Inside what seems like a small warehouse in the North Side is a coffee shop where dozens of people enjoy conversation, card games and a flat-screen plasma TV alongside coffee and pastries.
But what looks like a run-of-the-mill coffee shop is actually a program recently established by outpatient methadone treatment clinic Tadiso, Inc.
Marlene Burks, chief administrative officer of the Beaver Avenue clinic, explains that the coffee shop was created in December 2007 in response to client’s requests for a place to socialize during their recovery process.
The clinic’s clients, who are recovering from addiction to heroin and other drugs, “needed a place of their own — a safe, welcoming place to go outside of treatment,” she says. Methadone is a synthetic drug that blocks an addict’s withdrawal symptoms associated with narcotics like heroin and morphine. According to the Office of National Drug Control Policy, the methadone patient “remains physically dependent on the opioid, but is freed from the uncontrolled, compulsive and disruptive behavior seen in heroin addicts.”
The coffee shop is staffed by Tadiso’s own clients and funded through sales proceeds. Staffers work in two-hour shifts on a rotating basis and as payment are given gift certificates donated by local businesses at the end of each week. One client, who asked not to be identified, said she liked working at the shop because it gave her something positive to do during her free time.
“It gives me life skills — things that I forgot before I started [treatment],” she said. “Skills to get me back into the workforce after I’m done here.”
“It’s cool for those of us who aren’t driving,” said another client, who frequents the coffee shop while waiting for the bus. “They [don’t have] the staff in here, just the clients. That’s what’s nice. That’s the incentive.”
Burks explains that Tadiso focuses on a holistic approach in addition to the medical needs of clients’ recovery from opioid addictions.
“That’s why the coffee shop is so important, so their free time is used constructively,” she says.
There is a stigma associated with methadone clinics, whose presence in a community is often opposed by neighbors. Clinicians like Burks argue that the clinics are necessary because patients must also undergo therapy in addition to taking the drug to ensure recovery.
“Methadone treatment is more than just administering a substitute for narcotics,” she says. “We really try to stress the road to recovery through counseling.”
Tadiso and other clinics in Pittsburgh offer individual and group counseling, medical services and post-treatment therapy.
The clinic’s chief operating officer, Taru Cook, adds that methadone treatment isn’t usually a recovering addict’s first outpatient program.
“All of our clients have been to some outpatient programs before,” he says. “Methadone isn’t usually an option for someone’s first attempt at recovery.”
This article appears in Apr 10-16, 2008.
While this is an excellent idea, I do take issue with one thing stated. It is insinuated that methadone is simply a substitution therapy and that the “real” treatment is the counseling received. This is untrue. Many long term opiate addicts have sustained permanent damage to the endorphin system in the brain–the natural opiates we all have. Even long term abstinence, group therapy, counseling, meetings, etc will not repair this damage when it is permanent, as it sometimes is. Methadone is a substitution therapy, yes–but not for the heroin or other opiates. It is a substitute for the natural endorphins no longer being produced, in the same way that insulin replaces the chemicals no longer produced in the pancreas of the diabetic. Though some addicts may need counseling due to lifestyle issues, and it should always be offered, methadone is a very important part of the treatment and should not be relegated to the realm of unimportance next to the often questionable “counseling” that occurs at clinics. In fact, many long term patients have long since resolved their social and other issues they had when entering treatment and no longer require counseling of any kind–they are stable, compliant, functional, and should be able to see their physicians on a monthly basis for their medications instead of clogging up needed slots at a clinic.
This was a response from Zenith Texas.
Zenith Texas wrote “It is insinuated that methadone is simply a substitution therapy and that the “real” treatment is the counseling received. This is untrue.”
Actually the previous statement by Zenith Texas is not true. Methadone is a narcotic pain reliever, similar to morphine and is most definitely used to replace other narcotics in the body.
Zenith Texas wrote “Many long term opiate addicts have sustained permanent damage to the endorphin system in the brain–the natural opiates we all have. Even long term abstinence, group therapy, counseling, meetings, etc will not repair this damage when it is permanent, as it sometimes is. Methadone is a substitution therapy, yes–but not for the heroin or other opiates. It is a substitute for the natural endorphins no longer being produced, in the same way that insulin replaces the chemicals no longer produced in the pancreas of the diabetic.”
This is not true, this is propaganda from methadaone advocates. Even if this was true there are drugs that are not mood altering to replace endorphines. Methadone is a drug that get a patient high just like any other opiate and does not address the true source and core of addiction which is the feelings, behaviors and the reaction to feelings.
