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Vol. II, Issue No. 3 - March 1997 Special 6-Page Methadone Today

Faith in Recovery -Mike H.

Relapse and Relapse Prevention - Gina C.

Tapering Readiness Inventory - Source: U.S. Dept. of Health & Human Services

Am I Sober? - Ray

Cannonball Recipe - Magic

Termination - Joycelyn Woods

Briefly Speaking

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Although I am on Methadone, I do consider myself a recovering addict. My dose is 20mg, and I achieved this by not using over the last two years. I decreased slowly to a lower dose, stabilizing and then decreasing again. This was done in 10mg increments (one mg. a week for 10 weeks, stabilizing for 6 weeks, then starting the process again).

While decreasing, I got involved in AA/NA. At the tables, I quickly learned not to talk about my dosage and Methadone because I had more important problems. I realized I am not a drug addict, but I have a disease called addiction. We realize we are compulsive and want instant gratification, thinking we can manage that compulsion whether it be drugs, sex, money, gambling or whatever. My addictive personality would enable me to get anything whether it took an hour, a day, a week, or even a month, and at anyone's cost.

I believed I wasn't hurting anybody (it's my own body), but I didn't look at my family to know if they respected me, trusted me, or if they could count on me to fulfill my obligation to be there when they needed me. Addiction is a 24-hour disease, and I was married to it. The drugs were my family, and I would use them to get whatever I wanted, just like I used the people in my life.

I was becoming totally selfish, and surrendering myself was hard. Any man wants to think they can control their actions and manage their affairs, whether it is paying bills, making love, or holding down a job. None of this could be achieved; I was totally lost.

Every bottom I hit led me to a trap door that allowed me to fall further. Not until I got on Methadone did my highs and lows become stable. I started to become consistent in living without lies and excuses. I could finally wake up in the morning without having to lie again about the day before.

I quickly learned I was missing something. I knew what it was, but accepting it was hard because guilt came with it. I would, for the first time in 25 years, have to be honest with myself and my feelings. I didn't even know who I truly was because the drugs had made me into something I never set out to be.

The step of surrendering to the spirituality that was missing in my life had to begin in my head before it could find its way into my heart. The journey starts inside before you can truly take an honest step in life. To have a Higher Power, greater than myself, whom I choose to call God, I needed faith.

But, what is faith without the biblical or technical teachings? It simply is this to me:

• Faith isn't intellectualized; it just is.

• Faith isn't earned; it's a gift.

• Faith isn't optional; it's a must.

• Faith isn't manufactured; it's a blessing from God.

• Faith is trusting and believing.

  So, without understanding faith, you cannot have recovery. So, what is recovery? Recovery is the ability to control anger and settle differences without violence. Recovery is patience. It is the willingness to pass up instant gratification in favor of long-term gain. Recovery is the ability to sweat out a project or situation in spite of discouraging setbacks. Recovery is the faith to face frustration, discomfort, and defeat without complaint or relapse. Recovery is humility.
  
  It is being big enough to say, "I was wrong" and when right, not having to say, "I told you so." Recovery is the ability to make a decision and follow it through.
  
  An addict spends his life exploring endless possibilities and then does nothing. Recovery means dependability. Keeping one's word and coming through a crisis. An addict is the master of the alibi. We are confused and disorganized. Our lives are a maze of broken promises, unfinished business, and good intentions that never materialize.
  
  Recovery is the art of forgiving and living in peace with what we cannot change, the courage to change what we know should be changed, and the faith in ourselves to know the difference.

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"Relapse" refers to the process of returning to the use of drugs/alcohol after a period of abstinence (of being clean and sober). A relapse can occur at any time, regardless of the length of time of the abstinent period--be it days, weeks, months, or even years. Understanding the relapse process is important for preventing a relapse. Relapse prevention is a vital and necessary part of recovery.

Much of the following information came from two books: Staying Sober: A Guide for Relapse Prevention and Learning to Live Again: Guidelines for Recovery", both by Terence Gorski and Merlene Miller. Additional information came from a number of "relapse prevention" worksheets I have been given over the years by therapists.

