Beating Addiction – The Politics of Methadone

As the War on Drugs rages on with no end in sight, a catalyst for the conflict’s beginning has reemerged: heroin. National trends clearly indicate that heroin use is on the rise once again. And while heroin’s popularity today hasn’t triggered usage levels akin to the drug’s ‘70s heyday,  if upward trends continue, there’s a chance many cities and suburbs may begin to see broader health and crime effects. At least this time, the federal government has more ways of stunting demand for heroin that don’t just involve handcuffs and just-say-no deterrent strategies.

The final episode of this season’s Drugs, Inc. briefly follows the drug trade on Boston’s “methadone mile.” Though the area’s nickname is a sarcastic slight aimed at heroin users who populate the area, for the vast majority of recovering addicts, methadone clinics like those in the methadone mile are a vital tool for keeping abuse at bay.

However, while methadone and its newer cousin buprenorphine have been viable treatments for opiate abuse for decades, they remain highly stigmatized by those who favor cold-turkey approaches to addiction therapy.

Methadone is technically a pain reliever, but it’s overwhelmingly used as part of substitution therapy programs to treat opiate addiction. First regulated and made widely available in the ‘70s, methadone works to ween the body off of heroin by keeping withdraw symptoms at bay. If prescribed and taken correctly, methadone will not get users high or produce the euphoria levels sought by drug abusers. This process of treatment is called methadone maintenance. According to the Center for Substance Abuse Research, methadone maintenance has many positive life-benefits, and can reduce deaths related to heroin, a users’ involvement in crime and the spread of AIDS.

A more recent alternative, buprenorphine is considered a safer, and in many cases more effective alternative to methadone. The Washington Post reports that buprenorphine reduces respiratory depressions (an occasional side-effect of methadone), and inhibits the euphoric side effects that opiates can have.

But while substitution therapy programs  have become some of the most effective and widespread means for treating heroin addiction, arguments against this type of treatment persist. Opponents often point out that instead of trying to kick addiction permanently, heroin users are simply becoming dependent upon another drug. Other detractors also believe that take-home methadone pills can find their way onto the black market. It’s true that users can become addicted to methadone if they are not properly prescribed and treated, and methadone pills can be found in some drug markets.

Buprenorphine also has its less attractive qualities. According to the Washington Post, the drug was involved in 42 deaths per year since 2012; the New York Times reports that not only have buprenorphine deaths increased, but the drug is also being taken as a substitute for heroin and is now being abused in places where the opiate isn’t available.

These complaints should be taken with a grain of salt – though each argument can point to validating examples, this evidence cannot discount the benefits that methadone and buprenorphine provide for thousands across the U.S. as a form of treatment for chronic addiction. And as long as drugs like heroin remain on the street, substitution therapy treatments may be one of the best ways to combat abuse.


  1. Angie
    September 4, 2014, 8:19 pm

    After viewing the episode on the Drug use in Boston, I couldn’t help but feel how irresponsible it was to film the 8 month pregnant heroin addict. Watching her shoot the heroin into her veins and her defenseless unborn baby was so disturbing and not stopping it was equal to accessory to child abuse. What’s the difference between that and in filming someone being beaten or stabbed? Do you not feel a moral obligation to the unborn child? How could you not notify authorities and have her placed in custody?

  2. KekiJeanne
    The U S of A
    September 6, 2014, 10:10 pm

    Sounds like you got a little peak. Now open your eyes & take a good look around at the world we live in.

  3. sun
    United States
    September 7, 2014, 9:06 pm

    Baby is almost to term. How do you think the film crew could have intervened that would change the outcome of the baby?

  4. Al
    September 7, 2014, 9:42 pm

    Oh Angie- if only you had any understanding of the reality of addiction. Here are a few points: 1- pregnancy does not make someone suddenly not addicted. That would be miraculous. 2- heroin withdrawal is actually more harmful to a fetus than ongoing use- but treating with subutex or methadone is definitely preferable. 3- that woman will be reported to the department of children and families as soon as the child is born. They will attempt to get her into treatment, but she will not be allowed to parent solo unless some major changes occur for her. 4- the disturbing thing is the “shock effect” shots of IV use. Why would they want to trigger continually struggling addicts?

