Methadone Books

From the nomadic tribes of the Middle East centuries ago, to the streets of America's cities today, to suburban homes tomorrow; "Heroin" offers an in-depth review of every aspect of the drug as we know it. Humberto Fernandez has crafted a finely detailed look at a killer that we know too little about. With personal stories from recovering and active addicts, Fernandez shows us the every day life of an addict. His detailed account of the origins of the heroin trade points out the incredible staying power that this drug has shown. The author also goes into great detail explaining the history of medical treatments that we have tried using to get the drug under our control. All in all, "Heroin" is a comprehensive and educational look at a subject that we all might be a little scared to face head on. Fernandez has done an excellent job at helping us take that first peek.

As a heroin addict I loved this book, I read it over and over the stories were very real and the information very correct, I highly recommend this book to anyone... esp if you are a family member of an addict, an addict or work in the field of addiction, I myself have spent 28 days at The Betty Ford center, in addition to at least 39 other programs so I have a fair amount of knowledge of the subject and I still learned much from this book.

The best book on the subject I've ever read. Brilliant, incisive and comprehensive. Highly recommend this book! Great for students, educators or concerned readers.

I found "Heroin", by Humberto Fernandez, a fascinating read. I especially enjoyed the personal stories. It's an indepth and engaging look at this terrible drug. I really feel it is a useful tool for anyone touched by Heroin. A powerful and important book.

This is a beautifully written, deep and wide-ranging examination of the origin, use, effect and politics of heroin. It reports with great feeling and power the personal stories of those caught up in this life-destroying drug. It should be must reading for every legislator, community leader, drug counselor -- and parent.

I have had the pleasure(if you want to call it that) of being on the so called state addiction for almost 12 years, and in my opinion we were made to be their lab rats to test this so called wonder drug on,and let me tell you this right from the outset IT DOES NOT DO WHAT IT IS SUPPOSED TO DO. They tell you that there is no side effects-WRONG there are plenty,but I'll let you find this out for yourselves.No, I'm not being cruel, but if you end up being put onto methadone,my advice to you is to get off it as quickly as you possibly can. There is also a good side to it,that being no more stealing, no more injecting with other people's tools, and you get your fix for nothing eveyday without fail.But you must sign a Contract telling them that you will become a slave to their every whim etc. Me myself have been on 200mls for almost 4 years,and I must pick this up and drink it in front of the chemist and whoever else happens to be there at the time. To be truthful I wish they had gave me the choice of Heroin in cigarettes,I would have jumped at the chance. A) Because it is a lot easier to come off than methadone B) The withdrawel period is not anything like what it is coming of green ginger. C) Their seems to be a lot more help coming off heroin than there is coming of the juice. D) There is no need to become an expert liar just to get what you actually need, and not what they think you need. E) There is a big difference between what you actually need and what you end up getting. Well this was just a few words from someone who has been down the rocky road of METHADONE>see yous all later surf dudes@

I am using this book to help prepare a class in opioid replacement therapy. This book has great articles, each of which are very informative. I will probably make this book required reading in my class.

This is an excellent review of international literature and practical guidance for anyone involved with opioid addiction, or curious about it. Includes an excellent discussion of the "moral basis" for resistance to maintenance treatments, debunking it thoroughly. A MUST READ for professionals and community members dealing with the heroin/pharmaceutical opiate epidemic.

Methadone is obviously the most succesfull form of treatment available today hopefully this book will shed some light on a subject that many people do not understand that being adiction relapse and recovery.

This is a key book to read if you want to get to grips with the vast literature on the topic of opiate agonist maintenance. Its unusually well written and scientifically authoritative and really the best thing around on the subject at the moment

Poppies deals primarily with Eric's addiction to opium and his unusual way of getting it but also delves into a little philosophy and comic humor, all bound together in a very entertaining way. In portraying the horrers of addiction he conveys a sustained hopefullness that is inspiring instead of worthy of pity. I think the book is truly one of a kind.

