Registered: Jan 2005
Posted October 14th, 2005 12:30 PM IP
I was not at all surprised about the content in the documentary, Methadonia, which I watched on HBO.
This documentary film was about destitution, not about addiction in general, or methadone in particular.
Yes, there were many scientific inaccuracies, and a total disregard in presenting any of the data, or interviewing any of the experts in the field. But this is how it is everyday, in talking to physicians, counselors, nurses, patients, and their families.
Since the time I became seriously interested in addiction medicine, I could see there were two pervasive misleading issues, which had always led me astray.
One is destitution. Its the elephant in the room--never really addressed--full of politically sensitive and incorrect issues. Every single "patient" in the film was severely destitute. Dr. Dole, long ago, wrote that methadone by itself could not help with this problem. Unfortunately, as methadone treatment evolved, it became associated with destitution. There are many reasons for this, but it has had a severely negative impact. As the film demonstrated, destitution is a severe problem, affecting all aspects of a person's existence. The methadone treatment in these destitute people was acting as a harm reduction modality--a concept the film did not explore.
The second issue which always has a negative impact is the addiction vocabulary problem. Commonly used words in the film were: junkies, dope, addicts, clean, meth, shit, fuckin, crap, bullshit,--the counselor at NYCAT was using some of these words. These are all slang terms, and have no place in a discussion of a medical disease. Yet, many people continue to use these terms, which makes addiction and methadone treatment appear to be removed from any medical mainstream.
Who did I feel the most compassion for? Leah, the child Susie and Eddie conceived. What an environment to have to grow up in. Susie already has 2 children in foster care. Again, nothing to do with methadone or addiction--everything to do with destitution.
I would be very interested to meet Mr. Negroponte, and find out where he is "coming from." I suspect from the usual misinformation and misconception which plagues the field of addiction medicine. Of course, all my medical maintenance patients are outraged by the film, but the conundrum of the rehabilitated stable patient wanting to remain anonymous has no solution. A few of my patients are willing to meet with Mr. Negroponte--I hope this can happen in the future.
Edwin A. Salsitz,M.D., FASAM
Medical Director Office -Based
Opioid Therapy, Dept. of Medicine
Beth Israel Medical Center
First Ave @ 16th Street
New York, N.Y. 10003
- METHADONE SUPPORT ORG.
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