Heroin Addiction - An Addict's View

How NOT to operate a methadone clinic
A first hand account by a patient of this clinic.

This letter was posted to the methadone mailing list. It details some pretty horrendous treatment suffered by the patients at one particular clinic in the USA, where the author has first hand experience. All names have been censored except that of the author who is quite proud to be taking this stand against the inhumane practices of the clinic and is one of the few with the courage to make a stand.

For the uninitiated:

Methadone maintenance at a clinic requires the patient, at first, to attend the clinic every day and consume the methadone in front of the clinic staff. After some time of good behaviour, (the amount of time and what constitutes 'good behaviour' varies from clinic to clinic) the patient gets "take aways" or "take homes": daily doses that they can take home a few at a time and consume without having to attend the clinic.

Medical maintenance means that the patient is prescribed methadone as an ordinary pharmeceutical drug. They get a prescription from a doctor, get it filled at the pharmacy, take it home and use it as directed.

Here is the letter:

Hi All~
I've been offline for a short while but came back on just in time to see M****'s reply to G*** about the Marijuana Testing. Well, G***, I have some news for you! I can hardly believe this one myself, but when discussing this Clinic out here in Gloucester, MA, almost ANYTHING horrible is possible it seems. . .

The place I am currently stuck on (until my spot on the Medical Maintenance opens up - just a couple more weeks!!) has just instituted a NEW Policy move!! ANY dirty urines for Marijuana will get you DETOXED out here!! Did you ever hear of such an insane "policy" for 'helping addicts'?? But, then again, this is the SAME Clinic that has NO Regulations for Transfer Patients: you are just a NEW JUNKIE out here. Period. No matter WHAT kind of Record you bring with you, no matter HOW LONG you have been clean - you are STILL just a NEW JUNKIE from the streets to them and are treated accordingly!

This is also the same Clinic that took a Wife onboard for Treatment while denying the HUSBAND whose habit and addiction was exactly the same as his wife's. Within 6 months they had broken up; there were no other MMT's for HIM to go to anywhere nearby and so he, of course, was reduced to continuing his use of heroin. They had a 9 year old son, too.

AND this is the same Program that will Administratively Detox you WITHIN 10 DAYS if you should DARE to say that you want OFF of the Program and the Clinic disagrees with you!!! You are then told that you will either STAY ON the Clinic OR face an AMA (Against Medical Acvice!!) 10 Day Detox... How's THAT for basic SLAVERY?? Now, to me that says either you do what THEY want with YOUR body or go back to shooting dope...

So, I guess it doesn't surprise me AT ALL that their NEW Policy is Detox for smoking Pot!!

Anyone out there who is reading this and happens to be considering a Transfer to the **** Clinic in Gloucester, MA - BEWARE~!! In my 7 years of Treatment this time around on Methadone, and in my prior 8 years of Treatment back in the '70's, I have NEVER seen such an Unethical group of Providers!!

There is nothing here for ANYONE seeking real help with their Disease; only a sick and twisted group of folks thoroughly interested in Power Tripping over some sick people. It's degrading, disgusting and downright contemptable to see what is transpiring out here under the guise of Treatment!!

I have over 5 FULL years now of documented and committed Recovery. I was accepted to a Medical Maintenance Program on the basis of an excellent Record that extends back all of those years. I was even given Recommendations by both Counselors and Directors from my prior Programs. But, upon coming here, I was literally TOLD by the doctor (JOKE!!) that I was "nothing but another new junkie to them; I had to PROVE MYSELF before I'd be considered anything else!!"

That was a huge mistake on their part because it's brought out a total committment to fight these people to the very end of the Legal System if I must!! I'll do it for myself and for my own dignity, but MOSTLY I will do it for the other 100 patients out here who didn't even KNOW that there WAS a way to fight back!!! **** has had its own way so long that they have come to think of themselves as invulnerable and in TOTAL CHARGE!!! Hell, they don't even subscribe to the least of the MA Regulations and Guidelines; they've written their own!!

