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Let’s Stop Judging Recovery: Vivitrol, Methadone, Suboxone: Whatever Works

My most favorite meme ever: “Recovery from anything is the most badass thing a person can do.” The courage it takes to overcome and transform should never be up for debate. Unfortunately, how we define recovery from addiction often is.

The lines seem blurry. For years now we’ve misguidedly debated whether folks prescribed Methadone or Suboxone can truly be said to be in recovery. Our newest development is Vivitrol, which further blurs traditional views on both addiction recovery and medication assisted treatment.

In her recent article, Jackie Farwell gives an otherwise fair and balanced depiction of the role Vivitrol can play in opiate addiction recovery and recovery from alcoholism. Noting that using Vivitrol requires that a person be abstinent and free from withdrawal symptoms she makes the grave mistake of saying, “(this leaves) only those most motivated to get clean.” <face palm>

Evaluating the degree to which an addict is motivated to get clean is not only problematic, it’s a misguided and potentially hurtful judgment. In the context of the article, those who use this medication (Vivitrol) are more motivated than those who use other medications (Methadone, Suboxone) or even those who choose abstinence without medication. Even worse, the judgment weighs no contributing circumstances of any kind.

Addiction never exists in isolation. There are always problematic circumstances.

It’s pointless to get philosophical about why we judge. It’s better to live by Bob Dylan’s words, “Don’t criticize what you don’t understand.” While addiction is something I understand well, I also know that each person’s recovery is unique.

I’m embarrassed to admit that there was a time when I judged people who use methadone to support their recovery. I was arrogant and wrong for doing so. I went on to serve people who helped me to see that they’d have died without it.

A colleague of mine took me to task and asked how I could possibly support opiate replacement therapy. I heard myself say, “Because nobody has ever gotten a bad dose of methadone but people are dying from heroin laced with Fentanyl.”

The closer one gets to the problem, the more open to solutions we become.

What’s lost in all our discussions and media portrayals is the difference between dependence and addiction. When folks portray using Methadone or Suboxone as “trading one addiction for another” they are objectively wrong. They’re trading addiction for dependence. They move from living with one of the most destructive forces a person can endure to having their disease medically monitored. Their functioning is generally improved, often dramatically.

To understand the use of a drug like Vivitrol, we must consider why a person would take a drug to ensure that they don’t take drugs. Vivitrol is a thirty day dose of nothing but Naltrexone, a medication that blocks opiate receptors. By making this commitment, the recovering addict/alcoholic gives themselves the security of knowing that using their drug of choice will not get them high.

The National Institute On Drug Abuse tells us that alcohol and drug abuse costs our society hundreds of billions each year in increased health care costs, crime, and lost productivity. Creating more options to support recovery benefits us all. One of our largest obstacles remains a lack of knowledge regarding addiction (one of very few stigmatized diseases in our society) and the processes of recovery.

It’s one of the hardest things a human being can overcome. Let’s move away from judgment and support undertakings that benefit us all.

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