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Friday, February 18, 2011

Tom's Comment to my last post-comment form wouldn't work!

Hi Dawn, 
Tried to comment on your blog and couldn't get it to take my comment for some reason.  Will you post this for me?
Thanks!  Tom
Here's my comment:
Dawn, I can't help but like you--even though I don't particularly want to like you because I often disagree with you and sometimes cringe at your, um, directness.  But I do like you, and respect you too.  You are all you and really real.
 Some thoughts:
 1.  The term "clean" is slang.  If you stop to think about it it's pretty rude and insulting (which I don't anticipate will register for you but will for some others).  It's a product of the profound lack of empathy and respect our culture has for people struggling with DRUG addiction. People aren't "dirty" for alcohol or "dirty" for tobacco.  They are "dirty" for marijuana, cocaine or heroin.  Smokers aren't "clean" when they quit with or without medication.  The term just isn't used in that context.  If you go to your doctor for some Chantix, I can promise you your doctor won't discuss your attempt to quit in terms of dirty vs. clean.  But the same doctor would not hesitate to tell an opiate dependent patient that the medical lab results for a urine drug screen came back "dirty."  No other medical lab test is discussed in this way.  Even most drug treatment providers see no problem calling their clients "dirty" or "clean."  Language matters not just because of hurt feelings, but because it profoundly influences the way people are treated by doctors, politicians, drug treatment providers, judges, probation officers, police and others in ways that really hurt people.
 2.  The important distinction is not between "dirty" vs. "clean" but between "in recovery" and "not in recovery."  For my thoughts on whether people in medication-assisted treatment are in recovery please see my blog post "People in Methadone-Assisted Recovery Are in Real Recovery"
 3.  Recovery is a personal journey.  It is a process.  It takes place over time.  For most people in includes periods of use and non-use.  We should allow people to define recovery for themselves, and offer our encouragement and support for any positive change.  If someone says they are in recovery, they are in recovery.  To behave otherwise is like telling someone on a diet, "well you may be eating right, exercising, 20 lbs. lighter and on your way to living longer, but none of that matters because you are either thin or fat --and no matter what you say I say in my book you are still fat!" How motivating and supportive is that?
 4. WHY do you "need" parents to "know" that their loved one is not "clean."  I would say what the need to know is that medication-assisted treatment is scientifically proven to be the most effective treatment for opiate dependence, and saves lives.  Seriously, why does a Mom need to know whether you think her daughter is "clean" enough to meet your arbitrary standard? And by the way, the brain chemistry of a long-term opiate user has changed so that abstinence "tickles" the opiate receptor sites like hell --which is why people succumb to overwhelming and persistent cravings, relapse and suffer the consequences (overdose death, incarceration, loss of family relationships, loss of housing, loss of job etc).
 p.s. If you come to MY blog, EVERYBODY is clean (unless they have been in the mud), and many people are in recovery too

Tom's Website is here


  1. Tom LOL, I like you too!

    "4. WHY do you "need" parents to "know" that their loved one is not "clean." I would say what the need to know is that medication-assisted treatment is scientifically proven to be the most effective treatment for opiate dependence, and saves lives. Seriously, why does a Mom need to know whether you think her daughter is "clean" enough to meet your arbitrary standard? "

    I don't? This post was because my daughter, on MMT keeps telling me how clean she is because all her tests come back clean. How she has been clean for 4 years now.

    I'm not particularly impressed. Firstly, I know she has used. Secondly, I know that she can call the hotline at midnight and find out if her 'group' is being tested the next day and just miss her dose. Then, by the next test, she will test clean. Thirdly, I know that this is her 3rd attempt at MMT, and her 9th or 10th rehab. As soon as she goes off MMT she will use again.

    So, for me, her being clean will mean absence of any drugs, legal or not. It's MY arbitrary line. After 12 years of dealing with a heroin addict, I can have an arbitrary line. To me, clean is clean. I am not denying her 'recovery', but then, she will be 'in recovery' for life, and most likely in MMT recovery. So, that's okay, but don't come telling ME you are clean. Tell me you are not using and on MMT to keep you from using. Splitting hairs, I know :::nodding::: but I'm like that.

    I freely admit I am addicted to cigarettes and NOT CLEAN from nicotine. I also admit to the glass of merlot every night that my cardiologist allows me. Not clean. Not an alcoholic, but not clean. So I am imposing the same standards on myself.

    And, after all, it's my blog and I can write whatever I feel the need to write. I did put a disclaimer at the top saying it was ONLY MY OPINION, not medical fact!!

  2. The differentiating between the terms "dirty" and "clean" vs using the terms, lets say, "positive" and "negative" does resonate with me. I was one of those mom's who didn't like anyone saying that a child was a "bad boy." What they did may have been bad or in poor little boy judgment, but they are not to me words do matter. I guess I was taught the terms dirty and clean and in my state of sheer exhaustion lol I glommed onto them for lack of any better terminology.

    I do appreciate the insight shared in Tom's comment. I'm always learning...

  3. My "arbitrary" standard for my daughter to be clean, not using, in recovery, whatever you want to call it is because if she isn't and I let her in my life and in my house, she will steal from me and hurt me emotionally, psycholigically, financially, etc. Knowing this upfront, and knowing that we have given her many opportunities to relinquish drugs, however unsuccessfully, I would be a fool if I had not learned my lesson. So my compassion for my daughter's disease and her unwillingness to get well, is down to almost zero. Sad, but true.

  4. It resonates with me too.....clean and dirty need to be updated,...I think...for different addict vocabulary. There's just so much ignorance about addiction out there, and those terms only exacerbate it.

