Why would anyone use methadone?

I’m not talking about, why would anyone use methadone instead of cold turkey detox, I’m talking about why would anyone in their right mind use methadone instead of buprenorphine?

Really…I want to know, so if you’ve chosen methadone over buprenorphine or suboxone…why??? Firstly, I should say that I never used either in my battles with opiate type pain pills, but I understand and respect the use of opiate substitution as a valid and respectable choice in a recovery program. But I just don’t get what’s better about methadone.

The drug is more easily abused You have to go to a clinic to take it It is very addictive The eventual detox off of methadone is terrible

So why, when buprenorphine has little potential for abuse, and can be prescribed in a month’ supply, when it’s far less addictive than methadone and when the eventual withdrawal and detox pains are nowhere near as bad as for methadone…why?

I know that there are some problems with finding a doctor capable of prescribing the drug in some parts of the country, and I also know that it is more expensive, but when you consider the cost benefit ration and weigh the options, buprenorphine just seem to me to come up a clear winner. So if any one can answer me this question, I would love to know why so many people still choose methadone.

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I’m not talking about, why would anyone use methadone instead of cold turkey detox, I’m talking about why would anyone in their right mind use methadone instead of buprenorphine?

Really…I want to know, so if you’ve chosen methadone over buprenorphine or suboxone…why??? Firstly, I should say that I never used either in my battles with opiate type pain pills, but I understand and respect the use of opiate substitution as a valid and respectable choice in a recovery program. But I just don’t get what’s better about methadone.

The drug is more easily abused You have to go to a clinic to take it It is very addictive The eventual detox off of methadone is terrible

So why, when buprenorphine has little potential for abuse, and can be prescribed in a month’ supply, when it’s far less addictive than methadone and when the eventual withdrawal and detox pains are nowhere near as bad as for methadone…why?

I know that there are some problems with finding a doctor capable of prescribing the drug in some parts of the country, and I also know that it is more expensive, but when you consider the cost benefit ration and weigh the options, buprenorphine just seem to me to come up a clear winner. So if any one can answer me this question, I would love to know why so many people still choose methadone.

Pharmaceutical companies are making millions on the sale of unapproved drugs

As much as the pharmaceutical companies might argue for greater self regulation as a way to streamline the approvals process and reduce the expense to the consumer (while creating greater profits as well) certain unsettling reports about the industry as a whole should raise serious questions about the industry’s ability to self regulate.

Most notoriously of recent months is the oxycontin settlement, where executives in the company were found guilty of misleading doctors and the general public about the dependency risk of oxycontin, and just last night on CNN was another report about troubling drug company practices.

Apparently, there are massive quantities of medications sold throughout the country everyday that have not yet been approved by the FDA as safe, and some of these drugs have been on the market, consumed and available for some time.

How can this happen?

Through the FDA drug approval process, when drugs apply to begin testing for approval, they are issued a 10 digit tracking number. Problematically, this same 10 digit number is used by pharmacists selling the drug, whether or not they have been approved. What has happened is that doctors and pharmacists mistakenly believe that since the drug has the FDA number and is available for sale, that it has passed FDA testing as safe; when this is too often not the case.

A knowing disregard of the law

But although doctors and pharmacists may claim legitimate ignorance, obviously the manufacturers of the drugs are well aware of the status of each and every drug they market, and well aware that they are selling what is reported to be over 65 million filled prescriptions worth of these illegal drugs each year. Obviously this is not the FDA’s finest moment either, but the fact that pharmaceutical companies are knowingly exploiting a previous lack in enforcement on the sale of unapproved drugs for profit is shameless, and seriously damages their credibility as a self regulating industry.

Prescription drugs currently contribute to a massive abuse and addiction problem, and we may need to tighten regulation and control ever further on the production and sale of drugs, and obviously those in a position to profit from the sale of these drugs cannot be relied on to act ethically, or with the best interests of the public in mind. The money to be made in the pharmaceutical industry is enormous, and while the vast majority in the industry are likely conscientious and moral people, there are obviously enough that will engage in questionable practices–risking the safety of consumers–that the industry as a whole cannot be trusted to act with integrity.

As much as the pharmaceutical companies might argue for greater self regulation as a way to streamline the approvals process and reduce the expense to the consumer (while creating greater profits as well) certain unsettling reports about the industry as a whole should raise serious questions about the industry’s ability to self regulate.

Most notoriously of recent months is the oxycontin settlement, where executives in the company were found guilty of misleading doctors and the general public about the dependency risk of oxycontin, and just last night on CNN was another report about troubling drug company practices.

Apparently, there are massive quantities of medications sold throughout the country everyday that have not yet been approved by the FDA as safe, and some of these drugs have been on the market, consumed and available for some time.

How can this happen?

Through the FDA drug approval process, when drugs apply to begin testing for approval, they are issued a 10 digit tracking number. Problematically, this same 10 digit number is used by pharmacists selling the drug, whether or not they have been approved. What has happened is that doctors and pharmacists mistakenly believe that since the drug has the FDA number and is available for sale, that it has passed FDA testing as safe; when this is too often not the case.

A knowing disregard of the law

But although doctors and pharmacists may claim legitimate ignorance, obviously the manufacturers of the drugs are well aware of the status of each and every drug they market, and well aware that they are selling what is reported to be over 65 million filled prescriptions worth of these illegal drugs each year. Obviously this is not the FDA’s finest moment either, but the fact that pharmaceutical companies are knowingly exploiting a previous lack in enforcement on the sale of unapproved drugs for profit is shameless, and seriously damages their credibility as a self regulating industry.

