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"A life is not important except in the impact it has on other lives."  -Anonymous 

Greetings!  What can I say, I have honestly missed sharing with you every month! I
know many of you think I couldn't possibly have problems like all of you but you
would be surprised to discover I do.  All of us working here deal with exactly the same problems. Neither, Rita nor I have any health insurance.  We definitely can understand how difficult it is for you.  We both deal with chronic pain on a daily
basis. 

We sincerely care about all of you. We have been experienced "substance abuse." We understand all of what "substance abuse" encounters. It wasn't easy for either  
of us to find our way through the wilderness to what worked for us. Once we had discovered methadone, we didn't understand why there was such stigma and even
more discrimination against such a medication which worked beautifully to end
the agonizing withdrawal symptoms and constant craving.

I remember.  I had finally discovered this new medication and it really worked for me.  I wanted to shout it from the roof tops but I found out if I did people would view me with disdain and I possibly could lose my position at work.  I found out
hardly no one approved of the medication and I could not understand why but I was determined to find out why. It was my quest for knowledge about "substance
abuse" and my desire to learn about the medication I was taking and the injustice
I encountered receiving "Methadone Maintenance Treatment" which led me to the
opening of "Medical Assisted Treatment of America."

I have enjoyed every minute since I started sharing my knowledge with all of you on "Medical Assisted Treatment of America." I have met many of you dealing with
the same identical problems and it brought such healing to me to know I was not alone. You, too had tried everything and had found nothing to work for you until
you discovered methadone. I didn't feel alone any longer.  The more I talked with all of you, I began to realize I had been called to take a stand for what I believed in and to start advocating against the stigma and discrimination attached to the one medication, methadone which truly worked.  

Many have joined me along the way and I am truly thankful for all of you.  It is not easy to take a stand and announce to the world I am on methadone. Most people try and keep it a secret for to speak of it openly could affect our employment and loss of our family and friend's goodwill.  It shouldn't be like it is! Therefore, if we
wanted to talk to others we had to do it secretly. We found it difficult to deal with
the injustice we encountered at many of our  very own "Methadone Maintenance
Treatment Programs."  There still not been much improvement even after all these years but has become worse because of the deaths which have occurred from the illicit use of methadone.

We have stayed together and more of have joined with us in the pursuit for justice.
I have tried to be there for each and everyone of you and we have all tried to help each other
 by listening, sharing our experiences and knowledge, supporting and encouraging each other to continue on in our fight for patient's rights. I am proud to say we have many engaged in our battle to change the way we are seen through the eyes of the world.  I really want to thank all of you for being there, not only for me, but for each other. I believe we possess a sensitivity many others lack and it is why we become addicted easier because we are more sensitized to pain and find it
much more difficult to deal with. 

I can say I know first hand by listening many of you have experienced your share of agonizing pain, emotional and physical and yet, most of you always have the time to help another in need . Many of you were there for me when I wanted to give up because I  became so frustrated at all the injustice but you would not let me quit. I thank you for all of your support and for believing we could "Make A  Difference!" Now, since it is almost time for Halloween, I am hoping all of you will exercise diligence if you take your children "Trick or Treating."

Halloween is certainly not what it used to be. It is not as safe for your children as it was many years ago.  If you have small children under the age of six, I would think you would certainly want to be their escort. I would only take them to the "homes" of people I knew fairly well.  Please keep a close watch on them at all times for it doesn't take but a few seconds for one of them to go missing.  If any of you has ever had it happen to you, then you know just how distressing it can be. We don't need it to happen to any child this Halloween.

I believe it is important to share with your children the true meaning of Halloween.
How many of you really understand what it is all about ?  I am going to share with you enough to hopefully peak your interest. It is only my belief but I believe as soon as they are old enough to understand, they should know why we celebrate Halloween. It is possible as they grow older, they may choose not to celebrate it .  


Christian History of Halloween – The Origins
Halloween began to evolve as early as AD 270 from the Celt’s culture in Ireland who practiced a special costume party event the night before their annual feast of “Samhain,” which had a two-fold purpose. The feast was not only a memorial to commemorate their deceased relatives but also a thanksgiving to close the end of the summer season of light and to prepare diligently for entering into the darkness of the long winter season.

Superstition has it that the "eve" before the feast was then a time to ward off any evil spirits which they believed were cast out or released from the spirit world realm into their physical world and who would come to attack the feast celebration. Believing that the demons, witches, and hobgoblins were real and existed, October 31 then became an annual costume event to try through disguised appearance to fool the evil spirits into thinking they were not humans to be harmed.

