Methadone

Before that, Sebi's never worked for me.

Methadone never worked for me.

This has worked for me.

And look, evidently, I've changed.

It's the part that turned Jerry Jaffe into a sort of hated person in Washington.

But Methadone clinics that they were funding at the time were only about one third of the clinics that they were funding otherwise.

They were funding a lot of other programs, a lot of abstinence-based programs, detox programs, counseling, therapeutic communities, halfway houses, all of this other stuff.

We hang this albatross around Sayo Dab and Jerry Jaffe's neck saying, oh, you're Mr. Methadone and you're pushing this on the country and blah, blah, blah.

But that's not what he was doing.

He was a big proponent of what he called multimodal treatment options.

Like it was just awful.

And finally I went over his, um, I finally won his trust when I was like, no, I've read all of your papers at the Library of Congress.

Yeah, there's a couple of different camps I've run into too, man.

Like one is like, y'all take anyone through the steps that can be on Suboxone, Methadone, you know, whatever.

And the other camp is like, no, if you have a taper off date, I'll still sponsor you, but we'll start, you know, step work and all that stuff.

Like once you, you know, once you're off, I do it to take it back, like straight to the literature or something like that.

this? 70%.

That's got to be higher than methadone clinics and shit.

Methadone's, I think, 25.

Yeah.

And that's just so you don't fucking die from the fucking withdrawals or whatever the fuck.

Yeah, I mean, if I'm drowning out here, and they say in the original treatment manuals that we have to have the desperation of a drowning man, right? So when you picture someone out there drowning, you look at that lifeboat as MAT is a lifeboat, right? And I don't, like Dr.

Nicole says, and I fully 100% agree with her, like there's all sorts of MAT medications, but we tend to like hang our hat on that MAT is Suboxone, Sublocade, Methadone, you know, things like that.

There's all sorts of MAT medications.

I am not against MAT.

something of like a moral failure and just keeping in mind like the stigma and working towards a more non-judgmental patient-centered space so

these are three medications i want every clinician to at least recognize for opioid use disorder methadone buprenorphine and naltrexone these are the top three you should understand and they're not interchangeable Methadone is a full new agonist, and for opioid use disorder treatment, it's generally provided in an opioid treatment program, which you'll see it refer as OTP.

Buprenorphine is a partial agonist, and one of the major changes is that the X waiver is gone, which means that clinicians with a DEA, appropriate DEA registration, can prescribe buprenorphine without any additional waiver.

And that's what I think one of the reasons why we're seeing a reduction on overdose deaths.

The brain has to be completely free from opioid exposure for at least a year and a half before it will begin to produce its own dopamine and serotonin.

So Suboxone and Methadone are substitute opioids.

They're given at dosages that are lower so that an individual can have a restoration of functioning without experiencing withdrawal.

Got it.

I'd been in meetings for a long time, didn't stay sober.

My nickname then was Methadone Joe.

And the woman that gave me the name, Methadone Joe, she's dead, you know.

And we laughed about everything, didn't follow any direction.

And when I got sober, I started to glow, you know.

I tried to be normal like my brother, my cousins, you know.

They all thought about annuity plans and insurance, and mortgages, and I didn't give a shit.

You knew about Speedballs and Methadone.

And when that friend fell asleep at their flat, he decided to try the methadone and combined with the alcohol in his system, it was enough to kill him at the age of just 31 as methadone.

was reported in the coroner's hearing for the death.

Methadone's what called a centrist nervous system depressive, which if taken in quantity can affect the part of the brain that controls breathing.

This coupled with alcohol can be devastating, which would have meant that first he would have fallen asleep, then his breathing would have become shallower and shallower until it just stopped.

altogether, which hopefully is a cautionary tale to anyone out there who is not fighting heroin addiction to maybe not have a go at trying methadone after a sesh.