Methadone services have come some distance since this original work was conducted. However it provides details of the level of provision of methadone maintenance and detoxification across 12 EU member states and demonstrates major variation in the level of provision. It provides a detailed description of the development of drug treatment services in each of the countries and also provides a good qualitative description of two to three treatment programmes in each country. This enables the reader to get beyond the statistics and get a feel for aspects of methadone treatment delivery. The key message from it is that methadone treatment is not a single entity but instead is a title given to many different treatments across Europe. Its a good companion to the Ward Mattick and Hall et al book on Opioid Replacement Treatments if you are planning or delivering drug treament services

Welcome to Methadonia is a thoughtful, compassionate, empathic, insightful view of Methadone Maintainence Therapy at a methadone clinic, which appears better managed and staffed than many.

It is difficult to understand why this book has received so many derogatory reviews, which appear to be written by people who have only read a fraction of the book. This book describes a range of methadone patients, who were treated, at the methadone clinic. Baldino describes some high functioning methadone patients who were actually able to not only cease using any other drugs, but eventually became free of methadone. Some were able to work, study or take care of their families. Many clinic patients were unable to become self supporting members of society, but were able to reduce or eliminate the criminal acts, previously necessary to maintain expensive heroin habits. "Chippers" who deliberately used other drugs, including heroin, cocaine, Xanax, Klonopin, Valium, marijuana or alcohol in addition to methadone comprised a lower functioning patient group.

Baldino explores the issue of whether children of methadone patients should be allowed to accompany their parents to methadone clinics, where they might witness vulgarity, profanity, oversedated or strung-out patients and drug dealing outside the clinic.

Baldino also advocates for detoxing pregnant patients from methadone to avoid addicting the newborn. She explains pregnant methadone patients could be gradually detoxed over the nine month pregnancy.

Welcome to Methadonia was published in 1967 and copyrighted in 2000, before Buprenorphine became approved for treatment of opiate addiction. Buprenorphine, available as Suboxone, or Subutex offers a much safer, less addictive alternative to Methadone, for patients addicted to doses of 30 milligrams or less of Methadone daily. Buprenorphine is considered 10 percent as addictive as methadone and thirty percent as addictive as heroin.


Methadone deaths have skyrocketed, since this book was copyrighted. The National Center for Health Statistics reports 3,849 poisoning deaths, involving methadone, in 2,004. Methadone kills more people than heroin, in the United States and is the deadliest painkiller drug. It is time to look at safer treatments.

Baldino proposed a more humane, opiate maintainence program based on LAAM, which possesses a longer half life, than methadone. LAAM could be dosed every three days, unlike methadone, which requires daily dosing. After this book was published, LAAM fell into disfavor due to prolonged QT heart arrthymias, although methadone also causes prolonged QT arrthymias. A 1973 study found QT prolongation arrthymia occurred in 34% of methadone-treated individuals compared with only 3% of heroin addicts who were not treated with methadone. Lipski J, Stimmel B, Donoso E. The effect of heroin and multiple drug abuse on the electrocardiogram. Am Heart 1973; 86: 663-68. Potentially fatal prolonged QT arrthymias appear far more often in high dose methadone patients and appear infrequent, in patients taking less than 40 milligrams daily. LAAM was removed from the European market in 2001 and has received a black box warning from the FDA.

The author obviously was extensively trained to believe unconditional positive regard is essential for successful counseling and psychotherapy. Many counselors, trained in client centered psychotherapy or attempting to maintain a "turn the other cheek" approach, struggle with confronting abusive, disruptive or dishonest behaviors of severely traumatized, addicted or criminal clients. Many counselors eventually realize modeling appropriate boundaries to clients and confronting inappropriate behavior can be therapeutic to clients and feel comfortable setting and maintaining appropriate boundaries, with clients. Ms. Rachel Baldino, MSW, LCSW, struggled with confronting inappropriate, abusive behaviors, of methadone patients, at the methadone clinic where she worked and described her struggles with honesty, humility and respect for her clients. Many students graduate from counseling programs, with little experience confronting inappropriate or abusive client behaviors. Frequently, counselors without formal counseling training, learn effective boundary setting faster than degreed counselors, and their ability to effectively confront and manage inappropriate client behaviors is an asset to the entire treatment program. Many counseling students would benefit from some front-line, in-the-trenches exposure to mentally ill, addicted or court ordered clients, before commiting to studying counseling.

This book could be helpful to counseling students or potential counseling students, who have not paid their dues, on the front lines of addiction treatment. Addiction is present in almost every segment of society and every counseling client population. Counseling students would benefit from more exposure to the realities of addiction counseling.

