Live line, the radio show on RTE presented by Joe Duffy, this week covered the topic of crime and anti social behaviour in Dublin City Centre. Many of the callers questioned the effectiveness of methadone treatment.
Methadone treatment is a topic that has interested me for many years. In 2004 I completed my doctorate in Adult Education. My research was partly funded by a Government of Ireland Scholarship to examine the use of methadone in the treatment of young people in the Crinan Youth Project, in Sean McDermott St. I concluded that methadone came to dominate the treatment of addiction, due to the power that doctors (medical hegemony) are given by Government.
I published a paper in The Adult Learner 2007, entitled ‘Is there a way out of this clinic?’. As the years go by the paper is attracting more readers. The paper explores the reasons why methadone is not effective and hens clients of methadone often feel trapped within the clinic. They sometimes refer to methadone as ‘liquid handcuffs’.
Since methadone was rolled out in the mid 90’s, methadone prescribing has also become a platform on which other drugs are prescribed. These drugs include Zimovaine and Valium, but there are many more. These drugs are some times referred to as ‘Z’ drugs.
It is my view that the over prescribing of prescription drugs, for what are in the most cases are emotional and social problems, on top of high doses of methadone that does not stop users from wanting or using heroin, leaves drug users trapped within a chemical maze, that geographically has become the city centre of Dublin.
As the title of my paper suggests ‘is there a way out of this clinic?’. If we are to reduce the anti social behavior associated with drug use, we need to provide education, housing and employment opportunities for drug users, to want to move out of addiction.
The over medicalization of drug users is contributing to the problem. Doctors are the highest paid professionals in the addiction service. While funding to community services for drug users are cut, those who prescribe methadone and prescription drugs continue to benefit economically from the current system. A system which is clearly not working.
No one profession has the solution to this problem. I believe we need professional democracy within the addiction services. In this professional democracy no one profession should hold a veto on demedicalizing a clients treatment or reducing their methadone. At the moment, the doctor holds all the power and the liability. As long as this situation continues, we will have overly medicated drug users, wandering around the city streets looking to buy or exchange their prescribed chemicals. Far away drugs are greener.
There is hope and it is to be found in the rising recovery movement. Soilse are taking a lead on promoting recovery and challenging the current system. Recently they published a research report called ‘Addiction Recovery: a contagious paradigm’. At the centre of this approach is the drug user, who realizes that recovery is possible. Recovery starts with self belief and a commitment to the journey. It does not depend on any expert or professional. Recovery is contagious as people in recovery want to share and give back by helping others. The power of the recovery movement is to be found in the collective power and action of the people most affected by addiction, the drug users themselves. It is a peoples movement, a social movement that is gaining momentum and recognition.