Saturday, October 30, 2010

MMT Program Campaign Proposals

This posting is my completed campaign for proposed changes to The Methadone Maintenance Treatment program. 

I am not pro or anti Methadone, I acknowledge The Methadone Maintenance Treatment program does have a place and purpose in our society for persons with drug addictions.   However, I am very uncomfortable and concerned with certain aspects of The Methadone Maintenance programs current operating format.   The existing program format must be restructured to put more emphasis on achieving an end result for the participant, not just maintenance.   Participants shouldn't have to, or be permitted to exist on this program for years.   These participants, just end up 'Methadone Junkies' who see no way out of the program, and without a timeframe, plan, or encouragement, why most stay on it for many years.

Addiction research and studies confirm that Methadone is highly addictive and one of the hardest drugs to withdraw from, with body tolerance to Methadone being higher and cravings stronger than Heroin.   Addiction professionals also confirm this is the reason why participants tend to 'Poly-abuse' or 'Top-up' with other substances while attempting to reduce their daily dose of Methadone.   Apparently it is quite common, and why drug abuse within this treatment program is a major problem.   To give drug addicts a more highly addictive drug than the one they were probably using, begs questioning, and why the treatment, maintenance and dependency of Methadone needs to be seriously investigated.

The Methadone mixture was originally mixed with a syrup so it couldn't be injected, but the mixture was altered and the sryup was removed towards the end of the 1990's.   The Methadone mixture could, and was used by most participants intravenously from then on.   Addiction professionals within The Methadone Maintenance program acknowledges the mixture being changed did promote the intravenous use of Methadone.   Participants on, and entering this program are mainly intravenous drug users, so why have a treatment program that almost encourages the addict to continue with their intravenous habit, also begs questioning.   A Methadone mixture that cannot be used intravenously urgently needs to be investigated and introduced back into this treatment program.

Very random urine and periodic blood testing should be a perquisite of The Methadone Maintenance
 program.   This would help to solve the drug abuse problem that widely exists with participants on the program.   Urine only detects some substances, whereas blood testing could detect all substances in the system.   It is necessary that the drug testing be very random, as addicts are knowledgeable enough to work their drug abuse around the testing that presently operates.   It is simply not random enough and allows too many loopholes.   The current guidelines, I believe, also need to be more rigid and participants held accountable for their actions.   The privilege of participants having take home doses of Methadone is one area of accountability that seriously needs to be reviewed.

Most addicts entering The Methadone Maintenance program are burdened with psychological problems, they suffer low self esteem, and have self worth issues, which are not professionally addressed at all within this treatment program.   All these psychological issues become a bigger burden and are accentuated with becoming addicted to Methadone.   I think that addiction professionals within this treatment program has lost sight of the fact that drug addiction is a mental and spiritual problem, as well as a physical problem.   In other words, you cannot heal the body without healing the mind as well.   Community Alcohol & Drug Services caseworkers are the only link these program participants have, and very few of these caseworkers are qualified addiction counsellors.   So regular professional counselling for participants must become a top priority within this treatment program.

I propose a time frame of 3 - 5 years be introduced for all participants to withdraw off Methadone and exit the program.   In that time, with regular therapy, constructive support and encouragement, partial Methadone withdrawal could be safely achieved under the current guidelines.   The final and tricky withdrawal phase of 3 - 6 months could be safely accomplished within a residential rehabilitation facility.

If the Opioid Substitution Practice Guidelines were changed to accommodate all these new measures, then all, including participants already on the program, would have to abide by them.

Admittedly an increase in funding would be required in the first 2 - 3 years to intially phase these new measures in - especially for the extra residential rehabilitation facilities, the cost of blood testing, and professional counsellors.   The long term monetary savings of funds allocated to Addiction Services, with not having participants on The Methadone Maintenance Treatment program for years, would be extremely beneficial and worthwhile, making this a very practical, sustainable solution.

I am aware of what the view point will be towards my proposals and suggestions from professionals within Addiction Services.   I am also knowledgeable enough to realise some years ago, when the program originally started, that timeframes for participants were attempted and weren't successful, with addicts having to enter back into The Methadone Maintenance program.