This is easily the best of the three books about methadone clinics, which I have reveiwed, so far.

Steven Sponaugle
Research Director, Florida Detox

I know alot of people disagree with me, but I don't think Ms. Baldino meant any harm or had any idea what sort of impact this kind of a book could have on things. The fact of the matter is that there is nothing wrong with the book if you don't know a thing about methadone or addiction. But if you do, this poor woman looks like the devil. (And let's be realistic here: most addicts don't like non-addicts in the field of addiction in any capacity anyway, right?)

As a former heroin addict and current methadone maintenance patient, I can attest that SOME of her book is accurate. But many of the suggestions and observations she makes are a result of just plain inexperience and ignorance. In the book, she said herself that she was freshly out of college when she got this job. I think she only remained in the methadone treatment field for a year or so. How much could she have really learned to write a 200-some page book?

The bottom line? Take all of what she says/writes with a grain--no make that a BLOCK--of salt. The book has the tendency to make methadone patients--and the clinic she worked at--look REALLY bad.

People probably don't realize that Ms. Baldino was fresh from college and the Boston Methadone Clinic where she worked was her first job. That alone should lead to cautious review of her opinions concerning a very important problem. Personally I thought she was just one more of the terrible, ill prepared, and notoriously subjective social workers who stop in at one of these facilities as a starting position on the way up. She was terribly frightened of her clients, and obviously unsuited for the job she had. So I would absorb her comments ...

What is most striking about this well-written work by Ms. Baldino in the bravery and honesty with which she descibes her experience as a young therapist working in a methadone clinic. Where other reviews have criticized Ms. Baldino for the feelings of fear and sadness she describes in working with methadone patients, I praise her for this honesty. She describes the emotions she experienced in working with these patients with such openness, not to condem patients of methadone clinics, but rather to facilitate the reader's understanding of her subjective experience. What's more, she uses her experience as a therapist, particularly the challenges that she faced in providing treatment to patients, to illustrate where many drug treatment programs are lacking in the services that they provide. Along these lines, one of the most valuable contributions that Ms. Baldino makes through this work are the specific and thoughful policy changes she recommends that would improve the effectiveness of treatment programs.

Poor Rachel, she has no idea of what harm she is doing with her privileged white guilt. This is the worst piece of writing I have ever had the misfortune of reading. Not only does it reinforce society's stereotypes about heroin users, it misleads future healing professionals to believe that heroin users are all hopeless losers, violent, criminal and anti-social freaks of nature. Well, we are not. And as both an addict and masters degreed mental health clinician I am sorry to know that one of my colleagues is out there writing such dishonorable work. I would like to let Rachel know that Methadone is a form Harm Reduction! And, furthermore, harm reduction is health care! Without harm reduction, all of her "clients" would have had HIV, Hep-C, or even worse, would not be "clients" at all due to overdose. I am out in the street having meaningful, therapeutic relationships with heroin users almost everyday. Drug users are the most creative, resourceful, passionate, intelligent, sensitive people I have ever met. They are funny, curious, intuitive, flexible, thriving, self-healing, crisis managing, competent, energetic, resilient survivors. And, most importantly, they demonstrate faith, vision and hope. Please, if you are a graduate student, don't give up on heroin users, or miss the awesome opportunity to work with one because of the book. Thanks Rachel for leaving my community, it is professionals such as yourself that keep users mistrustful of traditional service providers and isolated from life saving health care and the healing that one can find in relationship with a therapist who knows what they are doing.

This is a good book on current practice of methadone and other opioid agonist therapy, but it is very cautious about innovations in treatment (or a return to the more effective Dole-Nyswander model) like adequate dosing, use of other drugs and other therapuetic interventions. An excellent review of cost effectiveness.

Methadone Clinic provides a glimpse into the darker, seamier side of heroin addiction and methadone clinics. Although the author, David Steier, said he has worked as a methadone clinic counselor, he does not claim this book is non-fiction. The New York methadone clinic discussed in the book primarily serves heroin addicts, with very few chronic pain patients. The heroin addicts, in this book, have almost no interest in becoming addiction free and are mostly dishonest, manipulative, inconsiderate, abusive and profane. The addicts realize that they will not be denied treatment, despite disobeying clinic rules, since clinic methadone prevents them from committing even more crimes, to obtain more expensive, illegal black market heroin.

