ending stigma and social control – Workers World

In the 1930s, the German company IG Farben was looking for a solution to the opium shortage and the company’s inability to create new painkillers. The company found the solution in a chemical then called Dolophine.

Now called methadone (Methadose, Diskets), an urban legend has circulated that Dolophine was named after Adolf Hitler. This rumor should come as no surprise, as some of the IG Farben workforce were slaves from the Auschwitz death camp; and one of IG Farben’s subsidiaries supplied the poison gas, Zyklon B, which killed more than a million people in gas chambers.

But in fact, the label Dolophine comes from the Latin word “dolor”, which means pain, and the French word “fin” for “end”. It was a drug that ended the pain.

Methadone treatment developed

But pain was only one of the reasons methadone was used. After World War II, the US Narcotic Farm Addiction Research Center (a government-funded prison and research facility in Lexington, Kentucky, between 1935 and 1974) tested methadone on heroin-addicted patients, providing high levels of drug and then withdrawing it. , to see what would happen to the patients. When methadone was suspended, addicted patients continued to withdraw for days or even weeks.

Before the availability of methadone, codeine and morphine were used to treat heroin addiction. Researchers found the superiority of methadone over older treatments. In the mid-1950s, two American physicians – Vincent Dole and Marie Nyswander – developed the use of methadone as a maintenance program.

Believing that opioid addiction was a chronic disease—rather than a moral failure—Dr. Dole sought a drug that would serve opioid addicts the same way insulin serves the diabetic. He found it in methadone. Dr. Nyswander has researched and reported on his experiences trying to help addicted jazz musicians break free from addiction. Their collaboration was a match made in healthcare heaven.

Unfortunately, the response to this new discovery that methadone could stop the disease of addiction has not been so pleasant. In the medical field, those who advocate abstinence-only treatment models and those who advocate the medication-assisted treatment model with methadone have argued vehemently about goals and objectives.

On the left, the Black Panthers threatened to burn down methadone clinics because the method failed to address the root causes of addiction among people of color and the poor: poverty, racism, lack of access to health care and the systematic oppression by capitalism.

But the response to methadone treatment eventually turned into a lesser wave of criticism and a growing wave of acceptance.

Benefits of Methadone Treatment

Despite rumors that methadone could eat away at bones, destroy teeth, ruin kidneys, and damage livers, several studies in the 1970s showed there was no harm to long-term methadone users. . In the 1980s, during the AIDS epidemic, research showed that methadone users seroconverted to a lesser extent than non-methadone active addicts. (tinyurl.com/2f9dh4kn)

In the late 20th and early 21st centuries, methadone was found to increase the quality of life of its users, stop the spread of HIV and hepatitis C viruses, and stabilize even the most severe cases of addiction. to opioids. (tinyurl.com/3893jde6)

For these reasons, methadone is now considered one of the standard treatments in the treatment of drug addiction.

But questions remain: how to make methadone more accessible to people who need it? And why is the special methadone clinic program in the United States necessary, when other countries have liberalized their systems and made the drug available in regular pharmacies?

Methadone clinics a system of social control

The methadone clinic system needs to be fundamentally changed. The methadone clinic system — not methadone itself — is a system of social control.

Methadone clinics primarily serve people of color and people living in poverty. It is important to note this, because they receive much worse treatment than people on alternative drug treatment, buprenorphine (Suboxone, Subutex, Sublocade, Zubsolv). People on buprenorphine are mostly white people with private insurance and are considered more trustworthy than people on methadone. (jamanetwork.com, May 8, 2019)

Drs. Dole and Nyswander wanted methadone treatment to thrive because they believed addiction was a chronic disease like diabetes. Yet clinics have strayed from this philosophy by treating people with opioid use disorders as untrustworthy “junkies.” The methadone clinic system institutes rigid controls on blacks and browns and poor whites, who have not yet been able to stop methadone.

Methadone clinics control nearly every aspect of their subjects’ lives. The clinics control when an addict arrives and when he can fulfill his own responsibilities. Patients do not have the option of skipping group therapy and methadone clinic group activities. They must attend according to state laws.

The hours that methadone clinics stay open and dispense medication interrupt the responsibilities of living for methadone patients. With clinics often opening at 5 a.m., patients who have jobs often have to juggle treatment and work, often postponing work just to get their medication.

Day to day — the methadone system requires most patients to come in once a day, seven days a week. It was only during the COVID-19 pandemic that this changed. At the height of the epidemic, methadone treatment programs are allowed to give their stable patients 28 days of methadone. But it’s unclear if these relaxed rules will continue as COVID-19 recedes.

Drug industry chain

Under capitalism, addicts often pay high sums for the privilege of attending methadone clinic programs. They are emptied of their money every time they go to the clinic.

The price of methadone treatment for people who do not have insurance coverage is another link in the framework of control and operation of the methadone-clinic. The addiction industry makes money from human suffering – potentially more than $100 per clinic visit.

If a primary care physician could prescribe methadone, then that control and profit over the addict’s life would be enhanced, and he could truly reintegrate into society. If methadone was given under the care of a primary care physician, more people who need it could get it, and more people wouldn’t have to suffer from overdoses and die from addiction.

The methadone clinic system should be completely abolished. Patients should be able to get their treatment from their primary care physician, rather than loosely called “addiction specialists.” But in the meantime, how to liberalize the prescription of methadone for patients who need it?

Make Methadone Relaxed COVID-19 Permanent

One step is to pass the Opioid Treatment Access Act in Congress to make relaxed COVID-19 methadone dispensing rules permanent and allow patients to receive their treatment at a pharmacy after they are initiated into a program.

Another is to fight the stigma of people who use methadone. The methadone clinic system allows for stereotypical images of “junkies” being dosed with methadone at the clinic. Promote the understanding that methadone patients are regular people receiving medication for a long-term chronic condition, such as diabetes.

However, there is resistance to efforts to liberalize the prescription and distribution of methadone.

The American Association for the Treatment of Opiate Dependence, serving the interests of the clinical methadone system, opposes even the most minor reforms. The group opposes the OTAA because, in its own words, it would lead to an increase in “diversion,” or the illicit distribution of methadone.

But the reason methadone is being diverted is because the people who need it can’t get it because of the roadblocks in the current system. Patients are required to have opioids in their system, despite the fact that they would be in withdrawal for needing this drug; patients are required to accept counseling even if they cannot meet due to other responsibilities. It is actually easier to get heroin, fentanyl and its analogues on the street than to get into a methadone program!

Marxists – and those in recovery – should work to liberalize methadone. People could get methadone without being considered addicts. People seeking methadone deserve better.

Comments are closed.