T say " it's been tried and it doesn't work" is a cop out to me, that was some years ago.   I know what is required and how difficult it is for participants to withdraw from Methadone, and any attempt will never be successful without a new approach.   The Methadone Maintenance program has been operating for some thirty years or so.   It has become bigger, with more persons entering, but certainly not better, or even worthwhile anymore.   A huge amount of Government health funding goes towards this particular treatment program.   So for future benefits The Methadone Maintenance program must be streamlined for success, not just sustainability.

I don't have a crystal ball in front of me, I just know from my own experience with Shane on this Methadone Maintenance program for 14 years, that this treatment program and the services that exist around it, or lack of them, seriously require attention.

The Methadone Maintenance Treatment program operates world wide.   However, programs in other countries are structured and operated differently to the MMT program in New Zealand.   With funding and duration of treatment for overseas program being the major difference to our MMT program here in New Zealand.

Government Health Officials and Addiction professionals attend world wide Drug Addiction Treatment conferences annually.   One would assume then with all this new knowledge and expertise that firstly, the MMT program in New Zealand would have improved after 30 years, and secondly, that the success rate for complete Methadone withdrawal would be higher than the 2% figure quoted in 2007/08.

The Methadone Maintenance program funding figure for 2008/09 was $13.6 million dollars, with approximately 4600 persons enrolled nationally in the program that same year.   The funding that keeps this treatment program operating, is in reality taxpayers money, that is something none of us should loose sight of.


                                                     End Of Campaign

Shane's 14 years on The Methadone Maintenance program, his drug abuse, and drug addiction was summarized into 2 pages and included with this campaign.   The following list is to whom the campaign has been forwarded out to.

                                                        Members Of Parliment

Mr John Key -  Prime Minister                                   
Mr Bill English -    Deputy Prime Minister
Hon Tony Ryall -  Minister of Health                          
Hon Jonathan Coleman -  Ass Minister of Health
Mr Russel Norman -  Minister Health/well being         
Ms Tariana Turia -  Ass Minister of Health
Ms Heather Roy - Ass Minister of Health                   
Ms Ruth Dyson - Spokesperson.  Labout Party      
Mr Lian Galloway - Spokesperson. Labour Party       
Mr Keven Hague - Spokesperson. Green Party
Ms Sue Kedgley -  Spokesperson. Green Party          
Mr Phil Goff - Opp. Leader Labour Party
Ms Annette King -  Opp. Deputy Leader. Labour Party

                                                      District Health Boards

Mr Brian Rousseau -  chief executive.  Southern DHB
Mr John Peters -  chief executive.   Nelson/Marlborough  DHB
Mr David Meates  -  chief executive.  Canterbury  DHB
Dr Kevin Snee  -  chief executive.   Hawkes Bay  DHB
Mr Craig Climo  -  chief executive.   Waikato  DHB
Mr Phil Cammish  -  chief executive.  Bay of Plenty  DHB
Mr Garry Smith  -  chief executive.   Auckland  DHB
Mr Dave Davies  -  chief executive.  Waitemata  DHB

                                      Community Alcohol & Drug Services

Dr Murray Hunt  -  Medical Director  CADS  Hamilton
Mr Robert Steenhuisen  -  Regional Manager  CADS  Auckland
MS Clarissa Brodrick  -  Manager  CADS  Auckland
Mr Louis Miller  -  Manager of Alcohol & Drug Services.  Blenheim
Dr Alfred Dell'Ario  -  Clinical Director of Alcohol & Drug Services.  Canterbury
The Manager.   CADS  Wellington
Mr Rob Warriner -  chief executive.  Walsh Trust
Mr Tim Harding  - chief executive.   Care NZ


Mr Paul Holmes  -  TV and Radio Host
Mr Leighton Smith  -   Radio Host
Ms Bernadette Courtney  -  editor.  The Dominion Post Newspaper
Mr Andrew Holden  -  editor.   The Christchurch Press
Mr Tim Murphy  -  editor.    The New Zealand Herald  -  weekday edition
Mr David Hastings  -  deputy editor.   The New Zealand Herald  - weekday edition
Mr Bryce Johns  -  editor.  The New Zealand Herald  -  Sunday edition
Mr Jonathan Milne  -  deputy editor.   The New Zealand Herald  -  Sunday edition

Hopefully there maybe a reasonably positive response to my Methadone Maintenance Program campaign this time around.   I do need readers and followers of my blog to get behind this campaign, especially those in New Zealand.    Persons wishing to support my campaign can do so through my email address.
 I will be loading a normal posting on my blog in few days time.


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