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What if....

Discussion in '~ Articles ~ Info ~ Links ~ Data ~' started by arlenewla, Dec 19, 2007.

  1. arlenewla

    arlenewla Well-Known Member

    there were no such things as MMT or BMT?

    Lets take a journey back in time, say about about 50 years before the use of Methadone as a maintenance drug and way before Sub.

    What did junkies do? How did they get clean?

    What choices were there?

    Did they continue to using because there was nothing to buffer?

    Or did they just get tough....kick...and be done with it?

    Are we better for for maintenance opiates?

    Have they made the process of getting clean more difficult and confusing?

    Do we have too many options these days? How well has science served us?

    Have maintenance drugs retarded the growing up phase of junkies?

    Have they proved to be a junkie's best friend...or worst enemy?

    Would the old time junkie be amused...laughing at this new generation of junkies seeking a *new way* of getting clean?

    Have we become a creation of modern science's version of the hopeless dope fiend?

    Thoughts please.:)

    Arlene F.
    Exodus From MMT;12-25-02
    <center>THIS TOO SHALL PASS</center>
  2. c-atrox

    c-atrox Well-Known Member

    Arlene. Let's go back even further... Prior to say 1920 there were certainly drugs, and drug addicts, but there was no "drug problem" per se, because addiction was weighed with moral/and legal issues. Some addicts never got clean, while others did. The vast majority of addicts did not commit crimes. Criminalization in a sense led to the first serious stabs at "treatment." Of course the most famous treatment program was the Federal Hospital at Lexington, KY. When I started using in the 1970's there were still old dope fiends in New York who had been through Lexington in the 1940's. Mr Anslinger, who headed drug enforcement in the US for almost as long as Hoover ran the FBI looked at the poor track record at Lexington and along with his medical advisors declared that "heroin addiction was uncurable." Once a junkie, always a junkie. MMT was premised on that idea. The notion that you could never really quit. It was always a flawed idea. In reality it's likely that half of all addicts who survived long enough quit, but nobody was looking for or counting those people. In it's own way MMT was far more humane than locking people up. And in the 1960's it could be argued that worked to the extent that fewer people went to jail. (That unfortunately changed as well with the Rockefeller Drugs laws of the 1970's and the tread in virtually all States to adopt the Rockefeller model -- which is still in place. Ironically Rockefeller thought that tough laws would convince MORE addicts into MMT.) However, since MMT was based on a flawed assumption, it was always a doubled edged sword.

    I'm not sure that the real question is what would have happened if there had never been MMT/BMT. I think it's what would have happened if "treatment" hadn't become profit driven. Methadone works very well as a short term detox drug -- better, frankly, from what I've seen, than bupe. But clinics (and private docs dishing suboxone) have a vested interest in MT. Opiate detox isn't rocket science. There isn't a physician in the country, or even a pharmacist who can't titrate dosage to put together a substitution/taper detox for any addict who walks in off the street. Advocates of MMT/BMT argue that detoxing sin't even, that MT discourages relapse in the form of illicit drugs. To buy that argue you have to believe that no one in MT is ever going to seek "treatment." Some would, some wouldn't. Those who do may relapse, but they're likely to detox again and seek more treatment. As you know, I'm not a 12 Step fan, but looking at all forms of treatment I believe it's fair to say, try enough programs and something will click. As for the MT clients who don't seek treatment... like those who do seek help, some will mature out (the real mechanism by which a large number of addict/alcoholics get better) and those who don't represent the group of MT clients most likely to cheat while on MT -- which defeats the whole purpose.

    My assumption would be this. Without MMT in the 1960's more people would have gone to jail -- but since the 1970's had M clinics served only as detox stations then pointing addicts at recovery models we would have had much greater success.