The Druids, who were the Celt’s ruling class, required of everyone to attempt tricking the evil spirits by dressing up to look like goblins, witches, and devils, and by carving ugly, monstrous faces on gourds lighted with candles, and by sweetly putting treats outside their door. The challenge, according to superstition, was to divert the evil spirits attention away from their feast the following day. 

Christian Halloween – Understand the Origins
Christian Halloween? Halloween is undoubtedly more misunderstood than any other holiday event. Is it hocus-pocus superstition or truly Christian focused?

It can appear to be nothing more than a pagan event dreamed up by some deviant opportunist and/or candy and costume manufacturer, but All Hallows Eve was actually intended to be a righteous opportunity purposed in history past to commemorate old saints.

We encourage you to carefully examine the history of Halloween. Halloween, which comes from the word All Hallows Eve is tied directly to All Saints Day celebrated on November 1 of each year to commemorate the old saints who have past on. These “saints” were heroes and martyrs for the Christian Faith.

"It's Your  Choice."  We ask you make your decision
 wisely   based on the information you possess on the
neighborhood you live in. If you have children under the
age of six, they should be accompanied by you or a
responsible adult, not by their teenage brothers or
sisters.Please proceed with caution.

Christian Halloween – The Pros and Cons?
We understand that much of Halloween has manipulated and “tricked” by the secular pagan world and much of what happens on Halloween is far from spiritual. In fact, some of the Halloween traditions have pagan origins.

The Bible doesn’t speak directly about Halloween, but some biblical principles apply. One things is clear -- all pagan practices are to be avoided. Witchcraft, occult practices, sorcery, etc. are strictly forbidding in the Bible (Exodus 22:18; Acts 8:9-24; Acts 16, 19). It is obvious that a small child dressing up as a princess or a cowboy isn’t involving themselves with witchcraft, so what is a biblical stance on Halloween?

Parents, the decision is up to you. If you decide Halloween is something fun for your children, make sure they are kept far away from the evil aspects of Halloween. When believers participate in anything (even Halloween), their attitudes, dress, and behavior should glorify Christ (Philippians 1:27)

What about children from seven years through twelve?  Should they be accompanied by an adult?  It is one of the questions asked. I am giving you only my opinion.


I, being a parent, certainly believe from the ages seven through twelve they should be accompained by either their parents or mature adults.  It depends on the area in which they are going and if it is away from your neighborhood, they definitely should be escorted and not by their older brother or sister (teenagers).
Teenagers can run into their friends and are side-tracked very easily.  They may have the best intentions but just aren't mature enough to make wise decisions.

I think it would be much wiser to suggest having a Halloween Costume Ball.  You could invite all their friends to your house and provide activities there for them to enjoy and have peace knowing exactly where they were.  They should have the opportunity to celebrate Halloween otherwise they will resent you if you forbid them but I believe in taking precautions at the same time because you just never know what one will do today. Persoanlly, I believe, once they become teenagers,they are much to old to participate in "Trick or Treating."  We still have some coming to our door each year.

I believe it is alright for them to take their younger brothers and sisters  around in your own neighborhood if they are mature teenagers.  I believe for a group of teenagers going around from neighborhood to neighborhood to collect candy on
Halloween is proof enough for me -- they haven't grown up.  There is a time to put away childish things and go on with your life. You can have "Halloween Costume Balls" and celebrate Halloween once you become a teenager but going out "Trick Or Treating" is a bit too much!  Comments Welcome.

I will leave you with one thought- check out all of your children's candy and throw out all which looks suspicious.  If you are having a "Halloween Costume
Ball" check in and make sure no alcoholic beverages have been sneaked in. It is always a temptation for our young adults as well as any drugs, illegal or legal. Now, you are on your way to having the best Halloween available.   
  

Please don't forget if you are having people over and you take any kind of medications, put them out of the reach of your guests. Thank you and I wish you a very "Happy Halloween!"


I was reading "Methadone Today," a quarterly newsletter I receive.   Let me share  
with you what I read, I was absolute astounded at the ignorance. They never fail to surprise me. It is simply unacceptable what some of them believe is right.

A patient wrote to the newsletter about her clinic's improvement:   

There is a "sign up " process to deter people from simply entering treatment on a whim because they can't find a fix that day. You must call the confidential intake phone number, then go in to meet with the doctor (maybe a week or two wait), then go to the lab for testing (maybe a day or two wait), then come back to the clinic for the intake exam with the doctor (done only two times a week).  You are dosed that very same day. The entire process can take as little as a week or as much as three weeks.  

The Editor of the newsletter answered with the comment:

It's good to see a methadone clinic moving in the right direction.  However, we would like to specifically address this clinic's "intake process."  We don't see any benefit in a required waiting period before initiation in treatment.