The book overflows with profanity, which will offend some readers. The author, David Steier, describes how he frequently offered cigarettes to patients and how he smoked cigarettes, with patients, in his counselors office, with methadone clinic patients. Offering patients cigarettes would be prohibited, by most counseling programs, which would also prohibit cigarette smoking, on the premises.

Problems with methadone and other drug dealing, on and adjacent to the methadone clinic, are given a face, by descriptions of counselors being required to patrol the immediate neighborhood and facility grounds, and patients being prohibited from "loitering," in the vicinity of the methadone clinic. You would not want this methadone clinic in your neighborhood.

The underqualification, lack of education and experience,low pay and high turnover of methadone counselors are described, along with the ineffective supervision, lack of support and extreme pressures they face from management and patients. This book puts a human face on the abusive client and how they abuse and manipulate counselors.

The low pay and high counselor turnover, at Methadone clinics helps explain the following alarming information:

149 staff in U.S. methadone clinics were surveyed about their knowledge of methadone toxicity. Only 14% knew that a methadone maintenance patient's risk of dying was highest in the first two weeks of treatment, and only 15% knew that starting new maintenance patients on daily doses of 30 mg. to 40 mg. of methadone could be unsafe. (Maxwell, J.C., Pullum, T.W. & Tannert, K (2005).Deaths of clients in methadone treatment in Texas: 1994-2002. Drug and Alcohol Dependence, 78(1), 73-81).

There appears to be no justification for the low pay and shortage of counseling and medical staff, at Methadone clinics, since the clinics appear to be highly profitable, with profits reported, from 16 to 50 percent of revenue, after taxes. CRC, treating over 20,000 methadone patients daily, reports daily profits per Methadone patient of $10.91 to $11.07.

This book mostly overlooks chronic pain patients, who are not abusing clinic methadone and may need methadone pain treatment, until they receive more effective pain treatment, with transdermal prescription pain creams, colchicine infusions, electroauriculotherapy, prolotherapy, or effective treatment of Lymes Disease, Lupus, fibromyalgia, Bartonella, Babesia, migraines, etc. These pain patients tend to be honest, self supporting, contributing members of society, to the extent their disabilities allow them to be. Without talking to the author, it is unknown whether his methadone clinic had patients like this or whether almost the entire caseload consisted of heroin addicts.

Since this is a novel, it is difficult to determine if some methadone clinics are as horrible, as the one described, in this novel. A very grim, depressing picture of methadone clinics is portrayed, in this novel.

I am rating this book a 2, since I feel it may portray a more negative picture of methadone clinics than they deserve. If the author is a whistleblower and some methadone clinics are this terrible, the book deserves a 4.

Although there were some worthwhile thougts in this book, the incredible amount of grammatical and spelling errors made it very difficult to wade through. It almost seems like a (very) rough draft that was never edited before going on to publication, with many of the errors being ones that a young child would have caught. It distracted greatly from the book's quality, and when I remember the book, that is what I recall, not the content itself.

This book is so poorly written that it was very difficult to read. The spelling, punctuation, amd grammatical errors were everywhere. Jargon was overused and over explained. The abundance of quotation marks drove me crazy.

I don't disagree with the author's points, but it reads like an editorial. I have to question what ax is she grinding? She says she worked at 3 clinics. Why work at 3 clinics if you are so at odds with what goes on there?

I went into this book looking to learn something new, but there is no documented research here. It's just one person's opinion.

Inside the Methdone Clinic Industry totally ignores the illegal diversion of Methadone and the Methadone overdose epidemic, which kills almost 4,000 people, annually, in the United States. Methadone overdoses now kill more Americans, than heroin. California inspectors discovered one Methadone Clinic was unable to account for 22,069 milligrams of methadone, over 400 potential fatal overdoses! Berry fails to discuss overprescribing of Methadone, during treatment initiation or for chronic pain. Berry provides no discussion of Methadone alternatives, including Suboxone, Subutex, Buprenex, Morphine pumps, Duragesic patches, accupuncture, or other pain treatments, including transdermal pain creams, prolotherapy, intravenous colchicine for ruptured discs, etc.