So, I guess it's time to try to stop them!! And I urge all of you out there reading this - don't just buckle under when you're treated like less than what you are - a HUMAN BEING deserving of respect, dignity and PROPER MEDICAL CARE.

We are so damn lucky to be in an age where the Computer and all of its wonderful capacity is available to us!! Let's USE THIS to fight back, to join together and let the Providers KNOW that we have had ENOUGH!!! We just won't accept anymore of being treated like animals - actually, there are better laws protecting THEM than there are for US!!! I'm sick to death of it all; but MAD sick!!

Well, I didn't mean to get off on some Soap Box here. I just wanted to check back in with old friends and mention that, YES, there are some dangerous providers out there running clinics that rule our very LIVES! ! And it PISSES ME OFF!! Thank God, too, because they've got ME angry enough now to do WHATEVER I HAVE TO to see that it finally STOPS!!

Imagine....a HEROIN addict being PUSHED BACK to the streets, AIDS, Hep C, robbery, pain, stealing, lying, and all the other joys of addiction - for SMOKING POT???????

Something is VERY wrong here. VERY WRONG!!!

With a hug for all,
Bobbi

Rose here again:

When I saw the above letter I immediately decided that it deserved to be in a place where people could read it and learn from it. People are so used to viewing heroin addicts and methadone patients as the bad guys, now let them see that when we give ourselves over to be 'treated' we also can easily become victims. How many people will make a complaint against their boss? How many fewer would make that complaint if the boss was also dispensing a medication that was saving their life?

I wrote to Bobbi, asking for permission to reproduce her letter here. She willingly obliged and sent me another letter that she had recently written to another person. This next letter details her own case against the **** Clinic in Gloucester, MA.

Hi again, Rose!!

Here is that letter I wrote yesterday to someone who asked me how I was accepted into Medical Maintenance! And my response took me all over the place - which frequently happens to me when I get to writing about clinics and such like : ) Thought it might just give you a CLEARER picture of **** - ready for some nightmares??!! This place is SICK.

I honestly think that the doctor (HA!!) should be removed from practice. Just as a little aside....here in America anyone with 4 years of Medical School gets an MD License. BUT then they are EXPECTED to continue ON with their Education in some specialty in a Hospital somewhere. Now, I happen to know about this because I am a Nurse myself!! You CAN have JUST the MD training but NO reputable Hospital would EVER let you work there; it'd leave them open to lawsuits. Still, the LAW says that any boob with JUST the 4 year Medical School Degree HAS an MD. I don't think that I've ever run into ANY doctor with JUST that for credentials - uh...until HERE at ****!!

The jerk here is from some hick school out in New Jersey that ALSO teaches Dentistry. And that is ALL he has!!!!!!! But he was hired to treat US! Can you believe that???? I even double checked it by going to the computer and looking up the American Medical Association's listing of Doctors in this Country. There he was - with NO training in ANY field whatsoever!!! Just the very basic Medical School Degree.

No wonder addiction is winning the race in America, if this is all they think it deserves to treat it!!!!

Now, here's the other letter, Rose!!

Just saw your post to me on the (methadone mailing)List and you won't believe how I got onto Medical Maintenance. I still have trouble believing in this miracle myself!!! It was because of the Abuses at this Clinic that I am presently on that I found myself going to Med Maint!

I recently transferred over to this Program (HA!) in Gloucester, MA - back in September, it was. I did so because my husband of 5 years picked up again. I did NOT want to be around anyone using; my Recovery was too vital and important to me. Plus the fact that my Disease had taken me from being a Nurse with 3 lovely kids to being a street corner prostitute with a 2 bundle a day habit AND a gram of coke a day, too. I was just about as low as any female could go. And in just 6 years, too. I'd lost EVERYTHING in life that mattered to me - including my own self-respect, dignity and 2 babies born on the street while I was using. Like I said, my Disease took me all the way to hell... I NEVER want that in my life again. I would rather be dead than be reduced to the animal I was.