I learned that a relapse can begin long before a person picks up the drug again! There are always warning signs that a relapse may be on the way. Changes in a person's thinking, attitudes, and feelings usually precede a relapse. There are triggers that may set off these changes and high-risk situations that may cause the triggers. If an addict can learn to recognize and identify these triggers, high-risk situations, and warning signs, he or she may be able to learn how to prevent a relapse from occurring.

Some triggers that may cause changes in thinking, feelings, and attitudes include stress, exhaustion, frustration, resentment, depression, self-pity, loneliness, and boredom. For some addicts, having money in their pocket is a big trigger. Thinking you can visit your old using friends can be a trigger or thinking you can use just one more time. Other triggers include relationship problems, being physically sick, romanticizing your using days, or having unrealistic expectations for your life in recovery.

Some high-risk situations may include being expected to attend a family function (like a wedding or holiday celebration) where liquor may be served, going to bars, visiting old using friends, or living with a person who uses drugs.

A warning sign may be a thought like thinking you can use a drug other than your drug of choice, i.e. thinking you can smoke marijuana since your drug of choice was heroin. Sometimes a craving for your drug of choice occurs for what seems to be no reason at all.

So, how do we prevent high-risk situations, or what do we do to handle cravings and/or triggers? There are a number of things an addict can do. Attending Narcotic Anonymous (NA), Alcoholics Anonymous (AA), or Methadone Is Recovery meetings helps tremendously--these programs give you tools to use to prevent a relapse. Plus, you can get a sponsor and meet other recovering addicts whom you can call or visit if you feel a relapse "coming on." Calling a hotline may help (see Methadone Today, Vol. I, No. IX, p. 3 for national hotlines, or look in the Yellow Pages of your phone book).

Avoid going to high-risk places, such as bars. If you MUST attend a family activity where liquor is served, take a recovering addict or a non-using, non-drinking friend with you, and stay the minimum amount of time to make an appearance.

Try redirecting your activity: Exercise, visit a non-using friend, go to a movie or some other activity you enjoy, meditate, read recovery literature, write your thoughts in a journal, and think away from the drug instead of dwelling on thoughts of using.

It can be done. This may all sound tough, or even impossible, but every day, thousands of recovering addicts live happy, fulfilling lives by practicing relapse prevention. They are living proof it can be done if you make a conscious choice not to use. Becoming aware of YOUR triggers and high-risk situations is the first step to preventing a possible relapse. Make a list of your triggers now (before they occur) and plan what you could do whenever they occur.

What should you do if a relapse happens? First, stop and think! Here are some things you may want to try: Call your sponsor or recovering friend. If necessary, go inpatient in a treatment center. Get counseling. Attend a meeting. The main thing is to realize that you can stop a relapse from continuing. You can learn from your relapse; you learn what to look for and how to prevent a relapse from occurring.

Sometimes we allow ourselves to feel so guilty about a relapse that we continue to use. So, do not beat yourself up if you do relapse. It's not the end of the world.

Editor's Note: In some areas, Narcotics Anonymous does not let methadone patients speak in their meetings as they consider them to still be "using." However, this is not the belief of either Methadone Today, DONT, NAMA or scientific literature; methadone is a successful medication for opiate addiction just as insulin is a medication for diabetes. If you would like to form a Methadone is Recovery meeting and need literature to help you get started, write to Methadone Today at the address on the back page.

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People talk all the time about how great sobriety is. Am I sober?

I hear people at NA and AA meetings counting the days, hours (and maybe seconds) that they have been clean and sober while they smoke nicotine and drink caffeine, both mind altering and addictive drugs. Are they sober?

I quit drugs in ‘79 after 3 on and off times in a methadone maintenance clinic. When I got sober in the 80s, my problems had just begun. In 1985, I got hit with a depression so bad that I was bed ridden for two years--it came out of nowhere. I lost everything. I lost my company, my house, my first brand new truck, my wife, my partner in business, my work connections, and my mind! I was sober!

