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.