More Methadone

Colin Mixson
Mar/30/2010

"On May 18, 2000, the governor of Vermont signed into law Bill S.303 that legalizes long-term methadone treatment, ending a long debate between the legislature and the governor on how to respond to the alarming increase in heroin abuse in the state. The first long-term methadone clinic is expected to open in Vermont by the summer of 2002."
Portsmouth Herald, 01/11/2000

For just shy of a decade, Burlington has been home to one of Vermont’s two methadone clinics. Methadone is a drug used to block withdrawal symptoms and combat addiction in opiate based narcotics. It has proven to be safe and effective. When medically supervised, long-term methadone treatment causes no adverse effects to the heart, lungs, liver, kidneys, bones, blood, brain, or other vital body organs. Methadone withdrawal is also much slower than it is with heroin. The result of which makes it possible to maintain an addict on methadone without harsh side effects. This is fortunate, because the nature of heroin addiction can sometimes make it necessary for patients to remain on methadone treatment for many years.

Furthermore methadone maintenance is highly cost-effective. According to the New York Academy of Medicine one year of methadone treatment costs about $5,000 per patient. The Office of National Drug Control Policy also stated that methadone treatment costs about $13 per day and is considered a cost-effective alternative to incarceration. This seems especially frugal considering the $109,000 lifetime Medicaid cost for each injecting drug user with AIDS.

Most importantly, methadone treatment makes living without addiction a possibility for many people. The National Institute on Drug Abuse found that outpatients receiving methadone treatment decreased their weekly heroin use by 69%. The Office of National Drug Control Policy states, "This decrease in use allows for the individual's health and productivity to improve. Patients were no longer required to live a life of crime to support their habit, and criminal activity decreased by 52% among these patients and full-time employment increased by 24%."

However, despite the drug’s effectiveness, its availability is generally limited. Vermont itself only recently legalized the use of methadone, and today has only two clinics. One is located in Brattleboro; the other is located at the University Health Center in Burlington. This is all well and good, or at least it would be if Vermont was more akin in size to Hawaii, or Rhode Island. While Vermont is not notably large in terms of population or geography, it is none the less of sufficient size, regardless of its infamous weather, that spanning Vermont on a daily basis can be described as a universally undesirable task. Unfortunately, this is exactly how methadone clinics operate, on a day to day basis.

Instead of receiving their medication on a weekly or monthly basis, patients must resign themselves to appearing at their assigned clinic on a regular, and strictly observed schedule in order to receive their daily dose. Although methadone treatment is more effective, and presumably more desirable than incarceration, the scarcity of clinics in Vermont leaves many people driving several hours, and hundreds of miles a day to receive their medication. This can be especially problematic in a state like Vermont, which in the winter months is frequented by notorious ice and snow storms.

Anyone trying to hold a job, maintain a car or just save their money can understand the predicament of driving across state to make a meeting; a fact made more or less frustrating considering the meeting itself often takes as little as five minutes. The cost in transportation alone could prove financially crippling, and the balancing act of meeting a methadone appointment and fulfilling ones work obligations is taxing, and often impossible.

Another problem that occurs with having only two clinics in the state is that those cities which have clinics become veritable Mecca’s for recovering drug addicts. Many of these people will be helped by the program, but many of them will relapse. In fact, many people receiving treatment at the University Health Center are court appointed. They go there because they prefer drug treatment to incarceration, and may have no intention of quitting the drug they were convicted of using. Of course these people cannot be considered recovering drug addicts, but simply drug addicts, who by their very nature impose a criminal element on the city. Even the intent to quit does not preclude a person from the selling the drug, or providing connections to other users. By housing one of only two clinics, Burlington is also become the daily venue of conventions for drug users from the across the state.

Statistically speaking, methadone clinics help a lot of people cure themselves of opiate addiction. From a large scale perspective, it seems as though the whole process is working just fine. However, from the human perspective, methadone treatment can sometimes prove an insurmountable task in and of itself.