It took me 2 full years of being on Methadone before I was able to finally put down all of the drugs. I'd been fighting in court for one of the children I'd given birth to on the street; a losing battle since she was being fought for by a couple who were LAWYERS in the same Family Court I was fighting in~!! I finally HAD to just walk away from that pain; then I was able to get clean.

So...now it's been over 5 FULL years of perfect Clinic attendance, never late on bottles, always paid my little bill, full time employnment the last 2years, always made Groups (the first year), and ALWAYS went to Counseling - weekly - although I only HAD to go monthly at my Level. I still felt that the extra visits were conducive to my Recovery and went. I was treated with respect at my last two clinics; they had seen the Dramatic changes in me as I worked toward Recovery, and I was treated accordingly.

My ONLY reason for transfer was this: I moved here to be near one of my daughters with whom reconcilliation still needed more work. She offered to have me share her apartment so we could be together. This was joyful news to me since the daughter I'm talking about is K*****, my youngest, who I dragged onto the streets with me when she was only 9... There will always be need for healing there because there is a lot of pain. But this was like a miracle to me - being able to live together again! So, I moved... AFTER checking into this **** place out here.

I KNEW I'd be stuck with losing my 2X a week Take Homes - that happened BOTH times I've transferred - even though BOTH transfers were actually a progression in my Recovery!! But the State MUST have its little pound of flesh from us : )

What I DIDN'T expect was that I would be treated with disdain, contempt and denigration!!!!!! As I said, in my very INTAKE Interview with the joke of a doctor up here, I was told that I was NOT a 5 year Recovery patient - just another JUNKIE (their very WORD!!) to them, and I would NEED prove myself before I could EXPECT ANYTHING from them!

I was INCENSED with RAGE! My prior Clinic TOLD them how committed I was to Recovery and how SUPERB my Record was~!! She did eveything in her power to try to get them to accept me the way that I AM - in other words, make SOME kind of concession to my record and give me SOME leeway!! Nope. And furthermore, I was told that if I didn't LIKE IT I could LEAVE!!

My first MAJOR problem came almost immediately. I was NOT told in the packet of info on **** that I MUST attend Group Therapy! So, I had gone ahead and made employment plans! (I had NO idea that someone with 5YEARS of Recovery would even be EXPECTED to attend Groups; patients employed full time were always EXEMPT from them at my other clinics.) My "job" was providing Child Care for TWO of my daughters, too, so I had NO intention of letting THEM down to attend some damn GROUP that I did NOT need!!

**** had other plans!! Now, everything here is all fucking WRITING!! If you want an exemption, an emergency take home (most are denied!!), an absence from Counseling - you MUST put it in writing!!! Then you wait for an answer from the "Team"!! That means a group of Counselors who don't even KNOW you get to decide about your life!!

I was aghast at this place and its way of running and knew immediately that I was in TROUBLE because, you see, I would NEVER buckle down to these kinds of indignities!! Someone else maybe - but NOT me! I've come too damn far and worked too damn hard to get there to allow ANYONE to treat me like some recalcitrant, irresponsible dope fiend who needed her life MANAGED by the clinic!!

Did I mention, too, that the Counselors ONLY work from 9 - 5 and that Counseling is ALSO MANDATORY?? How in HELL can a patient work at a 9 - 5 job IF he has to go into Counseling EVERY WEEK?? Where is the Goal to Rehabilitate Patients????

So, I wrote my little letter stating that I could NOT attend Groups d/t my employment; there were NO Groups available during my FREE hours!!!

I was TOLD to QUIT MY JOB and attend OR DETOX!!! Now, think of this, B****!!! I came here with a PERFECT record AND 5 years of untainted Recovery and I am being TOLD to QUIT A JOB AND LET MY DAUGHTERS DOWN IN THE SAME BREATH!~!! Well, that did it!