I have been in all kinds of "help" programs--from therapeutic communities to state hospitals, four times now in methadone maintenance clinics, living with capution monks out of St. Bonaventure Church in Detroit (Jefferson House), and probation. I lingered on the verge of going to prison after two probation violations and two new B & E cases. Was I on the road to being sober?

After my six + years of not having a drug habit--after losing everything, I tried three suicide attempts. I was diagnosed as being manic-depressive and was found guilty of being mentally ill. I was sober.

I entered a mental health program but couldn't deal with all the medication they gave me. Lithium didn't work, and I've been a guinea pig for over ten years now, when the medication started. Did I lose my sobriety?

I couldn't handle the "got no brain; goin' insane--insane in the membrane," so I went back on pain-killing narcotics. I wasn't sober.

In January 1990, I rejoined the methadone clinic--my New Year's Resolution for that year (the resolution was to stay alive and get the best help possible). I've stayed almost 100% off non-prescribed medication since then. I am now medicated with methadone and bi-polar drugs (for manic-depression). Am I sober?

What is sobriety? I say that it's what you want it to be. I don't count days, hours, and years. When I went to an NA meeting, they told me that the six years I counted as sobriety wasn't sobriety. What do they base that on? If no drugs are allowable, why do I see all the nicotine, caffeine, and sugar at those meetings?

If you have a habit, do your best to help yourself and not hurt others. Different things work for different people. Try to achieve peace with yourself and others, even if you need drugs for life like the doctors say I will need for my bi-polar disorder. If saying on methadone for life is your ticket to a better, more comfortable life, stay on it! It's better than prison--it's safer than illegal drugs and dope houses to me. NA and AA doesn't seem to work for me, but it works for thousands for periods in their lives. Go by your gut feeling.

P.S. If you are conning your therapist and others, you are conning yourself. If you are dealing with people you can't deal with without lying, seek out different people.

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We, as methadone patients, suffer enough. Don't let constipation be an additional burden. I will show you how to feel better, look better, possibly live longer and lower your daily dose. No Magic, just good common sense and routine maintenance.

But first, let me briefly take you on a little story of how this wonderful, life-saving, natural, cheap, home-made laxative actually changed my life--saved the quality of my life, if not, my very life. As you all know, constipation can really be a big problem for methadone patients, especially if you consume meat and high-protein type foods; also, if you drink and eat too many dairy products.

You see, as humans, not only are we the only species that continues to drink milk after being weaned by our mothers, but many of us are extremely allergic to milk and it's products. Don't get me wrong--I'm not telling you not to consume what you like, but do it in moderation; otherwise, with Methadone and/or other opiate use, you will have to pay a price--a very uncomfortable one at that.

The human being has receptor sites from the mouth, stomach and beyond. Meat and dairy products are very hard to digest. The energy it takes to digest and the fuel you get from these foods is almost equal--just about not worth eating them in the first place. Also, they are both full of mucous, which helps to coat many of your once open receptor sites--(like glue)--hard for the absorption of Methadone. Add to this low, daily intake of fluids (mainly water) and fibers, and it becomes cement in those sites.

Ask yourself, am I a meat eater? Do I eat and drink lots of dairy products? Do I smoke? Do I drink alcohol? Do I consume lots of caffeine-type beverages during the day? Do I really care about my body? Do I drink 8 glasses of water a day, or am I trying even if I only get four down ? Do I eat enough grains, breads, vegetables, and fruit daily? Do I exercise? Only you will know the answers.

