[tudorw]

I have a couple of friends on methadone, they are cordial, relatively together and in a totally safer place than prior. I would rather that than the other so it's legitimate approach in my eyes, they have the rest of their lives to figure out when they can stop.

"Detoxifications and drug free modalities, although appealing to an understandable desire for recovery without medications, produces only 5-10% success rate. Methadone maintenance is associated with success rates ranging from 60 - 90%. The longer the people are in this modality the greater their chances are of achieving stable long-term abstinence."

http://www.csam-asam.org/methadone-treatment-issues

[jlg23]

> I have a couple of friends on methadone, they are cordial, relatively together and in a totally safer place than prior.

From my work with injecting drug users about a decade ago: None prefers methadone, they only take it because, when in a treatment program, they get it for free and unadulterated. When it comes to actually ceasing consumption, at least on the mindvox drug users list, the consensus seemed to be, that is is easier when first switching back to heroin.

Ask your friends whether it is the methadone as a substance that helped them or the decriminalization and steady supply they don't have to worry about. From experience, I bet on the latter.

[tomohawk]

We now have a methadone clinic in our local shopping center, right next to a large childcare facility. Since then, crime has gone way up. The grocery store now has armed guards.

This is not what a solution should look like.

[serf]

>This is not what a solution should look like.

I'm not necessarily a supporter of suboxone / methadone / whatever , but this NIMBY rhetoric isn't helpful, either.

It's rare for the down-turn of an area to have one extraordinary cause.

I guess that the suggestion is that methadone clinics create crime where there otherwise wasn't -- but I don't see it that way in my community.

What I see these clinics provide is a centralization of potentially bad actors for authorities to keep tabs on while they seek guidance or pay court-ordered time to the system otherwise.

What's the alternative here? Cease these communal style clinics? If one believes in these treatment options whatsoever then it must be realized that cessation of these clinics would take that care option away from many people who may find legitimate use.

I don't have alternatives to the clinics , but I do have insight into what one should pay attention to when an area begins to struggle:

Income, education, and general upward mobility within society.

[flachsechs]

> It's rare for the down-turn of an area to have one extraordinary cause.

no it's not. he's talking about a single store. in my town it's the homeless shelter and halfway house that causes a 5 block radius around it to be a terrible place to live.

we're not talking about building more housing, or zoning for high density commercial/residential mixes, or building public transit, or eliminating cars from downtown cores, or building more bus routes, or bikeshares, or uber, or any number of things that people actually want. we're talking about methadone clinics and halfway houses next to where affluent people live.

if you pretend like it's hard to understand why people don't want those things in their residential/shopping neighborhoods, you're just going to alienate everyone you communicate with. you can't just invoke the magic 'nimby' and get people to change their minds. __they don't want these things next to where they live__.

[BudVVeezer]

> __they don't want these things next to where they live__.

Which is the precise definition of Not In My Back Yard...

[flachsechs]

yeah, and good luck convincing anyone, anywhere that building a methadone clinic in their back yard is a good idea.

here's another turn of phrase you might find handy: choose your battles.

[grkvlt]

why should it be a problem? in the UK, methadone is normally dispensed from a regular pharmacy, just like any other prescription you might get from your doctor. I wonder if what you are seeing is that the clinic has been placed in a neighbourhood that already had high crime/homelessness/etc. since that is where the addicts who need its services are? it just seems odd that a clinic would be placed in an affluent area, where property costs are probably high, and the service users have to travel to get there, but maybe it's an american thing?

[jupp0r]

I know some people complaining about the noise from child care in their neighborhood.

[nipplesurvey]

the methadone clinic near(ish) my house is a well known place to score dope.

the junkers have basically turned the nearest subway into hamsterdam.

[nasredin]

McNulty: If Snot Boogie always stole the money, why'd you let him play?

Man On Stoop: Got to. This America, man

[rantanplan]

> they have the rest of their lives to figure out when they can stop.

The answer is: never.

Only if they get into a program that guarantees they will be detoxified in 6 months(or so). This is rare unfortunately because it needs the addict's consent, which is rarely given. They usually choose the "open-ended" program because it's easier.

They only use methadone because it's a legal(but controlled) drug. It's not that much better than heroin.

[tudorw]

never and alive is just fine, methadone satiates the addiction though does not really deliver a 'high' anymore so these friends can fill their lives with more interesting things, at some point methadone might get de-prioritised, in the meantime, I support them with love and encouragement, they recognised they were in a situation and took intelligent pro-active steps to move their lives forward, I'm not them, I'm not inside their mind, I don't know how hard it is for them, I'm not here to judge.

[rantanplan]

No one is judging no one. And you should keep supporting them any way you can.

But I am just stating facts.

> at some point methadone might get de-prioritised

But that is wishful thinking, not reality. Open-ended programs do not work. Period.

By far most people in such programs relapse multiple times. You can't expect from the addict to kick the drug off out of sheer will and good intentions.

> took intelligent pro-active steps to move their lives forward

You don't understand addiction and how it works. It has nothing to with intelligence or logic. When someone chooses an open-ended program is because the people around them force them to take some action and they choose the easiest one.

Again, no one is judging and no one said those people do not need love, quite the opposite. But open-ended programs destroy their lives.

[tudorw]

You're talking in absolutes, with no references, do you have any supporting evidence, did you read the linked article, I seem to some good science on my side.

"For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question — including the World Health Organization, the Institute of Medicine, the National Institute on Drug Abuse and the Office of National Drug Control Policy."

https://fivethirtyeight.com/features/what-science-says-to-do...

[rantanplan]

I'm talking with more than 20 years of experience being close to people who follow these treatments.

One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs.

Are these the same scientists that think prescribing Vicodin, as if it's aspirin, is a good thing?

[Blackthorn]

> One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs.

Who cares? Nobody talks this way about a person who has to take heart medicine every day to survive, and not that many talk this way about me when I take Lexapro every day to not get depressed. What makes methadone so different?

[cloverich]

> I'm talking with more than 20 years of experience

Experience is valuable but for driving systematic changes, unreliable. Its too easy to color personal experience with bias of many kinds. That's the entire point of science, to eliminate those biases and document the underlying evidence to support a claim like: "Methadone does not work."