Published: June 18, 2007 08:33 am      

For better, not worse

Methadone doctors, patients discuss the drug’s benefits

Editor’s note: Patient names and some personal information has been omitted to protect patient confidentiality.



Dana shivered Friday as she sat nervously in the clinic waiting room, anxiously waiting to see a doctor.

She was irritable and her stomach was cramping after two days without the morphine injection she had come to rely on.

It was her first visit to Lexington Professional Associates, a methadone clinic which treats patients suffering from drug addictions just like hers. It is a visit she hopes will help her regain a normal life.

Reports of the negative effects of methadone have circulated throughout Kentucky recently, following an announcement by the Office of the State Medical Examiner naming the drug as the leading cause of death in drug overdose victims last year.

However, the therapeutic and rehabilitating effects achieved by carefully maintained methadone treatment often are overlooked, some doctors say.

For nearly 10 years, Dana, 49, has suffered from a growing drug addiction. Her battle with drugs did not begin as a means of recreation. Instead, the former registered nurse began taking Demerol for headaches, which led to a Lortab addiction and eventually to morphine.

“I just want to get off morphine,” Dana told Dr. Stephen Lamb, a medical professional at the clinic. “I’m tired of sticking myself. I just want to be healthy.”

‘Relatively boring’

Lexington Professional Associates treats many Madison Countians among the clinic’s more than 300 patients each week. In fact, Lamb said so many of the clinic’s patients come from Madison County, it would be beneficial for Richmond to have its own methadone clinic.

Methadone, while an opiate itself, can be used to treat opiate and opiad drug addictions. While it is most commonly known for heroin treatment, it also can be used to help addicts kick morphine and codeine, as well as oxycodones such as Oxycontin and Percocet, hydrocodones such as Vicodin and Lortabs and propoxyphene such as Darvon and Darvocet.

Methadone is an “agonist,” and does not produce the high people experience with other drugs. Lamb described the drug as “relatively boring.”

“This means the methadone itself blocks the euphoric effects of opiates, and given the proper dosage, eliminates drug cravings, and the physical withdrawal associated with the drug,” a pamphlet the clinic provides to its patients states.

The goal is to give patients just enough methadone to help them feel normal again, Lamb said.

“We want them to get enough methadone that they can go 24 hours without physical symptoms and are so free of cravings they almost never think of drugs,” Lamb said.

‘Worse than hell’

At 18 years old, Vicky was diagnosed with a calcium deficiency which constantly produced painful kidney stones, she said. For years, doctors prescribed her one pain medicine after another, which led to a difficult addiction by the age of 21.

Before seeking help from a methadone clinic nearly four years ago, Vicky, now 35, said she was taking 10 pills a day and spending more than $700 a week on her habit.

“My husband makes very good money,” Vicky said. “But I depleted our savings account. Our bills were always late. Our house payment was late. It was a mess. I lived in absolute hell. I had to scheme and hide things from my husband. It was worse than hell.”

Vicky blames being young and naive about the drugs she was taking for getting her hooked. She tried going to a rehab clinic when she began feeling suicidal, but after four days they released her and she was “nowhere near ready” to re-enter the world drug free, she said.

Vicky recently transferred to the Lexington clinic, and said methadone treatment has given her a new life.

“It’s like taking Tylenol for me. I get nothing from it,” she said. “I haven’t in years. I go to school. I work. I have everything back to normal.”

Although Vicky feared becoming hooked on another drug when she decided to take methadone for treatment, she said being addicted to the other painkillers was worth the risk.

“It terrifies me to this day to be dependent on something,” she said. “It is difficult. But it angers me so much to always hear the bad (about methadone). You don’t hear about the success of these clinics. I am a success story.”

Getting treated

Patients must go to the clinic seven days a week for treatment and counseling and are charged $90 per week, a relative discount from the high cost of street drugs, Lamb said. After being evaluated by a clinic physician, each patient receives their specified dose in the form of an orange, chalky, dissolvable tablet which is mixed with water and taken in liquid form.

The Lexington clinic employs a staff of highly trained and educated professionals including nurses, doctors, counselors and other medical associates who help to treat each patient. The facility also is accredited by the Commission on Accreditation of Rehabilitation Facilities.

Co-owners Lesa Watts and Shirley Carrier also own clinics in Corbin and Paducah. The women said they got into the business after serving as nurses under the previous owners and seeing the good that can be done through methadone treatment. Watts and Carrier agreed that with the rampant spread of prescription drug abuse, the effective treatment of methadone has been proven.

“I started part time as a nurse, and as I got more involved and educated myself more, I realized (drug abuse) was such an epidemic and there was no place for them to go,” Carrier said. “I’m very passionate about what I do, and I believe in what I do. I have seen it make a difference in people’s lives.”

There are many rules the patients must follow, such as discontinuing their former drug use and maintaining a clean drug screening. If the rules are followed, patients can receive one take-home dose after 90 days of treatment and a second take-home after another 90 days.

If the rules are not followed, patients become in danger of being asked to leave the clinic. As with any drug, there is danger of abuse, which is what leads to the high mortality statistics, Lamb said. But because of stringent regulations for methadone clinics, abuse is nearly impossible within the clinic structure.

“I look upon medicine as the equivalent to a chain saw,” Lamb said. “You have to respect its power for good or harm. If you don’t understand it, are reckless or careless, it can do a lot of harm.”

After hearing news of the medical examiner’s release related to methadone, Lamb said he investigated the report and was told none of the overdose deaths to which the report referred were clinic related.

Getting it right

Leslie has been going to the methadone clinic for almost a year and is still having difficulty reaching her “therapeutic level” with the treatment, despite a high dosage, Lamb said.

“I am waking up in the middle of the night having dreams about drugs,” Leslie told Lamb during a visit Friday.

Leslie, 27, began her drug addiction with alcohol at the age of 15. Before she turned 16, Leslie was experimenting with marijuana, cocaine and pain pills.

“I was using 400 mg of Percocet a day,” Leslie said. “I was spending about $1,000 a week, easy.”

Leslie found herself in trouble with the law after being caught selling cocaine to support her pill habit. In September, she finally will be off probation for the crime. Leslie’s situation is not abnormal, Lamb said. Sometimes patients require a split dose — one in the morning and a second later in the day — to help their bodies regulate the drug better and help it last longer. Although she still has not reached her perfect dosage, Leslie said her life already is a lot different.

“I feel a lot more in control,” she said. “I’m still having cravings, but it is 10 times better than the roller-coaster ride I was on before. I wouldn’t change it for the world. I have been in 10 different rehabs — from real expensive to the basic, state-ordered classes — the whole spectrum.”

Leslie said the methadone has worked for her because instead of hearing “don’t do that,” she is getting the medication and the support she needs.

“You can talk until you’re blue in the face, but sometimes you need support,” she said. “And the counselors here get that.”

Kelly Foreman can be reached at kforeman@richmondregister.com or 624-6694.