Imagine the effect on society if the methadone clinics suddenly shut their doors? There would be rioting, robbery, and a lot of people going back to using illicit drugs just to be able to function.

There is a large group of people in America who have been affected by the novel virus COVID-19 in a different way than most. We are the people who rely on methadone clinics to dispense medication for our opioid use disorder (OUD). Imagine a life where you depend on a building to stay open so that you can function and take care of your responsibilities. This is my reality along with thousands of other patients. We receive our medication at a location outside of the house on a daily, weekly, or biweekly basis. Because of this, we are unable to #StayTheFuckHome.

Methadone is a synthetic opioid that has been in use since the 1950s. It was originally created as an alternative to morphine and is now considered the “gold standard” for treating opioid dependence. It is strictly regulated by the federal government and only certain facilities are able to dispense it, i.e. methadone clinics. When you become a patient at a methadone clinic, you have to come in every day for your dose. Why would anyone in their right mind agree to this? This is the biggest complaint that patients have. Methadone is often referred to as “liquid handcuffs” for this reason.

When I first started treatment four years ago, I had to come in every day and take my medicine in front of a nurse. After months of clean drug tests, I was able to take a bottle of methadone home with me. Today, I get 13 bottles every other week. I have been successful in creating a life that is free from illicit substances. When I stopped using, I became a wife and mother, an active member of my church, and I went back to college last January. There have been tons of other success stories similar to mine. People have gone from homeless and addicted to heroin to buying their first home and graduating from college. Stopping the use of opioids completely is a success in itself. Methadone is a lifesaving medication.

When news of COVID-19 broke, I started to worry about my clinic closing. And I wasn’t the only one: message boards became flooded with patients who were panicking. All of us had the same kinds of questions: Would they give us extra bottles until a cure is found? Am I going to show up to the clinic only to find the lights off and the door locked? Will I have to go back to street drugs when the medicine that I have runs out? Will the clinic run out of methadone completely?

The staff at these clinics now have to worry about controlling the possible spread of the virus in their facilities and their patients becoming panicked. I have overheard patients talk about hoarding their medication in case they aren’t able to dose at their clinic. Others have decided to taper off of their medication completely and quickly so they won’t be sick if their clinic can’t accommodate them. Schools are closing, people are being told to stay home, the NBA cancelled their season…

Are we cared enough about to be taken care of? Are we important enough that our recovery won’t be jeopardized during this time? It seems like, as former drug addicts, we don’t really garner the kind of sympathy that someone denied their insulin would get.

So, what does this mean for us? Will we get our strictly controlled but very much needed medicine while everything seems to be closing down?

The answer: Yes, but the rules are changing during this national crisis. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Opioid Treatment Programs (OTP) have been granted the ability to give stable patients 28 days of medication. Less stable patients are able to be given up to 14 days of medication as long as they are able to demonstrate the capacity to store their methadone safely. Each clinic has their own set of rules, but across the board they are all trying to prevent long lines and close contact between patients.

When I go to the clinic this week, I will be coming home with 28 individual doses of methadone instead of my usual 13. I am very fortunate to have had years of clean drug tests, which has enabled me to come in once every two weeks. For safety reasons, most clinics have completely suspended the requirement to attend group therapy indefinitely. Some are also having patients attend their individual counseling sessions over the phone. Whatever can be done to prevent long lines and packed waiting rooms is being implemented in different ways across the country. Many methadone (and suboxone) clinics have an employee outside of the building screening patients and taking their temperature. If someone has contracted the virus or are in a high-risk category, a dosing nurse might even bring your medication out to your car. It seems that these OTP’s are doing everything they can to keep their patients stable.

Imagine the effect on society if the methadone clinics suddenly shut their doors? There would be rioting, robbery, and a lot of people going back to using illicit drugs just to be able to function.

But what about those new to the program? The ones who haven’t passed enough drug tests to earn these take-home privileges? Are they still going to have to come in every day and risk increased exposure to this virus? I belong to an online community that has patients from across the country so I decided to ask these questions. One person answered that they went from going daily to receiving two days of medication every time they go in. This lowers the number of patients in the building significantly. Not everyone will be able to take their methadone at home while drinking their morning coffee. One of the biggest problems that the methadone clinics deal with is diversion: when the patient sells their take-home methadone or trades it for illicit drugs. Other patients will take two days’ worth of medication at one time.

Methadone is one of THE STRONGEST opioids and the consequences of taking the wrong dose of this medication for an opiate-naïve individual could be fatal. Taking methadone on top of other opioids can also have tragic results. This is something that the Program Director considers when changing the rules during this pandemic to make sure that everyone is taken care of. Do you give someone an extremely potent, addictive medication to take home when they haven’t passed a drug test and are still using heroin and other substances? Different places are implementing different strategies depending on their statistics, directors, and concerns. Some clinics are requiring these patients to continue coming in daily but will ask that they come in at different times during their hours of operation. Or a nurse may come outside to deliver daily doses of methadone to patients showing symptoms of COVID-19.

Sadly, not everyone has been following the new rules and allowing patients to take home extra medications. I spoke to a patient in Indiana who told me her clinic still had long lines and people standing close to each other. This is dangerous and unacceptable. If your clinic isn’t following the SAMHSA guidelines and not practicing social distancing then you can try talking to the program director, who is likely the highest authority at the clinic. Find out what they plan to do to protect you and the other clients at risk. It’s important to advocate for yourself.

If you are a patient on MMT and are reading this today, I hope that I have put your mind at ease for the time being. The social and economic repercussions of closing down our country’s methadone clinics would be catastrophic. The government knows this and have set rules in place to accommodate us and keep us stable. There is no need to panic or jeopardize your recovery because of what’s going on. Our families need us to stay strong and stable right now more than ever.

View the original article at thefix.com

Fri, April 24, 2020| The Fix|In Coronavirus, Covid-19

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