    This has always been the issue that gets to me. If we woke up tomorrow and opiates were decriminalized and 1/5th of the money we spend jailing addicts for drug crimes went into detox and treatment at first there would be a slight spike in addictions, but within a few years we would probably right where we are now, with far greater resources to deal with addiction and a whole lot more money to support other public health issues.
  3. JET

    JET Well-Known Member


    Years ago, late 70s I was into the hard drug. All the people I hung around also did H. Those that did not get on methadone (no sub back then) and continued to use for years and years and years, either wound up in jail, slowly dying of some type of liver disease (hep/cirrhosis/cancer) or HIV, or ODd long ago. There are not many older junkies, some, but not alot. Dirty needles, dirty dope, numerous ailments their shattered bodies could not fight. They died way to early.

    OK finally my opinion. I think it is a double edged sword. Maintenance kept some alive. Still others that might have had a chance to get totally clean, did not, they just switched addictions. Junkies back then sold their souls and their bodies, and methadone was not as readily availble as it is today. A curse for some, but it might have saved some lives. Some people have no desire to get C and S and still others that are incapable.

    Honesty and real life can be depressing at time, no? Did I answer any of your questions, looking back I was rambling?

  4. Jack Butler

    Jack Butler Well-Known Member

    Wow. What a pithy assemblage of queries you pose here. [:p] I doubt anyone will want to read what I'm sure will be my equally pithy response, but here goes...
    Well, it would be a very different world for me. I suppose for the world at large it would have meant a few more opiate addicts would have died as a direct result of their misadventures. Or maybe not. Property crimes would likely have remained at or near pre-MMT levels. The one thing MMT has done is to make us more manageable for the guardians of society. And, like tranquilizing drugs for the mentally ill, I think MMT is ultimately a political and economic solution. Though I'm sure the doctors that pioneered its development were well-meaning, I think they were perhaps a bit myopic. It's hardly the most humane development in the treatment of addiction. Personally, I abhor it. To me it represents a black abyss of pain and loss.

    Now, when you say "about 50 years before the use of Methadone as a maintenance drug", I'm thinking circa 1918. Pre- Lexington, Pre-Daytop, back in the wild and woolly early pioneer days of addiction treatment when detox was conducted under the auspices and care of a few brave religious charities, a few brave medical practitioners, and, of course, the streets. Addicts and addiction were still newly demonized then. And during that time, all of the naive (and ultimately failed) treatment methods of the preceding few decades were still prominent in the minds of those who wished to "cure" the addict. The fact that cocaine and heroin had each been previously offered as "cures" for morphine addiction indicates the level of naivet? our forebears were emerging from. I cannot imagine how isolated and desperate a junkie in that era must have felt.

    I've never met a junkie from that era though. And since most of the information about treatment providers of that era is anecdotal, it's difficult to say with certainty how the garden variety addict approached getting clean. I can only assume that they kicked using whatever means their environment may have offered. I imagine it was usually quite abrupt and to-the-point. The image of Ewan McGregor's character in the closing scenes of Trainspotting comes to mind. And for the addict with means, I suspect there was a bit more wet-nursing and a few comfort meds involved.

    Is it a bad thing that an addict would suffer a measure of pain and despair during detox? I'm not convinced it is. As long as real health threats such as suicide or cardiac arrest are considered first, I think that the "negatives" of the detox experience are what the addict ultimately values in the long run. They give a real identifiable incentive to get serious about recovery.

    I, personally, ended up having to clean up from methadone without meds or supervision of any kind. I had no ready access to anyone who understood addiction or withdrawal. And further, the environment and particulars of the situation I was in dictated that I couldn't share my burden with a single soul. I had to go to work sick, pay bills sick, do my shopping sick, sh**, shower, shave, and sleep (or try to) sick. Everything was done sick, most of it done alone, and it seemed like it would never end. In retrospect, I'm amazed that I didn't opt for suicide or resort back to MMT. I wouldn't have chosen that particular path in a million years, nor would I choose it for anyone else. But I think that for me, that path was what it took. I will never forget the experience. And now, for the first time ever, I have absolutely not one single reservation that I can or should use any self-administered or recreational drug.

    (btw.. the fact that I did it alone is not something I'm proud of. I'm sure I would enjoy better emotional health today if I had had someone to commune with and help guide me through the dark hours.)

