The Case for Opioid Replacement Therapy

Considering the fact that I work as a counselor in a methadone clinic, I am always hearing a ton of different opinions about opioid replacement therapy. For those of you who don’t know, opioid replacement therapy is when people who are addicted to opiates like heroid and painkillers start a medication like methadone or suboxone. These medications are also opiates, but they don’t block all other opiates from working, and they don’t make you feel “high”.  These medications can be an effective way to manage addiction, and they can actually save lives.

Critics say that you aren’t really helping the addict–that you are merely substituting one drug for another. While technically this is true, it is really not the same. When you are addicted to heroin, it’s impossible to function in regular life. It’s also dangerous. You could always do too much or get a “bad” bag that is laced with something fatal. Heroin also makes you feel high so it is the high that you are always chasing. Medications like methadone and suboxone do not make the patients high, and they can easily function in regular life.

There is also the matter of pain. Many people who develop bad drug habits start with the issue of chronic pain that they are trying to treat. If these patients are not taking any opiates, they may be in really bad pain all of the time. This pain may then cause them to take whatever drugs are available, and it may lead to illicit drug use.

Drugs like methadone and suboxone are effective in terms of pain management. There are some patients who take these medications specifically for pain. If you suffer from chronic pain, you may have to come to terms with the fact that you will always have to take some kind of medication in order to minimize your pain to a level that you can live with.

I work as a counselor at a methadone clinic, and I have seen personally methadone save many people’s lives. If they are at the point where they cannot stop doing heroin, they need something like methadone. I started taking suboxone three years ago to get myself off of heroin. Eventually, I was able to come off of it. Now I am completely clean and sober. But we need to get rid of this idea that patients who take methadone or suboxone to deal with their addiction are somehow not “totally clean”.