Berry discusses costs patients pay for treatment, which average, about $400 monthly. She makes a good point that most insurance plans should pay for Methadone Maintenance, but do not. She also discusses applicants for Methadone Maintenence Treatment, who die, while they wait for treatment openings, at Methadone Clinics and correctly asserts Methadone Maintenence should be more widely available.

The most useful information, in this book, is the perspective concerning counseling, at Methadone clinics. Berry worked at three different Methadone clinics, including one where staff turnover was 400 percent, in one year. She observes many chronic Methadone patients know more about Methadone and chemical dependency, than the green, inexperienced counselors, who are assigned to them, by the clinics. She explains Methadone counselors have little time for counseling patients, after completing documentation paperwork, monitoring urine drug tests, etc., and monitoring lines, at medication dispensing windows, or performing other security functions. Methadone counseling or casework is generally viewed as an undesirable counseling job, which some counselors endure while obtaining adequate experience or education, qualifying them for better counseling work.

Another problem with Methadone counseling, again partly due to rapid counselor turnover, is a tendency of counselors to distance themselves emotionally from patients. Many counselors have not been allowed to say goodbye to their assigned clients, when clients are discharged, move or the counselor leaves the program. Lack of an opportunity for closure, with counseling clients, encourages Methadone counselors to avoid an emotional connection, with their clients. Excessive turnover of counselors causes clients to avoid trusting new counselors, with their issues. Clients become weary of telling a procession of new counselors the same personal information.

From a counseling perspective, most Methadone clinic counseling is very ineffective, due to high turnover, inability of patients to select their counselor, underqualification of counselors, mandatory counseling for chronic pain patients, who often do not need counseling and inadequate time for patients, who experienced trauma or are in abusive environments or relationships.

The low pay and high counselor turnover, at Methadone clinics helps explain the following alarming information:

149 staff in U.S. methadone clinics were surveyed about their knowledge of methadone toxicity. Only 14% knew that a methadone maintenance patient's risk of dying was highest in the first two weeks of treatment, and only 15% knew that starting new maintenance patients on daily doses of 30 mg. to 40 mg. of methadone could be unsafe. (Maxwell, J.C., Pullum, T.W. & Tannert, K (2005).Deaths of clients in methadone treatment in Texas: 1994-2002. Drug and Alcohol Dependence, 78(1), 73-81).

The problems with counseling, at Methadone clinics are very credible, and have been reported by many Florida Detox Methadone Detox patients, who have received counseling, at Methadone Clinics, prior to Methadone Detox, at Florida Detox.

There appears to be no justification for the low pay and shortage of counseling and medical staff, at Methadone clinics, since the clinics appear to be highly profitable, with profits reported, from 16 to 50 percent of revenue, after taxes. CRC, treating over 20,000 methadone patients daily, reports daily profits per Methadone patient of $10.91 to $11.07.

Berry provides a good discussion of the undeserved, counterproductive stigma and discrimination suffered by Methadone patients, who frequently are responsible, self-supporting, contributing members of society, who work, support their families and often are well educated, sometimes with advanced professional degrees. She explains that no segment of society is immune, from chemical dependency, since any of us could be disabled, with chronic pain, with almost no warning. Her concern for chemically dependent patients is obvious.

Possibly the most important concept, conveyed by this book, is the vulnerability of Methadone clinic patients, when they do not have a choice of clinics. Since they are very dependent, on clinic Methadone, they are very hesitant to assert their rights, or complain about clinic policies or staff, due to possible retaliation or dismissal, from treatment. Berry also reveals the dissatisfaction of opiate dependent veterans, with Veteran's Administration treatment programs. Veterans often have even fewer treatment choices, in the Veterans Administration, and sometimes seek treatment, in non Veterans Administration programs, due to the difficulty of traveling extremely long distances, to the closest Veterans Administration facility, which essentially has no competition.

This short book contains numerous misspellings, incomplete sentences and grammatical errors, which could have been eliminated, with a spell and grammer checker. The number of errors is amazing, since the author represents that she holds a Masters Degree in Chemical Dependency Counseling.
_________________
Steven Sponaugle
Research Director, Florida Detox