    [FONT=Verdana, Arial, Helvetica]quote: Are we the better for maintenance opiates? [/FONT]​

    Well, I think that's up for debate. I guess you would first need to define "we". Without a doubt there are those who have benefited from the implementation of opiate maintenance programs. I'm just not convinced it's the clients. It has only prolonged the inevitable and magnified the loss for me. Yet there's no shortage of advocates who would tell you otherwise. I'm not so enamoured of my own opinion that I would make a declaration for the rest of the world. I would surely advocate for truth in advertising though. At present that doesn't exist.

    [FONT=Verdana, Arial, Helvetica]quote: Have they made the process of getting clean more difficult and confusing? [/FONT]​
    Yes. Now, that they certainly have done. They are a distraction at best. And it's funny, but I've never seen them "at best". They always seem to be on the "at worst" end of the scale.

    [FONT=Verdana, Arial, Helvetica]quote: Do we have too many options these days? [/FONT]​
    Perhaps. I definitely am of the opinion that all of the available options should not be presented to the addict like an ala carte menu.

    [FONT=Verdana, Arial, Helvetica]quote: How well has science served us? [/FONT]​
    I would say that science, when unfettered, has done a commendable job. Politicians and the pharmaceutical industry, however, have not.

    [FONT=Verdana, Arial, Helvetica]quote: Have maintenance drugs retarded the growing up phase of junkies? [/FONT]​

    Definitely. There is no question. Maintenance drugs do retard the maturation process in those who use them. It's not a pleasant thing to comprehend or admit to, but it is fact. And that's not to say that being on MMT makes one "immature", per se, but it surely keeps one from reaching the full measure of maturity one is capable of.

    [FONT=Verdana, Arial, Helvetica]quote: Have they proved to be a junkie's best friend...or worst enemy? [/FONT]​

    [FONT=Verdana, Arial, Helvetica]quote: Would the old time junkie be amused...laughing at this new generation of junkies seeking a *new way* of getting clean? [/FONT]​
    If given this information during one of those times when they were capable of laughter, I'm sure they would have roared.

    [FONT=Verdana, Arial, Helvetica]quote: Have we become a creation of modern science's version of the hopeless dope fiend? [/FONT]​

    A frankenstein, no doubt. But, though MMT/BMT doesn't make things any clearer or easier, I refuse to accept that it has the power to make anyone hopeless. It just pushes them a little further in that direction. Until you are dead or mentally damaged beyond the threshold of reason, you have hope.

    Wow! I haven't expressed that many opinions in a lo-o-ong time. Not really even sure if it's good for me. Oh, well. You certainly prompted me to think. And that can't be bad.



    May the forces of evil become confused on the way to your house.
    -George Carlin
  5. JET

    JET Well-Known Member

    Wow Jack Butler,

    Great post.

    And how are your stones doing now?

  6. Jack Butler

    Jack Butler Well-Known Member

    Er.. those too, have passed. [:I]

    Feeling much better now. Thanks for asking.

  7. Zandy

    Zandy Well-Known Member

    What did junkies do? How did they get clean?

    What choices were there?
    Just Do It ! Make up your mind and Just do it.Many a junkie landed in jail no choices there..
  8. peacenik

    peacenik Administrator

    Boy I agree Zandy. You know one thing that I think gets missed, is that back in the 40's and 50's, there weren't really many treatment centers for alcoholics or pill addicts either.

    By the 80's, when rehabs became a big business, MM was well ensconced and many heroin addicts, including me, had already gone on methadone before being exposed to any real attempts at treatment.

    Here's another what if.......suppose Drs Dole and Nyswander hadn't come up with their discovery till today. Do you think methadone, today, would be accepted as a legitimate form of treatment?


    <center>"More will be revealed"</center>
  9. arlenewla

    arlenewla Well-Known Member


    MM is neither legitimate nor is it treatment.:D


    Arlene F.
    Exodus From MMT;12-25-02
    <center>THIS TOO SHALL PASS</center>

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