I am a member of NAMA. In fact, I'm the New England Chapter's Vice President!! I made some phone calls and wrote some letters AND published what was occurring on the (methadone mailing)List!! I got the State involved - but THAT was next to useless!!

This damn clinic ALWAYS refers to us as CLIENTS here. They do NOT have a Patient's Bill of Rights prominently placed anywhere in the Clinic! (God forbid that the PATIENTS find out that that is what they ARE and that they have RIGHTS!!!). This is AGAINST the Mass State Laws!! ALL Clinics must have it displayed.

Well, not only did they NOT get violated for that but the jerk from the State told me that he could NOT help me!!! That **** did NOT violate ANY State Laws!!! Bullshit! They follow NONE of the Guidelines written by the State; they do what they WANT up here and have for years. No one knew that they could fight. AND there is NO other Clinic around so people are SCARED to make waves. Screw THAT!!

My next move was to write to a doctor who'd just been given leave to start a Med Maint Program. He'd seen my stuff on the List because he used to be a Member. He asked me for my Records going back the 5 years from both last Clinics AND if I could get any personal recommendations from my prior Counselors. I did - AND the Directors, too!!

Because of the conditions I was under here (by then I was under NOTICE TO DETOX for NOT attending Groups - a PARENTING GROUP, no less, and I am a 47 year old GRANDMOTHER with NO small children at home!!!) and with my Records and recommendations to aid him he was able to squeeze me onto the Waiting List.

I will have to move to New Haven, CT when I finally am on, but it's a SMALL price to pay for choice of Methadone type, 30 days Take Home and self- medication!! I'm a Nurse and I NEVER thought to see this in my life!! It truly is a miracle to me~!!

But, since the day I dedicated myself to Recovery I've had little miracles happen all over the place. Someone or something is definately watching over me... It's WHY I am a member of NAMA, in fact. I feel that I have to give BACK for some of the wonder that has entered my life, to help other people who are in the same Hell that I was in... I guess that it's even helped me, too, in the long run. But, then again, when you give you always get!~!

So, here I am, STILL stuck at **** for a few more weeks, but KNOWING that its about over for me here!

Except for the Lawsuit that NAMA and I are going to institute once I am OUT! This place NEEDS desperately to be brought to the Public's attention!! It needs a CLEANING OUT like no place I've EVER seen before!! Funny though, how it's responsible for me being accepted to Medical Maintenance~!! I guess there IS a reason for everything that happens in life - even the apparently bad!!

I wish to God that I could give you MORE, B****. I'd love to say that you just need to go here or there and apply for Med Maint. But, it's not like that - not yet~! BUT, it will be!! And soon, I think... The NIH Consensus pretty much spells that out for us, and changes will start to happen.

It's got to be a bitch being on all that time and STILL going in once a week. The REASON that I LEFT Methadone back in the early '80's (and subsequently slipped after 14 CLEAN years!) was that I got SICK of going in once a week, too!!!

PLEASE! Do NOT let that happen! You 're close now to an end to that crap. And people like yourself will be the first ones taken on board to Med Maint~!

That is the very REASON for the Program I am going onto - it's a Pilot Project to test it out! And so far, so good!!! Hell, I've been waiting since SEPTEMBER for an opening - which, of course, means that I have to sit like a damned vulture waiting for someone to go down - and I was ONLY 5th on the LIST!! So, folks are doing pretty damn good on it! Which is heartening!!

Right now I sit at 2nd on the List. And, the Holidays being what they are for Addicts, if there is going to be an opening soon, it'll come right after Christmas or New Year's. I should finally be in by January. I sure as hell hope so because I JUST went before the Director for a Notice To Detox Hearing - AGAIN!! I get the answer in mid- week!

This one was for missing my 5th Group AFTER they made me sign a Contract NOT to miss anymore.... Jesus H. Christ! My daughter got her Nurse's Aide Certification so I was free on Wednesday evenings starting last month. I was stuck into that Parenting Group I mentioned - which PROVES that it's NOT about Recovery because it's totally nonsensical to stick a Grandmother into that particular Group!!! It was about POWER!!! THEIR Power to FORCE me to go to a Group - ANY Group!!

