Methadone therapy is a synonym for methadone addiction, and is not a real cure from drug dependency. The best way to get off heroin is to do it the hard way, and the honest way. Suffer the pains of detox, do the counseling, and then begin your life in recovery. It’s never easy, but it can work, and it can really free you from your heroin addiction. Any addiction to opiates is tough (I know firsthand!) and the dreaded agony of the pains of withdrawal make the thought of getting clean a pretty scary proposition. So when avoiding detox is coupled with some pretty impressive long term success rates when on methadone, it can be tempting to go the opiate substitution route, and try to get clean through a very long process of tapering down.
Methadone maintenance therapy has addicts trade their heroin use for safe doses of methadone. Doses that will keep the pains of withdrawal well away, but will not serve to intoxicate and will allow the user to function normally in society. The downside to this of course is that some people that entered methadone maintenance 10 or even 20 years ago remain methadone addicts, and although they are not using heroin (and as such are a part of the success rates as advertised by the statistics) they remain addicts, and much of their time and energy remains devoted to maintaining enough opiates in their blood to keep the pain of withdrawal away.
Better than heroin abuse, but I wouldn’t call that a cure. When using methadone, you need to visit a registered methadone clinic every day, or every other day, and take your oral dosage of methadone under supervision. You need to spend hours almost daily in the process of getting your drug, and remain in the company of other opiate addicts during all that time spent waiting around in methadone clinic waiting rooms. Additionally, many doctors are now arguing that the addiction to methadone is in fact more potent than the addiction to heroin, and as such the withdrawal, and the pains of withdrawal, are longer and more severe with methadone than with the original problem drug.
So why is switching to a more addictive drug considered a medically sound policy of drug cessation? I think that it comes down to a matter of public policy. In the view of the greater good, it is better to have heroin addicts functioning well in society, and receiving regular and free doses of a drug that keeps withdrawal away; but for the individual addict, this may not be a positive outcome. Much better is to endure the painful days of withdrawal, get the therapy and counseling you need, and try to rebuild your life without the need for any drug. It’s not the shortcut to "sobriety" that methadone is, but it’s a real cure, and it offers a life free from drugs and free from addiction.
Detox is hard, and it is painful, and it’s understandable that addicts would try to avoid it; but if the alternative to a few days of discomfort is a lifetime of addiction to methadone, then isn’t the price of withdrawal avoidance too high? On methadone, you’re not taking a trip out of town, you’re never going to Disneyland with the family and you’re always in the company of the people that remind you of what you once were. Get clean the hard and honest way, and learn what you need to live free from drug abuse, and stay sober over the long term. Not many addicts can resist the cravings and temptation to use during the first days of rehab, and the best way to detox is under medical supervision.
A supervised detox makes the process as safe and comfortable as possible, and at the very least, keeps you well away from access to drugs until the metabolites have been cleansed from your body. Detox alone is very rarely an effective cure, and most addicts will need the help of professionals, counseling, and education to have a real chance of staying clean for good. Heroin addiction is tough, but a life in drug recovery is a life full of hope and promise, and is surely better than a life of continuing addiction with methadone.