First of all, the reality of the situation in most cases is that the individual is going to continue to use illicit opiates until they get dosed. It is difficult to see a positive in an opiate addict interested in methadone treatment continuing to use illicit opiates for even a short period of time. If we are talking about I.V. administration, every day of use is another chance of contracting HCV or even HIV, unless the individual is lucky enough to have regular access to unused injection equipment, not to mention at least some risk of overdose.

Every day of illicit opiate use also means another chance of getting arrested and prosecuted for purchase, possession and use of illicit drugs-crimes with potentially very serious sentences.  Police and prosecutors are not going to give them a break
because they are "enrolled" in a methadone clinic but have not completed the "waiting period" of the intake process. And that doesn't even take into account the crimes the many opiate addicts commit to support their habits.

Second, I don't share the concern that without a "waiting period" they will get opiate addicts intaking "on a whim" because they couldn't "get a fix" that day. To the extent that actually happens, my response is "good."  How is this harming the individual, assuming they are good canditates for methadone treatment otherwise?
The 30mg starting dose is not going to kill them, and every day they are on methadone is a day that they are less likely to use opiates.  And even if they still use illicit opiates, they are less likely to use less than they would otherwise.

Does the clinic physician consider that maybe some opiate addicts that initiated
treatment "on a whim" will find that they like the stability of being on methadone and prefer being legally medicated in a safe place where they are not at risk of arrest and incarceration?

If the individual remains in treatment long enough, s/he will have to see a counselor .  A good counselor can bring these issues up and educate the patient about methadone treatment (i.e., that it is an option for opiate addicts who would like a more functional life without dealing with opiate withdrawal every day, with-out breaking the law and without scrounging up a ridiculous amount of money to support the opiate addiction?)

Finally having this "waiting period" assumes that at the end of time, the individual
will still have the money to pay for treatment.  If an individual can't get medicated
right away, they will probably spend the money they had for treatment on illicit
opiates to keep from getting sick. By making the addict wait, the best chance of him or her getting the treatment they need may have passed forever.    

Reference:  Methadone Today, Volume X111 Number 1, June 2008   
Editor:  Beth Francisco                     
 


Beth Francisco is the Editor of "Methadone Today."  She has contributed much to our cause.  She was my MentorI learned much from her and I admire her work.
She is still answering questions and educating people through the newsletter she
publishes on a quarterly basis.

Thank you Beth for addressing the issue.  I am hoping this finds you doing really well.  It is simply absurd what these clinics are doing. There are more than one of them and are all owned by the same person. The issue should be addressed.  It is like they have simply ignored the fact that "Addiction Is A Disease." It meets all the criteria required to make it a disease, the same as diabetes, hypertension, epilepsy and heart disease. 

It should not come as no surprise to us that there is a considerable segment of the population (including some MDs and politicians and scientists) that at some level believe that certain behavioral and affective disorders are not really health care situations; that these are the province of morality or patient "will" or personality deficit or something considered to be nonmedical and is therefore not deserving of attention or,importantly, support under health care insurance mechanisms. This is a very deep and meaty topic from the science to the public policy to the politics to the economics to the...

If you take a look at the "weight of evidence"  there is absolutely no way you can deny it is a disease. This position is shared by many organizations including the
World Health Organization, American Medical Association and the American
Psychiatric Association. How long must we endure the stigma and discrimination?
How many more people must die before it is recognized and treated as a disease?America doesn't seem to be able to get their act together.

It is for sure that Woodbridge Methadone Treatment Center located in Manassas, Virginia be recognized as one you want to stay away from.  It evidently does not believe Addiction is a disease, and therefore, I don't believe you would find your needs met nor receive the support needed to continue on in your treatment.  I ask
all of you to make a note and add it to your list and if you can avoid this one, at all cost, please do. Spread the word to all others you speak with.   

We would like to hear from any of you which have good ones to recommend and we certainly want to list all the ones deficient in what we need and believe in. We will be glad to announce it to all who frequent "Medical Assisted Treatment of America" if you have a legitimate complaints about one.  I am asking all of you to keep them coming and I will continue to report on them. I will get the news out to all the patients and we thank you for all of your reports.


About three weeks ago, The State of Georgia, Head of Addictive Disease, notified the three or four clinics providing state subsidized Medication Assisted Treatment Services that all their grant funds had been terminated. he 2009 State Budget  had removed the 1.5 million, thus removing the entire item,along with the opportunity to negotiate continued services.