So, I ended up very, VERY sick last Wednesday evening (the damn thing is from 6:30pm - 8:00pm; they make Groups available ALL the time so you have NO excuse to miss. But counseling MUST be from 9 - 5!! Did you ever hear of such arbitrary bullshit???) with Severe Acute Bronchitis.

Now, you can NOT call in sick!!! You MUST go in to the Group and let a Counselor LOOK AT YOU!! IF they determine that you are sick you are excused!!! Demeaning or WHAT? And, what gives them the MEDICAL KNOWLEDGE to make such a judgement??????

Anyway, I laid down for a nap with my alarm clock set: I never HEARD it because I was so damned ill!! I have a diagnosis of COPD now for 4 years. AND I have Hep C which interferes with healing, so when I get sick, I GET SICK! IT's in my Chart, too!

I got a Notice to Detox for Thanksgiving anyway... And now I have to fight THAT. While I am WAITING to be taken into a Med Maint Program, no less.

Just think of the ARROGANCE of these folks, luv!! To dare to just go ahead and Detox a patient with MY HISTORY - both as an active addict (I'm too far gone in the Disease to EVER detox again and survive!!) and as a Recovering Addict ( I have a PERFECT record of Recovery that was good enough to get me accepted into Med Maint!! How does **** explain DETOXING someone like ME??).

These bastards just do NOT care; no one has EVER dared to FIGHT them before!! Well, I've got news for them; their days in their little Dictatorship are OVER. I won't stop 'til I see this doctor and his little Concentration Camp Nursing Staff up before their respective Boards for Unethical Medical Practices. I am a Nurse myself and I KNOW how to fight BAD medical practitioners...: )

With a HUG to a fellow patient!!

Bobbi

End of letter. Rose here now.

Then Bobbi wrote to me again, giving me an update of her situation at the clinic. It is not good, but she is very fortunate that no matter what they do to her she has found a way out. Here is her last letter:

Dearest Rose~

Of COURSE you may use the letters!! I have a follow-up for you, too.

I am now on Notice of Detox for missing that Group, remember?? Well, my Appeal to the Clinic to stop it was DENIED! Now I Appeal to the State. And, more than likely that, too, will be denied.

At that point I will be leaving **** to go over to live at a Doctor's house in Connecticut. If you know the USA at all that is a trip of about 150 MILES! He has offered to let me LIVE with him and he'll medicate me daily as a patient of one of his regular Methadone Programs until my spot on his Medical Maintenance Program opens up. That's the one that I will only have to go to every 30 days.

But, now think of that!! Here is a doctor who has seen my Records and KNOWS how committed I am to Recovery. Because of it that is the length he is willing to go to help me!!

Out HERE my Record means absolutely NOTHING; they are doing all in their power to try to put me BACK to the streets!!!

It is going to be extremely inconvenient for me; I'll have to leave the apartment I JUST got into!! I won't have any job in New Haven - so how do I manage???? I'm worried sick about it...

But, the Doctor says not to worry - just get there!! How can there be such TOTALLY DIFFERENT people in Medicine working in the Field of Recovery????

All is NOT despair, though, Rose. NAMA is INCENSED with RAGE over this!! We have been in touch with many different agencies; THEY have, in turn, been in touch with **** - who chooses to just ignore them ALL and go along on their merry way!!

So, our NEXT step is going to have to be a Lawsuit!! But that's OK because it's probably just what is needed here - something so PUBLIC (NAMA will see to THAT you can bet on it!) that it will draw attention to this place and its hideous treatment of its patients.

There ARE laws governing Medical Ethics in this country! NO physician is exempt from them, either, and this bastard seems to think that because he is caring for JUNKIES, no one gives a shit!! WE SHALL SEE ABOUT THAT! I am determined that this place be stopped, Rose. And I will do whatever I must to stop it!!

