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Comment by rantanplan | Hacker News Reader

No one is judging no one. And you should keep supporting them any way you can.

But I am just stating facts.

> at some point methadone might get de-prioritised

But that is wishful thinking, not reality. Open-ended programs do not work. Period.

By far most people in such programs relapse multiple times. You can't expect from the addict to kick the drug off out of sheer will and good intentions.

> took intelligent pro-active steps to move their lives forward

You don't understand addiction and how it works. It has nothing to with intelligence or logic. When someone chooses an open-ended program is because the people around them force them to take some action and they choose the easiest one.

Again, no one is judging and no one said those people do not need love, quite the opposite. But open-ended programs destroy their lives.

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You're talking in absolutes, with no references, do you have any supporting evidence, did you read the linked article, I seem to some good science on my side.

"For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question — including the World Health Organization, the Institute of Medicine, the National Institute on Drug Abuse and the Office of National Drug Control Policy."

https://fivethirtyeight.com/features/what-science-says-to-do...

I'm talking with more than 20 years of experience being close to people who follow these treatments.

One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs.

Are these the same scientists that think prescribing Vicodin, as if it's aspirin, is a good thing?

> One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs.

Who cares? Nobody talks this way about a person who has to take heart medicine every day to survive, and not that many talk this way about me when I take Lexapro every day to not get depressed. What makes methadone so different?

> What makes methadone so different?

You can survive without it for starters. Not the case with heart medicine I guess?

If you saw people, with the same condition as yours, having a good quality of life without medicine wouldn't you not wonder if that could apply to you too?

In the case of drug addiction, I've seen many people successfully kicking off the habit in months and living a perfectly healthy life, as if almost nothing happened.

Life-long methadone users? Not so much. I can tell that people really think it's different from heroin but it's not really. It's just regulated. Think about it ;)

> I'm talking with more than 20 years of experience

Experience is valuable but for driving systematic changes, unreliable. Its too easy to color personal experience with bias of many kinds. That's the entire point of science, to eliminate those biases and document the underlying evidence to support a claim like: "Methadone does not work."

> That's the entire point of science

Challenge accepted :D

Scientific fact 1: methadone doesn't alleviate the addiction. It actually feeds it to the point that it increases the patient's tolerance at which point you have to increase the dosage.

Scientific fact 2: methadone doesn't provide the "high". Totally true. That's why the vast majority of patients seek it elsewhere(alcohol, cannabis, etc).

Scientific fact 3: Life-long methadone users have relapses more than once. Most clinics/doctors supporting methadone brush it off as "it's quite normal and logical".

Scientific fact 4: innumerable people have been able to kick off opioid addiction by following long-term(but not life-long) therapies.

General fact: You'd be hard pressed to find a drug, other than methadone, that has been so controversial in its usage.

More facts: these panels of "experts" don't provide evidence that long-term recovery doesn't work, but they opine that "hey, methadone is the best, true story.". Show me data, show me science ;)

Isn't it way too convenient for the drug industry? Has it ever happened before, I wonder?

Isn't it weird that heroin addiction in US has increased because of the gratuitous opioid prescriptions?

https://www.theguardian.com/society/2017/mar/29/us-heroin-us...

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