Myths About Methadone by Emmett Velten

Emmett Velten,
Ph.D. is the Clinical Supervisor at the BAART Methadone Program, San
Francisco, CA.

Methadone has
inspired an immense mythology. 
Perhaps it is the most extensive mythology surrounding any form of
medical or psychological treatment, living or dead.  Why has such a mythology
developed?  This question is
important given the deadly stakes of the AIDS epidemic and methadone’s
proven efficacy in attracting opiate addicts into treatment and reducing
their use of needles (Batki, 1988; Des Jarlais, Friedman, Novick et al,
1989; Joseph & Springer, 1990).

Research into psychology of rumor
suggests that there are two conditions under which rumor thrives.  One of them is high emotion.  The other condition is lack of
information.  Methadone
treatment amply meets these two criteria.  The rumors and mythology
surrounding methadone treatment may differ from normal rumors, because the
emotionality surrounding methadone largely causes the lack of information
about it.  What causes the
emotionality?  Prejudice!

Prejudice toward a group of people
involves judging them unfairly, as a group and negatively.  Such judgments are moralistic and
start with an impossible standard for the victims but one they are
expected to meet to be worthy. 
For instance, the standard may be maleness, or whiteness, which the
moralists consider the right way to be.  Those who don’t meet the stand,
for instance females or nonwhites, are inferior.  These judgments:

    (1) apply different standards to the
victims

The victims of the prejudice may become prejudiced to some
extent against themselves. 
All of these conditions exist in the case of methadone
patients.

Emotion often runs high in opinions about methadone. the
recipients of no other form of medical treatment are so routinely
discriminated against. For instance, by custom and law, San Francisco has
the reputation as one of the real citadels of freedom in America.  It is one of the few places that
take freedom seriously. Minorities abound, and, for the most part,
opportunity and harmony reign. Except for methadone patients.

Some Examples of Routine
Discrimination

Numerous drug and alcohol treatment
programs in San Francisco refuse to provide services to methadone
patients.  The most prominent
County-funded program for gays and lesbians, for instance, does not accept
methadone patients into group therapy.  The County-funded program to
provide mental health services for medically indigent adults does not
accept methadone patients. 
When San Francisco County has to pass along to drug and alcohol
clinics a 20% cut in waiting list reduction funds, it passed alone a 100%
cut to the methadone clinics, so that other treatment modalities would not
have to share the burden of the cuts.  At least one methadone patient,
who was going to lose his treatment slot, committed suicide.

In the first competition for Ryan White
emergency AIDS funds in San Francisco, largely orchestrated by the AIDS
Program, no methadone clinic received funding.  Yet, one of the drug-free
outpatient counseling programs received funds to hire a janitor!  At the second round of
competition, methadone maintenance was specifically excluded as �not a
priority service.�

At
a meeting in San Francisco about establishment of a residential treatment
facility for substance abusers who have AIDS, the question was asked,
�Will patients on methadone be allow to live there?�  No one knew the answer.  the question could be continued,
�Or will they be forced to die on the streets because of the prejudice
against methadone and against people who are on
methadone?