Clinics were given 45 minutes to respond to this decision which had clearly been made long before. The Department of Human Resources also handed down cuts for treatment of families with adolescents (3 million) and another (3 million) for TANF - Temporary Assistance for Needy Families. These cuts obviously drastically affect poor, powerless, disabled and chronically ill groups with little power to prevent this attack on their children and their health and subsistence need.

The notice of end of funds for "Medication Assisted Patients" may come this week. 400 Opiate Treatment Patients will now have to seek emergency rooms, or drug dealers or pill doctors instead of remaining stable and in treatment.  Governor Purdue and his hatchet men are slashing tires on the way out of office. Last year they eliminated a funds surplus to make themselves look good, now Georgia is broke so cut backs only make sense to this group which has rampaged through health services agencies.

135 psychiatric patients died in state hospitals and Purdue and the Republicans refuse to allow funds to correct the horrible care provided. The funds matching available from the Feds is not implemented because the Georgia legislature does not want treatment. They only want to help themselves and their friends to the "pork barrel."

The State of Georgia Pharmacy Board has added five to ten thousand dollars a month additional cost to clinics by requiring that a pharmacist be present when a dose is provided. This is contrary to all previous practice in Georgia.

APS, an auditing agency, is taking money from very good health programs in Georgia and driven small agencies out of business while saying they are creating agencies. States have refused to pay for anything in OpiateTreatment
Program except for standing at the windows drinking medication. This negates NIDA, CARF and and state research, and regulations placing emphasis on rehabilitation.

The use of these bureaucratic blocks to treatment may kill patients who cannot commute frequently enough to pay for services. There are a lot of aging, long term maintenance patients who have already been driven from what was a very beneficial program for them. Grady Hospital Drug Dependency unit is one of the programs threatened with total loss of State Grant funds.  As with many of their other services, Grady DDU is the only place with available services for Atlanta's poorest. How can you help? 

Thanks, Jim for giving us "Heads Up" on "What's Happening?" 

Reference:  Jim Taylor                      

What else are we to expect? It is my hope some of you will wake up. It's evident
we can't expect help from Washington. We certainly need to start raising  H_ _ _ with the constiuents we are sending to Washington. We need to rally together and bombard them with letters and facsimiles telling them what we expect from them .
Think about it ? There are four hundred patients losing their methadone and with
out any notice at all. How can it be right? What are they to do? It will be very hard on them to maintain employment and withdraw from methadone abruptly... It is not a medication you should be taken off but withdrawn very slowly over a year or more.

We need to let them know we aren't going to tolerate what has been going on. I don't care what it takes if we have to take up marching around the State Capitol.
People need help. How can they survive with the price of gas going higher each day?  It was very difficult to afford the gas to drive every day even in the 1990s to dose at the "Methadone Maintenance Treatment" Centers every day.  Now, it is 
impossible for most people.  It just doesn't make sense to me why it has to be every day for three months.  It may take three months for some, but not for all to stabilize.       

It's not that people don't want treatment, they do!  If Grady shuts down, it will cut treatment out for many who couldn't afford to pay the price of a privately owned   treatment program.  It's just not right what they have done.  They should have at  least given the patients a minimum of three months notice, at minimum. No! No!They don't care because they are addicts. No one really cares about them. They are discriminated against more than any class of people.

They will pay one way or the other.  If we don't find a way to help and provide the treatment they need then we can expect crime to multiply.  People will commit crime to obtain their  drugs and Hepatitis B, Hepatitis C and HIV will all increase. Unemployment  is higher than it ever has been and I assure people will find food to eat whether they beg,borrow or steal it.  It will be us, the tax payers footing the cost.  There has to be some other recourse we can take.  People are really hurting and there is many more than you know who want really want help but just can't afford it.    What more can I say to all of you? This is all wrong.


Below is a LTE that was published in Vancouver Sun,  I wanted to share: 

Re:  Methadone users' get pharmacy kickbacks. September 9

No one could fail to condemn people who are alleged to accept bribes such as this
...or, especially, those who offer them.

But The Sun's reporters and editors should refect on the use of the term "methadone  users." Whatever, the intent, the clear message is one of disdain .
These individuals receive a medication from specialty licensed physicians as part
of a treatment regimen known for forty years to be highly effective.  

Can you imagine describing diabetics, even those who are woefully non-compliant with medical advice, as "insulin users?"

Reference: RGNewman, MD


I am going to comment on the proposition that methadone "just replaces one drug with another" -something that I would imagine strikes resonance in some of the people reading my words. Well, I will admit freely here and now that methadone
treatment is indeed substituting one drug for another.   