MY STORY: Years ago, before herbs were very fashionable, I had to rely on harsh, chemical, store-bought laxatives (that sometimes didn't work and only made me feel worse), not to mention the many purchased and home-made-formula enemas that I used. One time, I was so plugged-up that it actually made me completely freaked-out--no kidding--I flipped!
I was taken to the County Hospital. As we were driving up, I remember how panic-stricken I felt. While parking, I noticed a huge wind (this struck me as highly unusual for such a calm, warm summer eve). As I got out, walking toward Emergency, the wind and the sounds were extremely frightening--almost smothering. Little did I realize (explained days after) that I was experiencing a life-flight helicopter landing on the roof--The Second Coming, I thought....???
Although it's embarrassing to tell you all this, I hope that it will show how crazy one can get when you can't eliminate the waste from your system. The doctors there didn't have a clue--I thought I was going crazy! If that waste lays inside you, your body continues to feed off of all those combined poisons--no wonder we feel like Shit!
A week later, still feeling miserable, I got to talking to an old friend about this problem. She knew of an Adventist Nurse who could probably help. One conversation with this blessed lady, and my life changed dramatically. She gave me this formula that they were using on elderly patients when they had trouble, due mainly to many of them having problems with swallowing pills and most over-the-counter laxatives being too hard on them:
I give to you all:

THE CANNONBALL RECIPE:
There are only 3 ingredients--1) Raisins 2) Dates 3) Senna Leaves (Not the Pods)--easy to make and the very cheapest, natural, safe and gentle, relief-giving laxative you could ever buy.

The ingredients can be purchased in Health food and Herb Shops; shop around for best bulk prices by the pound. A grinder is very helpful. Ideally, it is best to powder the leaves first and then add to the already ground-up raisins and dates.

This doesn't have to be exact measurements; you will need to experiment for your own bodily needs. Roughly, it's about 1/3 of each, then mix throughly and start rolling into CANNONBALLS, about the size of a Meatball (Did I say Meat? Sorry, I mean, Ping-Pong-ball-size).

Drink lots of water or fruit juices. Eat only one ball at about 9:00 p.m., or about 1 ½ to 2 ½ hours before bedtime--any earlier, you will get light cramps; any later, and it might work while you're at work! A 10:30-11:30 p.m. bedtime seems to work best for me, with complete elimination occurring when you get up in the morning. For those of you into the Mc Donald's way of life, you may also make a nice hot cup of Senna Leaf Tea--this will work faster, so adjust timing. Plus you may add honey/sugar for the tea (not bad tasting).

And for those of you who must have something all done up for your convenience, there are many new herbal laxatives that work equally well; i.e. Swiss-Kriss and Tam Tablets (remember not to eat anything after taking any of these Senna-based products. No matter how hungry you may become before bedtime (this shows you it's starting to clean your drain; your stomach will feel empty)--DON'T EAT--or you may not eliminate in the morning (for best results, try to sleep on your left side). Drink more water or have some of your special juices or tea. I myself like Swiss-Kriss when I don't have time for making the recipe. Good value & stronger than Tam Tablets.

Please remember I am not a doctor, except that I know how my own body works. Laxatives, natural or man-made, taken all the time, can and will become a problem; Hell, you could become addicted! Doesn't that scare you to death? But really, please be careful; I will not accept any responsibility or liability for foolish and careless use. Anyway, I really hope this info helps.

Not only am I a Vegetarian who consumes very little dairy products, but I carry a water bottle around and drink water all day long (you would be surprised how much water you need to consume daily just for maintaining what your body requires--not counting what it needs to keep the system flushed of the waste and built-up toxins.

One more important fact: Increase your Vitamin C intake to normal levels at least. You will also need to take or increase anything that your body will be getting rid of. I've read that potassium is lost and must be replaced (strain on the heart); I always eat a banana the next morning (any fresh fruit should work), but please check-out a book on nutrition, call a local nutritionist, or if you have a computer and Internet access, the nutritional world is just a click away.

One side benefit that I have witnessed in myself and a few who have partaken this course, is the lowering of daily dose--for real. With those receptor sites roto-rooted out and the new lease on life, you may soon feel it is possible to lower your dose 15-30mg. I am living proof; a year and a half ago, I was at 65mg, down from 80. Today, I'm at 15mg daily.