  5. sandra
    cambridge ma
    September 11, 2014, 1:23 pm

    Keeping peope strung out on methadone is unnecessary. Simply stated pharmaceutical companies thrive on it. Ask about imogene-used correctly heroin can be removed from a body in 24 hrs. with no withdrawal. You need a support system in place but on a methadone clinic gou have to have your own doctors & psychiatrists anyway so apart from the fact that drug companies can t make any $ off it, there’ s no reason to keep methadone clinics open. Save your tax dollars & scream for imogene.

  6. ken
    September 13, 2014, 1:09 pm

    Sandra your a complete an utter moron. I dont know where you get your info from but its complete BS. You can not even use methadone an come off of heroine without having some type of minute withdraws. Imogene is in Iowa an its a rehab facility. People like you make me sick. The reason we are in a heroin epidimic like the 70s is because of the DEA cutting down on doctors allowing them to perscribe needed oppiates to people. Do your homework an learn to spell.

  7. Pamela
    January 23, 2015, 7:56 am

    Sandra it’s people like u that keep the misinformation rollin.. Are u serious u truly believe its that easy.. I don’t know if I should laugh or cry…

  8. lee
    United States
    March 4, 2015, 3:25 am

    This War on drugs is completely idiotic to ANYONE who truly thinks our government is cracking down bc of the epidemic heroin and other drugs have become. Let’s just be simple here mother nature has naturally grown plants. Marijuana is finally getting changing peoples perspective on the benefits of the drug. That our government and pharmaceutical companies are now having to find new ways for how they are going to cash in. I really used to love watching this show this season has only given me even more frustration on the focus that our government is trying to save the people. Good god people. Really? Just going to be another sheep in the Hurd. Hello ibuprofen causes holes in your stomach overtime. That’s just one side effect. Nicotine cancer causing effects is when tobacco companies became industrialised. Adding additives and preservatives. These man made chemical legalized fda approved bullshit is the biggest problem for health issues. Its all about the Benjamin’s!! If show is going to continue promoting that our government is to be looked at in a positive way and gangsters and drug dealers addicts.. Look at the chain at government. Their both the same food chain wise up here.. The real predator is our government.

  9. tracy
    Mercer, PA
    September 22, 2015, 12:08 pm

    Wow! I am surprisingly overwhelmed with the lack of understanding regarding heroin addiction. I am an addictions counselor with a Methadone clinic. You all keep talking about money.. Methadone used for addiction treatment is extremely inexpensive. which is why medical assistance is willing to pay for the treatment. And sometimes it has to be used long-term in patients who have 20 years and better in active addiction. but the benefits are well worth it. It lowers the spread of HIV, it gives the addict the opportunity to build daily structure in their lives rather than being ill from withdrawal or drug seeking, and it reduces criminal behavior/incidents significantly. You are clearly uneducated on medication assisted treatment programs so please stop wasting time chiming in until you do some research. Thank you.

  10. Michael Stull
    Tallahassee Florida
    June 22, 2016, 9:22 am

    Actually Tracy when it comes to the cost to get Methadone that’s where you’re wrong because not every clinic has the same price point, although Methadone is a fairly inexpensive pharmaceutical to manufacture and produce and every clinic in existence should dispense this stuff for less than 5 dollars a day or simply for free, but unfortunately not all treatment centers have the same price points and believe it or not some clinics won’t allow you to charge if you’re broke will easily kick you out and make you go Cold Turkey if you can no longer afford it, or if you lose your job because they only care about the money not the patient. Now up north I have heard many stories about how cheap it is or how it costs nothing and insurance covers it and blah, blah, blah, but down south or at least in Florida where I reside, every single clinic in this state is privatized and owned by (Colonial Management Group LLC). and they are a strictly CASH ONLY operation that never lets anyone charge EVER for any reason, and guess how much it costs to dose everyday? 18 Fucking dollars and it goes up every year by a dollar or more! When I first started going up there it cost me 13 dollars a day now after only 3 years not even it’s 18 a day. Now that may not seem like a lot to some people, but for people who have families and kids to take care of and shitty jobs, and have to pay their own bills with no help from anyone, or people who are just plain struggling and have no job or a shitty low paying job. It gets to be a pain in the ass to afford 18 dollars a day everyday of every month of every year until you’re ready to start the tapering process which can take over a year in itself or much longer. So do a little research next time before you start arguing over how inexpensive it is, because like people no one clinic is exactly the same and some clinics charge even more than 18 dollars a day, the suboxone strips costs 28 dollars a day!!!!!