From the 2006 winter issue of the Canadian Society of Addiction Medicine Bulletin:

Methadone Maintenance Treatment has proven itself a medical alternative to the most harmful consequences of opiate drug addiction. It works well and allows opportunity for a deeply addicted person to regain a foothold in life.

Working with methadone clients on a daily basis teaches important lessons about the consequences of addiction and the benefits of recovery. The most obvious lesson is that of the health and social problems seen on a methadone program, most occur in those clients who persist with an addictive lifestyle.

It is also clear that those who do best with methadone treatment – those who regain stability and who assume responsibility for their lives – are clients who make changes to their lifestyle and who are actively engaged in their recovery from addiction.

This brief commentary offers a conceptual and practical framework for the integration of methadone maintenance treatment with the day to day process of recovery from addiction.

Early in methadone treatment, relief from the driving force of physical dependency, issues of shelter, safety and basic health of course take priority. But symptoms of active addiction will persist and impact negatively on engagement and progress in treatment.

The compulsion to run, to avoid and to use drugs of intoxication endures and is not addressed by methadone prescription. Issues of secrecy, shame, denial and blame are pervasive and powerful determinants of unhealthy choice and behavior. The mind is restless and is distracted by intrusive events of the past and an imagined future. Healthy priorities and routine have long been lost in habits of impulsivity and the demands of addiction.

Basic education on the persistent nature of addiction, the features of Post Acute Withdrawal Syndrome and the principles of recovery help clients to engage in their own treatment.

In this early phase of treatment, the most basic principle of recovery – honesty – just means to talk with a new doctor or counselor about what is really going on.

Other principles - to stay in the day, to prioritize self care, to take challenges one step at a time and to connect with those who understand addiction - all apply to methadone treatment in the same manner that they apply to other aspects of life in recovery.