Prescription drugs currently contribute to a massive abuse and addiction problem, and we may need to tighten regulation and control ever further on the production and sale of drugs, and obviously those in a position to profit from the sale of these drugs cannot be relied on to act ethically, or with the best interests of the public in mind. The money to be made in the pharmaceutical industry is enormous, and while the vast majority in the industry are likely conscientious and moral people, there are obviously enough that will engage in questionable practices–risking the safety of consumers–that the industry as a whole cannot be trusted to act with integrity.

Should doctors be prescribing so many pain pills?

The Mayo clinic states that the probability for abuse is low, if the pills are taken exactly as directed…and that is a big if! Anyone who has battled pain pills knows how seductive these medications can be, and when taking the legitimate dosage takes away the pain, and also makes you feel so good, it’s pretty easy to flirt with disaster by occasionally taking just a bit more than the recommended dosage.

Too often, occasionally upping the drugs leads to continually upping the drug, and before you know it you are hopelessly addicted to these medications originally prescribed to heal. It’s a complex issue, and these medications do serve a valid need for people with extreme pain, and often these medications are the difference between normal functioning, and chronic bedridden pain; and as such doctor’s groups have repeatedly lobbied against attempts made by drug regulatory agencies to increase monitoring and regulations to access. Doctor’s say that any increased regulations will make it too hard for legitimate pain patients to get the medications they need for their very real pain needs.

 So what’s to be done?

It seems clear that these medications do serve an important role in the pain management for many, but they also prove debilitating and addictive to millions, surely there must be some middle ground. I feel that the responsibility for the alleviation of the problem should ultimately begin with doctors, and they must start to prescribe these addictive drugs with less frequency. Using risk assessments such as issued by the Mayo clinic as a basis for a decision to prescribe powerful pain pills does not seem to be working, and while it is true that when used exactly as directed the risk of addiction is low, we cannot and should not ignore the reality of the situation.

Millions of people rely on these pain pills every day just for normal functioning and these people are hopelessly addicted, suffer many of the social and health problems associated with an addiction to any drug; and this must be regarded as powerful evidence requiring a change in our current pharmacological practices. I don’t know what the answer is, but I do know that ignoring the reality, and ignoring human nature is naive. If you give 100 children a box full of cookies, and tell them to eat just one every four hours…some may follow the instructions, but a lot sure won’t; and it seems that even as we age into "responsible" adults, we don’t change too much when temptation and pleasure is involved.

People in every society in the world get high, it’s in our nature, and doctors must consider the possibility for abuse versus the real requirement for medication when evaluating a person’s true need for pain pills. I was addicted to pain medications; and while I was in pain, and the medications prescribed worked very well for that pain, the pain they ultimately caused was far worse than pain they healed. I could have survived with less potent and less addictive medications, and while it would have been slightly less comfortable at the time, it would have been far better in the long run.

If someone has unbearable pain, then surely they need access to the best possible medications, but if the pain can be managed through any other means, perhaps addictive pain medications are not the best or safest choice.

The Mayo clinic states that the probability for abuse is low, if the pills are taken exactly as directed…and that is a big if! Anyone who has battled pain pills knows how seductive these medications can be, and when taking the legitimate dosage takes away the pain, and also makes you feel so good, it’s pretty easy to flirt with disaster by occasionally taking just a bit more than the recommended dosage.

Too often, occasionally upping the drugs leads to continually upping the drug, and before you know it you are hopelessly addicted to these medications originally prescribed to heal. It’s a complex issue, and these medications do serve a valid need for people with extreme pain, and often these medications are the difference between normal functioning, and chronic bedridden pain; and as such doctor’s groups have repeatedly lobbied against attempts made by drug regulatory agencies to increase monitoring and regulations to access. Doctor’s say that any increased regulations will make it too hard for legitimate pain patients to get the medications they need for their very real pain needs.

 So what’s to be done?

It seems clear that these medications do serve an important role in the pain management for many, but they also prove debilitating and addictive to millions, surely there must be some middle ground. I feel that the responsibility for the alleviation of the problem should ultimately begin with doctors, and they must start to prescribe these addictive drugs with less frequency. Using risk assessments such as issued by the Mayo clinic as a basis for a decision to prescribe powerful pain pills does not seem to be working, and while it is true that when used exactly as directed the risk of addiction is low, we cannot and should not ignore the reality of the situation.

Millions of people rely on these pain pills every day just for normal functioning and these people are hopelessly addicted, suffer many of the social and health problems associated with an addiction to any drug; and this must be regarded as powerful evidence requiring a change in our current pharmacological practices. I don’t know what the answer is, but I do know that ignoring the reality, and ignoring human nature is naive. If you give 100 children a box full of cookies, and tell them to eat just one every four hours…some may follow the instructions, but a lot sure won’t; and it seems that even as we age into "responsible" adults, we don’t change too much when temptation and pleasure is involved.

People in every society in the world get high, it’s in our nature, and doctors must consider the possibility for abuse versus the real requirement for medication when evaluating a person’s true need for pain pills. I was addicted to pain medications; and while I was in pain, and the medications prescribed worked very well for that pain, the pain they ultimately caused was far worse than pain they healed. I could have survived with less potent and less addictive medications, and while it would have been slightly less comfortable at the time, it would have been far better in the long run.

If someone has unbearable pain, then surely they need access to the best possible medications, but if the pain can be managed through any other means, perhaps addictive pain medications are not the best or safest choice.