I have felt since the early days of Recovery that God gave me back my life for a reason. What it was I didn't know - until I discovered NAMA last Christmas Eve. I was playing with my new Computer and BINGO!! There was this letter written by Joycelyn Woods, the VP of NAMA!! It was the most intelligent and forceful piece of writing I'd ever SEEN on addiction, addicts, and methadone!!

I IMMEDIATELY sat down and wrote to her!! We have been good friends ever since, and I have decided that no matter what else life may bring, Advocacy will have to be my first love!!

I am TIRED, Rose!! I am sick and tired to DEATH of how we are treated and of how we are perceived. A place like this shithole (sorry!!), ****, couldn't even EXIST if it weren't for the apathy that exists in care for addicts.

We must find a way to TEACH; we must find a way to bring ATTENTION to the plight. IF things were done differently there would be better Recovery Rates and more addicts would be functioning at levels that would bring them back into Society as constructive members!! The jails wouldn't be so damned full and overburdened!! And the Social Welfare Programs wouldn't be full of "lazy junkies".

But no one REALLY wants to FIGHT for this if they're comfortable on a Program and doing well; they "fit" into society so nicely that most people don't even KNOW that they are Addicts. But it is these VERY people who MUST come forward and do the fighting - they're the ones who'd be listened to!! I know that it's a scary proposition but it's going to have to happen IF we are ever going to really effect changes and make life on Clinics something bearable and dignified.

I do NOT call HAVING to attend Group Therapy on PARENTING at the age of 47 or LOSING my Recovery BEARABLE!!!

Can you IMAGINE the ARROGANCE of these bastards, Rose??? How can ANY doctor in THIS Country feel that he can get away with destroying an addicts hard earned Recovery of 5 FULL YEARS with there being no repercussions???

Because WE have allowed it to happen to ourselves. They have kept us neatly separate from each other - unable to band together for the purpose of fighting these injustices.

Now WE can change all of that - the tools ARE in our hands!! And I, for one, WILL pick them up and use them!! I am NOT about to just slink away to my Medical Maintenance and leave the other 115 patients up here in the hands of these Concentration Camp mentality butchers.

I will be comfortably ensconced on my Medical Maintenance within about a month at the longest; it would be SO damn EASY to just "forget about this unpleasantness" and move on to other nicer things. Hell, I am even tempted to do that, Rose! expose myself to public scrutiny?? Why allow my horrendous past on Drugs to come out where everyone can see it???

Because it is the only way that MY conscience will be at rest. Like I said - I was given a second chance at life. I SHOULD be dead or dying of AIDS - that's what the odds really should dictate for someone like me, right?? Well, I'm not - and it was only by the grace of God that I didn't die like all of my other friends.

So, now I have to give back. I only know that this is the right and proper thing to do - FIGHT. Fight for all the others who are still out there suffering and CAN'T fight for themselves!!

A place like **** is a scourge on Treatment. The HURT people - sick people who need help desperately. I've NEVER been so angry in any Treatment Environment in my years as an Addict, Rose; these people are an obscene, disgusting JOKE as a Program to help Addicts. The help you get there is help at the price of ALL human dignity or you go back to the street! How sick. The providers at this Clinic are actually as sick as - or perhaps SICKER than - the patients!!

Well, enough!! It's time for me to get my butt over there to get medicated!! I'll be awaiting your next letter. I like hearing about what it's like in other countries for us!! I think, too, that changes are about to sweep the entire world when it comes to treatment for Addiction. The damn Disease is just TOO deadly and is spreading TOO fast for them to do anything BUT make some changes in the Treatment Modalities!! As a nurse I see this pretty clearly!~! As an addict, I pray that the powers that be will see it, too!! : ) You take care - and it was wonderful to hear from you again. For future reference?? Use anything of mine you like!!! I'd be honored!

Love and a HUG for a sister!!!
Bobbi

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