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Readers Are Divided Over Maintenance Drugs

May 9, 2010
by Gary Enos
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I expected to see divergent opinions surface when we recently asked in an online poll, “Do you consider individuals in methadone or buprenorphine treatment to be in recovery?” I once had witnessed a respectful but spirited debate on this question among medical directors speaking at a conference sponsored by the National Association of Addiction Treatment Providers (NAATP), so I knew how this subject could generate highly charged views.

The written comments we received last month, for a poll in which about 58% of respondents equated methadone or buprenorphine maintenance with recovery, show how elusive a consensus definition of recovery can be for this field.

Here are some of the comments we received, starting with three answering in the affirmative:

“If the individual’s quality of life has improved as a result of the treatment, there is no question about recovery.”

“Where does it say recovery is abstinence? Those who do not understand what benefits medication-assisted treatment provides really need to educate themselves!”

“More so for buprenorphine, but the statistics are irrefutable even for an old-school, abstinence-only addict like me.”

Here are three from the opposite point of view:

“The pharmaceutical management of addiction is not the same thing as recovery from addiction, no matter how you slice it.”

“Harm reduction is a good thing, but I think they are avoiding the inevitable, which is going through withdrawals and getting it over with.”

“Recovery is about moving on with your life, free of anything that would hold you back. Being locked into regular visits to get your ‘medication’ does not constitute freedom.”


It is entirely possible that in some remote area, it is an absolute 100% requirement to spit in the spitoon before and after every meeting in order to be a member of the elite and therefore, "In Recovery."

If only we had a CURE for substance addiction, then the argument about someone on maintenance medications not being in recovery would be more valid. If addiction is a biological as well as social problem, then why not have medication as a treatment? Would we say that a diabetic person who stops eating high sugar and high fat foods and follows his insulin mediation regimen/maintaining a normal blood glucose level, etc. is in recovery or not?
For those who have had several attempts at more conventional treatments, medications such as burenorphine or naltrexone may be the effective treatment. Being involved in a sober support community will be the companion treatment.

Gary Enos


Gary Enos

Gary A. Enos has been the editor of Addiction Professional since its inception. He also...

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