American Association for the Treatment of Opioid Dependence
Washington, D.C. ~ April 13-16, 2003
Session: Workshop
April 15, 2003
Medication – Assisted Treatment in Different Practice Settings: Patients’ Perspectives
Joycelyn Woods, National Alliance of Methadone Advocates, Facilitator
NAMA representativees will discuss the administration of methadone in a variety of settings. Topics will include the patients’ perspective on which elements of practice contribute to a positive treatment setting and how common terminology used to describe treatment and patients is expected to change as methadone begins to be offered in more mainstream settings.
Basic Track
Methadone and Ibogaine: A Historical Comparison of Patient Status and Advocacy Issues
Howard Lotsof, Membership Director
National Alliance of Methadone Advocates
Dora Weiner Organization
A Retrospective
Though methadone, an opioid agonist therapy and ibogaine, a substance having diverse complex mechanisms of actions appear quite different in their effects both medications have strong patient advocacy support. With the two medications being so distinct in their dose regimen and treatment profile it is interesting to note the advantages of early generation patients of each modality and the power they held compared to later generations of patients.
Within the methadone context this special status of early patients, many of whom became Research Assistants (RAs) was directly attributable to the two doctors responsible for the development of methadone maintenance, Drs. Vincent Dole and Marie Nyswander. Ibogaine provides a somewhat different scenario wherein the medication’s discovery as an antiaddictive agent came from the drug using counter culture. As ibogaine was lead into formal regulatory development by its discoverer, Howard S. Lotsof, he maintained a strong working relationship with patients and patient advocates who were immediately incorporated into early research through the International Coalition for Addict Self-help (ICASH) founded by Robert Sisko and Dutch Addict Self-help (DASH), established by N.F.P. Adriaans, G. Frenken and their associates.
As methadone moved further and further from its Dole/Nyswander beginning, providers became repressive and controlling towards their patients with strong antipatient and antiadvocacy positions taken within clinics to which methadone distribution was restricted. It should be noted that there are exceptions and that agencies within the federal government as well as, private groups and some methadone clinics themselves have recognized the detrimental effects associated with stigma and prejudice towards patients and are now beginning to attempt to reverse these conditions that are not conducive to recovery or the benefit of patients.
Ibogaine has not moved that far from its roots and we do not yet see the biased treatment of patients nor the ability to control them in a manner associated with methadone clinics. However, the patients themselves appear to have little direct access to ibogaine and to no longer participate in its administration to other patients in therapeutic self-help environments. While Lotsof believes that the ibogaine community can return to a situation closely identified with the patient/provider relationship similar to the golden age of methadone, Dr. Dole, the father of methadone maintenance therapy believes that the return to such practices for methadone itself will not be possible.
This project of the Dora Weiner OrganizationDora Weiner Foundation (DWF) is to document in reports and photographs the early generation of patients and advocates within both the ibogaine and methadone community for historical comparison in the hope that we may improve the lives of current patients through an understanding of the past.
Methadone and Ibogaine: A Historical Comparison of Patient Status and Advocacy Issues.(powerpoint)
Manual Handout
Pain Management and the Methadone Patient
James Connolly, Regional Director
National Alliance of Methadone Advocates
Pennsylvania NAMA
(To Be Available)
Words That Hurt: How the words that are used promote stigma
Roxanne Baker, Chapter Coordinator
National Alliance of Methadone Advocates
NAMA NorCal
(To Be Available)