  5. What gets me about replacement therapy is that methadone is so ineffectual for me I basically had a full-blown psychotic breakdown when I finally switched heroin for methadone properly early last December. Now I'm getting comments that my bipolar symptoms (3 highs and 3 lows in about 10 weeks) are somehow to be expected on methadone therapy. These people know how extreme my mood swings get. I cannot post all the details they get an expurgated version. So unless they all think I'm lying and exaggerating I can't help wondering whether it's they who live in cloud cuckoo land, not me. They're my friends and they're only trying to be helpful and supportive, but frankly they're starting to do my head in.

    I'm sure methadone treatment works for some, but for me it just did not hit the spot. Depressed on heroin meant suicidally depressed on methadone. Or spending entire days just staring into space without the motivation to move.

    Yes of course it was almost certainly something "underlying" but my methadone clinic were shamefully inept in giving any treatment until things got so bad the walls were speaking to me and I thought we were in next year.

    Not good!

  6. @Gledwood. Always love hearing from you. Although we are on different sides of the issues, you, like me, are quite outspoken and no bullshit.

    I don't think MMT is good for my daughter. I'm not sure it keeps her from using AND she still has all the signs of using while on MMT. If MMT is so flippin good, why does she still nod off, have bizarre behavior, make bad decisions and lose contact with us for weeks at a time? Doesn't make sense to me.

    funny thing is, back when I was (true statement here) one of the ORIGINAL HAIGHT ASHBURY hippies, I had lots of friends who were junkies. Back then, methadone meant going to the clinic and getting a bottle of liquid methadone and clean needles and shooting it up instead of heroin. I wasn't (back then) particularly against or for methadone. It just was. But looking back, again, I only noticed ONE main difference in methadone vs heroin.

    A letter of the alphabet. S for P. The friends (patients) instead of spending their entire day revolving around doPe, spent their entire day revolving around doSe. They still didn't act normal, they still didn't function all that well. One couple in particular I remember, both addicts, lived in a real shithole, full of healthy plants, very hippiesh (is that a word?). I would go visit regularly. Their bottles and rubber and needles were right out on the counter, and every four hours or so, they would get up, go on over and inject, and then nod off for a hour or so after.

    When I see my daughter come back from the clinic, after orally swallowing her dose, she also nods off. and yes, she is driving a CAR with my 4 year old granddaughter in me the actual willies to even THINK about that. Detachment helps there, but not much.

    It does keep her from stealing from me to get dope money, but it hasn't stopped her from stealing GAS to get to the 45 minute away clinic. It hasn't stopped her life revolving around getting that flippin dose. It hasn't allowed her to become productive, or hold a job.

    Weird, isn't it? I read alot about how MMT is THE way to go, but I sure don't see it in reality. The clinic is full of just about everyone, doctors, lawyers, police officers, and regular old street junkies. All there at 5 am so they can get their dose, and do their nodding off before they go to work. ::shaking my head::: I suppose it brings down the crime statistics, but the clinics are NOT invested in any sort of 'weaning' the patients off methadone, which in the U.S. is VERY big business.

    Just doesn't make sense to me. Seems like ripping off the families who pay for the clinics is the primary goal of the privatized MMT clinics, and not helping any of the patients. It's easy to do the math.

    Average clinic serves 500 people a week, at a cost of $110. per person. MY GOD that is $55,000 a WEEK. the methadone cost them about $1,000 a week, the staff maybe another $5,000 in employee costs, leaving a whopping $49,000 a week in PROFIT.

    Trust MMT clinics? Nope LOL. No way.

  7. hi i answered your point at mine i don't mind it being public but you can email a reply if you prefer email i have problems with email sometimes which is why i only use it when it's not for public consumption

    if you email me and i don't get back please leave a blog comment and i'll be able to find the email hopefully. they keep altering the layout, the spam settings and how it works and i get lost in all that shit and just can't deal with it. sometimes i can't even find the button for "send a new message to someone whose name isn't on screen to click on" akkh it drives me nuts


  8. I recommend reading Guinevere Gets Sober's interview with Dr. Steven Scanlan, M.D.: "Suboxone: Amazing Detox Tool, Monster Maintenance Drug":
    Dr. Scanlan is board certified in psychiatry and addiction medicine, as well as being in recovery from opiate addiction himself. I know that Tom at Recovery Help Desk is a passionate advocate for methadone and suboxone use. My daughter, Hayley, told me that both of those drugs were easily available to her, illegally, and actually paved the way for her eventual IV heroin use. I also personally experienced how eager an addiction M.D. in town was to immediately put Hayley on suboxone - without examining her (she was covered in abcesses) or even taking her blood pressure. Dr. "X", had one 'opening' in his suboxone protocol program, and he was eager to fill it! According to Dr. Scanlan, the financial rewards to doctors who get patients on suboxone, are significant. Just say'in.

  9. Clean is a bad word in my opinion. It's used to tear people down who are really trying for happiness instead of an arbitrary standard set by family or 12 step programs. There is also a difference between physical dependence and addiction. I am addicted to oxycodone, but I am only dependent on suboxone because I can control my use, I don't get cravings to take more than necessary, and I am able to use less than the recommended amount each day. None of those things are true with oxycontin. Addiction is a disease, physical dependence to detox/maint drugs is a side effect. If you take antidepressants or ADHD drugs as prescribed (and never abuse them), you will become physically dependent and can experience withdrawal symptoms upon suddenly stopping. That doesn't make every depressed or ADD person a drug addict. And it certainly doesn't make them "dirty".

  10. S.J. firstly, to me clean is not using any street drugs. Those on methadone or suboxone who do not augment them with heroin, xananx or any other street drug are considered clean in my book. Those who use heroin or oxy's are dirty.

    It's really pretty clear cut. Addiction, whether a disease or a choice, is addiction. Once an addict, always an addict, just sometimes, you are an addict NOT in active addiction. Clean. When you cross that line, dirty.