Zenith Texas wrote “some addicts may need counseling due to lifestyle issues, and it should always be offered, methadone is a very important part of the treatment and should not be relegated to the realm of unimportance next to the often questionable “counseling” that occurs at clinics.” Interesting generalization.
Zenith Texas wrote “In fact, many long term patients have long since resolved their social and other issues they had when entering treatment and no longer require counseling of any kind–they are stable, compliant, functional, and should be able to see their physicians on a monthly basis for their medications instead of clogging up needed slots at a clinic.”
In fact over 75% of methadone clients in the USA are on public funding and are not contributing to society but are instead using our tax dollars to fund long term methadone treatment, pay their rent and other bills.
The stability mentioned is noting more than methadone clients using our tax dollars to fund every aspect of their lives while they use benzodiazapine, cocaine, marijuana, alcohol and other drugs while on methadone and even use tax dollra to obtain some of these drugs. A very small portion of methadone clients are only using methadane.
Zenith Texas comments sound very nice but the truth is, methadone is a replacement for opiates like herion and oxycontin and is a very poor treatment for addiction. If the life style of the addict is not addressed there is no forward progression. A methadone client who is totally funded by tax dollars in every way is not a stable, functional and productive member of society. Are there some clients that do fair to well on methadone, not many but yes there are some. But then again, there are some who live in prison who are stable as well.
The coffee shop is a great idea for those new to treatment that are genuinely afraid to go around old “so-called friends” that they used drugs with (before beginning an MMT program to get their lives back, these “old-so called- friends” were all they had). Those starting treatment without Family as a support network really need something like this coffee shop to start to learn how to live again and make friends that are clean of all illicit drugs. I just have one, actually two things to say…
Zenith – Texas, absolutely makes total sense in what she says. She is well educated. I’m going to ask you, although I think I already know the answer, but, do you have the disease of opioid addiction, or do you know someone you love that does? If you are so against Methadone Maintenance Treatment, then why haven’t you educated yourself a little more on this treatment before sharing your opinion?
Keep Advocating Zenith-Texas!
mlsswann, Florida wrote:
” The coffee shop is a great idea for those new to treatment that are genuinely afraid to go around old “so-called friends” that they used drugs with (before beginning an MMT program to get their lives back, these “old-so called- friends” were all they had). Those starting treatment without Family as a support network really need something like this coffee shop to start to learn how to live again and make friends that are clean of all illicit drugs. I just have one, actually two things to say…
Zenith – Texas, absolutely makes total sense in what she says. She is well educated. I’m going to ask you, although I think I already know the answer, but, do you have the disease of opioid addiction, or do you know someone you love that does? If you are so against Methadone Maintenance Treatment, then why haven’t you educated yourself a little more on this treatment before sharing your opinion?
Keep Advocating Zenith-Texas!”
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I agree that the coffee shop is a good idea for those trying to change People Places & Things as long as there are standards and rules in place for the clients. It is a good idea for MMT clients to makes friends with others that are clean from illicit drugs but unfortunately if these are other MMY clients this will be hard to do considering a very high percentage of MMT clients are testing positive for alcohol and illicit drugs monthly at MMT clinics.
If anyone reading this has any experience as a MMT client or MMT worker you will know what I am stating is correct. There is a reason why MMT clinics do not test for marijuana and alcohol and do not have specific tests for oxycontin, if they did they would have to address these drugs and lose their high numbers of success.
I find it interesting that mlsswann, Florida states zenith Texas is a “she.” Zenith never mentioned this in their post yet mlsswann, Florida knows her gender. Nice support for your own post zenith Texas. Next time you agree with yourself but using a different user name you can use the term “co-signing your own falsehoods.”
Just for informational purposes. I have the disease of addiction and there is no such thing as the “disease of opioid addiction.”
Addiction is addiction regardless of the substance involved, addiction is not about the drug, it’s about behaviors and feelings, the reaction to feelings, drugs are the symptom of the disease of addiction, not the problem. Once the drugs are stopped there is much to learn and much change to effect in our lives. With MMT, the drugs are never stopped thus the behavior changes needed in an addicts life rarely if ever occur in a MMT clients life.
I have been on both sides of the MMT tables as a user and a Therapist. You know, one of those Therapists that gives
“questionable “”counseling”” that occurs at clinics.”