I believe we take way too much Methadone. It only hooks us in deeper with our puppet masters--our beloved govt. I understand that there are many of us who absolutely need and require a higher dose--no question about it. I'm just asking you to explore. Even if that's not your goal, you will have a clearer head, less headaches, lose weight, and feel better than you have felt in a long time......Promise.

Peace and Profound Happiness be unto you, my struggling SISTERS and BROTHERS. Please Take Care.....MAGIC

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"Treatment of Opiate Addiction With Methadone: A Counselor Manual" - U.S. Department of Health and Human Services (DHHS) SMA94-2061
(From S. Brummett, R. Dumontet, L. Wermuth, M. Gold, J. L. Sorensen, S. Batki, R. Dennis & R. Heaphy (1986), Methadone Maintenance to Abstinence: The Tapering Network Project Manual, University of California, San Francisco, by permission).

The purpose of this inventory is to help you decide if you are ready to taper from methadone maintenance at this time. Each item represents an important part of the process of being ready to withdraw from methadone. The inventory can help to confirm whether or not you are ready.

The more questions you can honestly answer by checking "yes," the greater the likelihood that you are ready to taper from methadone. Consider that each "no" response represents an area that you probably need to work on to increase the odds of a successful taper and recovery.

1. Have you been abstaining from illegal drugs, such as heroin, cocaine, and speed?
2. Do you think you are able to cope with difficult situations without using drugs?
3. Are you employed or in school?
4. Are you staying away from contact with users and illegal activities?
5. Have you gotten rid of your "works"/"outfit"?
6. Are you living in a neighborhood that doesn't have a lot of drug use, and are you comfortable there?
7. Are you living in a stable family relationship?
8. Do you have nonuser friends that you spend time with?
9. Do you have friends or family who would be helpful during a taper?
10. Have you been participating in counseling that has been helpful?
11. Does your counselor think you are ready to taper?
12. Do you think you would ask for help when you were feeling bad during a taper?
13. Have you stabilized on a relatively low dose of methadone?
14. Have you been on methadone for a long time?
15. Are you in good mental and physical health?
16. Do you want to get off methadone?

Tapering off Methadone. Some patients will ask to be taken off treatment. Brummett et al. (1986) have found that "long-term opiate users face multiple barriers to successful tapering. Many methadone maintenance [patients] have not been drug free since adolescence, and by adulthood the drug use has had a marked impact on lifestyle, self-esteem, brain chemistry, and psychological and social functioning. Most [patients] lack confidence in their ability to taper successfully and fear losing all they have gained while on maintenance, including jobs, relationships, money and health. Indeed, many attribute their current success and control over their lives to being on methadone...Spouses and other family members may also fear relapse enough to dissuade the patient from tapering off."

Many fears surrounding tapering off are well founded, since most patients who attempt to detoxify from methadone are unsuccessful. The counselor should not automatically approach a desire to get off methadone as a good idea (only 10 to 20 percent of patients who taper off methadone achieve long-term abstinence). Getting off methadone too often translates into getting back on heroin.

Source: Treatment of Opiate Addiction With Methadone: A Counselor Manual - Technical Assistance Publication Series 7 (TAP 7) U.S. Department of Health and Human Services

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Methadone clinics are notorious for using the word "termination" when they remove a patient from the clinic. This is a horrible choice of words; termination comes from the criminal justice system. Of course, that's the way many methadone patients are seen through the eyes of clinics (as criminals).

Hospitals don't terminate a patient; they discharge--so why does a health delivery system use that terminology--THEIR PENAL ATTITUDE. I have always considered it a Freudian slip--because what does termination mean to the patient!

"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." - Mark Twain

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1691 - In Luneberg, Germany, the penalty for smoking tobacco is death (Szasz, T. [1975] Ceremonial Chemistry. New York: Doubleday/Anchor).

1889 - The John Hopkins Hospital, in Baltimore, Maryland, is opened. One of its world-famous founders, Dr. William Stewart Halsted, is a morphine addict. He continues to use morphine in large doses throughout his phenomenally successful surgical career lasting until his death in 1922 (Ibid).

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