But it is doing so in the knowledge that just this action itself has promise and value, and the hope that the person might be one of the 60% or so of opiate dependent people who respond particularly favorably to methadone treatment and therefore, particularly over time eliminate the more dangerous use of illicit street
drugs. 

You can certainly look at methadone in a very narrrow way and say that all
methadone treatment does is provide people with legal drugs, as if there is no value in doing this.  When I see someone who has been shooting up stuff that has arrived in this country in someone's bottom, and instead I see the person taking something that  at least contains no contaminants I see that as progress forward.

People usually enter methadone treatment  because they feel overwhelmed by their dependence on heroin or other opioids.  But not everyone who comes into methadone maintenance has the same goals.  Some people want to stop taking street opioids for good.  Some want to temporarily stop taking street opioids and some want to reduce or re-regulate their use of street opioids.

Some people begin methadone with the belief that they will need medication indefintely. Others feel they will only need it for a short time.

Regardless of what you hope to get from methadone maintenance, however, all the evidence agrees on these several points:  

People dependent on street opioids who receive methadone treatment are healthier and safer than those who do not.

They live longer, spend less time in jail and in the hospital, are less often infected with HIV, and commit fewer crimes.

It would be arrogant indeed if I claimed that methadone treatment was universally effective and that everyone offered it will nicely and neatly stop their use of everything else. But, particularly over time, that is what happens for a large 
proportion  of people on long-term methadone.

Poor methadone.  She never gets any good press.  If ever there was a Cinderella of a drug  - kept from the ball and always reminded how scruffy and inadequate she is - it is methadone.  It is interesting also how strong the misconception, even among treatment professionals, that methadone is not very effective. I still get told - (particularly by people who are not now dependent)that "no one just takes their
methadone"...They are all "topping it up."

This is a real shame, because methadone treatment is a major stabilizing force in the lives of half a million people around the world.  Methadone patients have created organizations in western countries around the world and we have developed communication and support structures that bind us together and give us an identity and purpose.  More than ever now, the people who are consumers of treatment services are starting to talk together, and compare notes, and take part themselves in the debate about "what to do about us" that has been going on around them for many years.  

I am not one of the people who feel that dependence on hard drugs is a great pasttime that should be venerated - and I believe that we are entitled to regulate and control access to strong addictive drugs.  I don't think that all drugs are the same,evidently they are not, and I see distinction between cannabis and alcohol
use and the much more problematic and compulsive dependency that takes place when using heroin and base cocaine.

Opioids have been used for thousands of years, and it has long been known that many people who have become dependent on opioids have extreme difficulty
permanently ending their use of them. 

Suffering through the withdrawal problem is only part of the problem.  The real difficulty comes once the period of withdrawal is over.

Just as in the case of those who are unable to stop smoking, it is difficult to explain why it is soo hard not to return to the use of opioids.  Reasons include
long-term depression, lack of energy, drug cravings and sudden attacks of vulnerability that sometimes mimic withdrawal sickness.  Some people find that
these problems diminish over time and eventually disappear altogether - but others continue to suffer these symptoms indefinitely, and many of them relapse
to their regualr use of opioids.

The reason people relapse often has nothing to do with lack of will power or other personaility problems.  Instead, it appears that people with a long peroid of opioid
problems have experienced changes to the part of the brain that allows a person to feel and function normally. This part of the brain makes and uses it s own natural opioids.

The best of these natural opioids are the chemicals known as "endorphins."  The word endorphin literally means "the morphine within."  Indeed, these chemicals
are functionally identical to morphine or heroin.  We still don't fully understand everything that these natural opioids do in the body, but evidence suggest that are involved with pain control, learning, regulating body temperature, and many other functions.

It is possible that people who develop a dependency on opioids were born with an endorphin system that makes them particularly vulnerable. For example, we know addiction runs in families.

Addiction might also be related to changes in the brain caused by an overuse of heroin or other opioids or it may be the result of a complex relationship between
gentics and the environment.

We do not yet know exactly how this malfunction occurs, or even whether all people who feel unable to stop using opioids have this damage.There is, however
an increasing amount of evidence that many people who find it difficult to end their use of opioids have experienced these physical changes- which are likely to be permanent.

There is not yet a test that can determine how much damage a person may have to his or her natural opioid system, or  how hard it may be for that person too stay away from all opioids. All we know for sure right now is that relapse is a major feature of opioid dependency. 

There is strong tendency for those who have been dependent to relapse, and not even the presence of severely negative social consequences seem to act as a deterrent to opiate use.

Methadone maintenance is a treatment for people who are dependent on opiate drugs. It is not a treatment for those who are not physically dependent on opiates.

Editor:  Deborah Shrira                            Date:  October 2008

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