I also have been helping people learn to live drug free for the last ten plus years, teaching coping skills, relapse prevention and how to develop a solid relapse prevention plan, life skills, chemical dependency & addiction education, dual diagnosis education, guiding 12 step and other supports into addicts lives, linking patients to life sustaining services, OVR funding, alda funding etc., helping client empower their lives and leaving the excuses, rationalizations, blaming, intellectualizing and other denial tools behind to move forward in a drug free life. I volunteer much of my time to do so, hold various degrees and certifications in addiction education and training.
I have dedicated my life to fighting the disease of addiction, within myself and others.
I have done more than writing a post about a cooffee shop.
I have done more than tell the lie that Methadone is a viable tool to treat addiction.
I have fought addiction without a drug in my body, evey day of my life for over a decade and I have taught many others to do so as well. I freely give away what I have learned. I do not make money from the suffering of addicts as methadone clinics do each day in this country.
I would say that is at least slightly educated.
Actually, I agree that methadone does replace the affect on the brain of other opioids. And it is being proven that the brain has an amazing ability to heal itself of damage caused by addiction. Though some people are on methadone for life, most people who fit this description walked into a clinic with that intention. I can’t believe that a methadone advocate would immediately find something to disagree with in response to a positive MAT article like this. The counselling, and other therapies are truly the difference between getting methadone from a clinic and heroin from a dealer, outside of legal issues. Methadone is only a portion of the equation, and to say that people outgrow the need to see counsellors is a completely misguided statement made by someone with a bias. I think this is a good article and wish more clinics would be this interested in their clients. Why would you attack this, do you think that clinics should be nothing more than dealers?
OK Zenith, this is a good one. Your reasoning gives much comfort to those addicted to methadone. but here’s what Dr. David Arneson has to say about your theory. I believe it because it happened for me. “…as your body heals and the receptors are synthesized in the body your own enkephlins and endorphins (natural body opiates) will start to be interactive in pain management…this may not be enough…yet many cases of chronic pain will subside if serotonin levels in the brain can be increased—the reason for doing amino acid therapy is to increase these levels. Anti-depressants don’t increase the production of anything over the long term…in fact it is well known that in the long term they decrease levels of neurotransmitters such as serotonin. Amino acids therapies work well on most cases of fibromyalgia even though many of these patients will fall victim to the use of methadone which just creates more problems.” Lets stick to facts instead of further crippling people with drug addictions, Max
Finally some good points from others that display facts instead of a bias opinion as the advocates have here. Good job Maximilian, Mars & Hillbilly Mars.
I have noticed that the advocates have nothing to say in the face of challenge of their statements with actual facts.
Just for informational purposes. An advocate’s journey to becoming an advocate lasts six hours.
That’s right; to become a Certified Methadone Advocate (CMA) it takes six hours and $100.00 to do so. I find it difficult to take a CMA seriously knowing the lack of real training and education that is involved.
Just for comparison. For every hour that a CMA trains, I have spent a year in school.
For every dollar of the one hundred a CMA spends for their credentials I have spent $500.00 on my education. For those mathematically challenged, that 100 x 500.00.
For every hour a CMA has spent in their six hour training I have taught people how to stay drug free for 1.5 years.
Instead of reading the propaganda of the Certified Methadone Advocates I’d like to hear more facts from care givers with actual educations.
I realize this is a late post, but everything Zenith Texas has said can be backed up by research, and the medical field. Advocates don’t say or do anything if they are not 100% sure of what they are saying.
It’s a shame that some people will type their opinions with a can of beer or some Grand Mariner in their hand. Oh, wait thats ok, liquor is leagal and readily avaiable on any corner in the US.
I’m glad to see this clinic make an effort at giving Patients a safe place to gather, and an opportunity to enhance their employment skills. I hope that during the counseling that Patients are further encouraged to start or complete their education and take their places in the work force. Mr. Frost, what reliable information do you make your statements on? Interesting that you state that 75% of MMT Patients are funded by our Government? So glad that abstinance has worked for you, but as someone who has spent over 25 years and a small fortune(funded by my Insurance and personal funds)on Counselors, therepists, drs. & in-patient rehab stays that I found to be worthless at best and downright destructive to my life and spirit in the end.Now I do realize that some 5% of those who use this mode of therapy do have success, however I was not in that 5%. I am employed full time, I pay for my treatment even though I have insurance that should be paying for it, I volunteer at my Temple and in my community. MMT is the only form of treatment that has worked for me. I hope that when you see the Patient that has failed at in Patient re-hab time after time, and they are on the verge of failure and using illicit drugs, that you will at least give them the information that could save them jail, disease or death. MMT has allowed me to complete my education, and to keep employment, to help my Children with College expenses and live a life worth living. Sincerely, Beth
Hey MrFrost: What drugs are you refering to when you say:
” Even if this was true there are drugs that are not mood altering to replace endorphines.”
