-medical and medical alternatives that intervene in eliminating alcohol or drug use. Counselors avail the various lifestyle alternatives to their patients. This may include bringing successful addicts to the counseling sessions to encourage them on how they too can be successful. The education program includes having the patient create a periodic list of positive and good things that have occurred since the rehabilitation program started. This list can be compared to a list of things the patient wishes to see changed. The comparison helps to highlight the benefits of treatment, despite drawbacks. Counseling sessions may take the format of individual sessions if it is necessary to give a patient a lot of attention (Mt Sinai J Med., 2000). The frequency of counseling sessions depends on the stage of development of the patient. Group therapy sessions help in discussions of a general nature and in encouraging patients for purposes of peer reinforcement and support.
Any Future Implications
Prior to use of methadone as a treatment option for addiction to illicit drugs, it is crucial to determine the health and psychological status of the patient. The treatment plan should avail sufficient supply of the drug throughout the treatment period to prevent relapse to the use of illicit drugs. Patients with known medical conditions ought to receive thee treatment with a lot of caution. This is especially so for patients with respiratory and heart complications. The treatment plan ought to have a method of screening patients to ensure that they are not using. Furthermore, take home medications should be administered with a lot of care. The program medical supervisor of any rehabilitation center ought to be sure of the patient’s level of responsibility to have unsupervised doses. This has been the trend especially with the increase in safety concerns on the use of methadone related treatments. Some centers carry out random call backs to patients to assess whether the patients have taken overdoses of the methadone. Sufficient control is necessary to prevent the use of the methadone drug other than by the persons for whom it intended to help medically (Stitzer, Iguchi and Felch, 1992). Staff should receive constant awareness and education programs on the best way to administer methadone doses the risks involved and the need to have psychological and medical history of patients prior to administration of the drug.
References
Mt Sinai J Med. 2000 Oct-Nov;67(5-6):347-64. Methadone maintenance treatment (MMT): a
review of historical and clinical issues. Joseph H1, Stancliff S, Langrod J. http://www.ncbi.nlm.nih.gov/pubmed/11064485
Meyer M. Wagner K, Benvenuto A. Plante D, Howard D (2007). Intrapartum and Postpartum Analgesia for Women Maintained on Methadone During Pregnancy.
Dole & Joseph, H.(1978). Outcome of Patients Treated with Methadone Maintenance. The New
York Academy of Sciences
Barry D, Beitel M, Joshi D, Schottenfeld R. (2009) Substance-Related Pain-Reduction Behaviors
Among Opioid Dependent Individuals Seeking Methadone Maintenance Treatment
McMurrow, M.E. (1981) The American Journal of Nursing
Austin, J.(2011, March 5). Lining up demand Pharmacies, Methadone Proliferate on Main
Street, Winnipeg Sun, p. 4
Stitzer, M., Iguchi, M. Y. & Felch, L. J. (1992). Contingent Take-Home Incentive: Effects on
Drug use of Methadone Maintenance Patients. Journal of Consulting and Clinical Psychology, Vol. 60 (6), 927-934.