Please list some of these other endorphine replacement drugs.
Thanks
Mr Frost, it is interesting that you feel that anyone who agrees with me must therefore BE me. Many people in the methadone community know me as I monitor many support boards and attend conferences and educational seminars with them, and they know that I am a female. I assure you that I do not post to back up my own posts.
In addition to my CMA training, I also have a degree in nursing (an RN degree) and have completed schooling and practicum for chemical dependency counseling. I make it my business to keep abreast of everything that is going on in opioid addiction therapy, I read reams of scientific papers, and I think for myself instead of believing rumors, stigma and prejudice.
You are WAY off the mark with your assesments about how many patients pay for their treatment–the majority of clinics in the US are private pay clinics. You are also way off on your assesment of how many patients are drug free on MMT. Statistics show that 65-90% of patients test drug free depending on the clinic.
Some people do need counseling, usually due to the havoc that addiction has brought about in their lives. However, not all do–the face of addiction is changing, and not everyone is a street person, homeless, jobless and strung out on heroin. Many people come from very functional backgrouns and need minimal counseling and assistance to put their lives back together if their primary problem is dysfunctional brain chemistry. Just as people with depression, bipolar disorder, etc may initially benefit from some counseling but if the medication works to repair their brain chemistry, likely do not need long term intensive counseling every week forevermore, the same is true of many addiction patients.
The proof is in the pudding. At any clinic you can see long term patients who have put their lives back together and have been living perfectly normal law abiding, happy lives for decades without benefit of intensive counseling or support groups.
While I DO think the coffee shop idea is a very good one–and I probably should have made that more clear in my firts post–I can assure you that my opinion on this matter did not come simply from my own ideas but from the studies and findings of much greater scientific minds than mine, such as Dr Vincent Dole, Dr Marie Nyswander, Dr Mary Jane Kreek, Dr Thomas Payte, Dr Benny Primm, Dr Edwin Salsitz, Dr. Robert Newman and other giants in the field of addiction treatment.
Now Mr Frost et al are you ready to challange an advocate that works hard to PROVE you running up a one way steet the wrong way?Quote: The proof is in the pudding” end quote. Sir? are you willing to take the leap?
One other thing, Mr Frost–you say there are drugs that are not mood altering to replace endorphins. That makes very little sense even if it were true. One of the primary functions of endorphins/enkephalins IS to regulate mood. They are the chemicals that make it possible for us to experience pleasure and happiness, feel joy, etc. With these chemicals depleted, the person is in an anhedonic state–unable to experience joy and pleasure, with nothing to fill their opiate receptors.
Therefore , any medication that repairs this system and re-regulates the brain chemistry is going to, by definition, be “mood altering”. There is no crime in taking a “mood altering” medication if you have a brain chemistry malfunction that affects your MOOD.
The coffee shop is a great idea, but its also used by some clients as easy ways to sell their drugs, and keeping warm doing it. A lot of clinics have client advocacy groups who do things for clients like picnics, ect. But we know someone always uses that time or place for something illegal. I have seen clients selling benzodiazapines (benzos) , pain pills, coke, crack, ect. It sucks and those people who are doing it should be thrown out….
This clinic Tadiso is a Very Non Client Friendly Clinic, The Doctor there (Dr. Reese) Berates the Clients and Insults and Degrades the Clients Calling them Worthless and many other Negative things. I have been to a few MMT Clinics and this one is by far the Worst, It is like Pulling Teeth to get an increase on, your Methadone there and Dr. reese always pulls out this paper that some moron wrote that the Majority of MMT Patients are stable with a 40 mg Dose. This is a Very Misleading Statement as everyones body and addictions are different. I have heard from many fellow patients there who have had bad experiences there and with Dr. reese, I am NOT stable on my dose which is 60mg. My Counselor surprisingly knows Very Little about Methadone and is NO Help what so ever. I Only wish I had Private Insurance and was able to return to Discovery House which is much more client Friendly and they dont have a problem increasing your dose past 60. I am really stuck between a rock and a hard place, I am looking at options such as contacting JACO or one of the Government agencies that deals ith MMT to Voice my Concerns, I should not have to do this but unfortunately I have no other otion