Senators Unveil Bipartisan "Methadone Accountability Package"

Harrisburg – A group of lawmakers and advocates unveiled a bipartisan package of legislation today overhauling Pennsylvania’s methadone treatment laws to increase fiscal accountability and safety, and reduce the unlawful use of methadone and methadone poisoning deaths.

Discussing their legislation at a Capitol news conference were Sen. Kim Ward (R-39), Sen. John Eichelberger (R-30), Sen. Mike Stack (D-5) and Sen. Don White (R-41). Also on hand was Marti Hottenstein, who helped found Helping America Reduce Methadone Deaths (HARMD) after the death of her son, as well as Sen. Elder Vogel (R-47), and Rep. Gene DiGirolamo (R-18).

"The state methadone program is spending tax dollars for open-ended treatment with no accountability or oversight," said Senator Ward. "It’s incredible that with so many lives – and tax dollars – at stake, no state agency has bothered to do an audit. I want to know what the state is spending and what it can do better."

They want to stop "open ended treatment" for opiate addiction? What if people wanted to limit the amount of time in treatment for diabetes, or high blood pressure? They don't realize that opiate addiction is not something that can be "quickly fixed". MMT is best used as a long term treatment method and NOT short term. Studies show that 90% of pts that leave MMT in the first year will relapse.

The measures making up the Methadone Accountability Package address the illegal diversion of methadone from treatment uses; methadone use and highway safety; and accountability in government-sponsored treatment, including cost to taxpayers, open-ended treatment, overdoses and deaths.

Why are they not reading the studies done by SAMHSA that show most of the diverted methadone is coming from pts being prescribed methadone in pain management clinics and NOT the methadone coming from methadone clinics? Because it is far easier to blame those of us being treated with methadone for adddictions than it is to blame those being prescribed for pain mgt. The public would support punishing opiate addicts before someone who is just "in pain".

• Senate Bill 1293 -- Requires reviews for all methadone-related deaths, and development of best practices to prevent future deaths. (Senator Stack)
  
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• Senate Bill 1294 -- Creates the Methadone Addiction Prevention and Treatment Act, to provide for the safe use of methadone to treat heroin and other opiate addictions. (Senator Stack)
  
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• Senate Bill 1376 -- Implements diversion control and dosing standards. ("Karl’s Law" – Senator Eichelberger)
  
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• Senate Bill 1377 -- Establishes clinic standards to prevent methadone-related highway accidents. (Senator Eichelberger)
  
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• Senate Bill 1378 -- Makes it a crime to drive under the influence of more than the prescribed dose of methadone. (Senator Eichelberger)
  
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• Senate Bill 1382 -- Requires a narcotic treatment plan with a one-year limit with an additional six months if progressing toward a full recovery. (Senator Ward)
  

again, you can not put limits on opiate addiction treatment! They would never tell a doctor how long they can treat someone for diabetes or other lifelong illnesses.

• Senate Bill 1383 -- Requires individuals to receive methadone treatment at a clinic closest to their residence. (Senator Ward)
  
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• Senate Resolution 348 -- Directs the Legislative Budget and Finance Committee to complete a performance audit of the state’s methadone treatment and transportation program. (Senator Ward)
  

Senator Eichelberger noted that guidelines in Pennsylvania covering methadone clinics are found only in regulation.

"Pennsylvania’s law has not kept pace with the changes in the prescription of methadone---and too frequently with deadly consequences," said Senator Eichelberger. "Methadone is a drug with its own unique properties. One pill or one dose can kill a non- or low-opiate-tolerant person. Even a day or two after the drug is taken, it has lead to fatalities for those who mix alcohol or other drugs."

The National Drug Intelligence Center reported a 109 percent increase in the unlawful diversion of methadone from 2003 to 2007. The National Center for Health Statistics found that, from 1999-2005, the number of poisoning deaths involving methadone increased 468 percent, and the rate of methadone deaths in younger individuals (age 15 to 24) increased eleven-fold.

The increase in methadone use and abuse has also affected highway safety. The National Highway Traffic Safety Administration found that a single dose can cause reductions in reaction time, visual acuity and information processing.

"Pennsylvania needs better laws to prevent methadone abuse and provide patients with the proper protections and treatment plans they need to achieve a lifetime of sobriety," Senator Stack said. "This package of bills is a solid step toward achieving those goals."

Senator White noted a new program that placed reasonable limits on the distance the Cambria and Indiana Counties Medical Assistance Transportation Program may reimburse Medical Assistance recipients for providing their own transportation to methadone treatment. He said the approach could serve as a model statewide.

"We are just starting to see the results of the new program, but indications are
that both Indiana County and Cambria County will realize thousands of dollars in savings each year without reducing treatments or placing an undue burden on their clients," Senator White said.

CONTACT your reps and tell them that you oppose the METHADONE ACCOUNTABILITY PACKAGE. Here is the contact information.

Contacts:
(Senator Ward) Vicki Wilken (717) 787-6063
(Senator Eichelberger) Lee Derr (717) 787-5490
(Senator Stack) Elizabeth Rementer (717) 787-5166
(Senator White) Joe Pittman (717) 787-8724


http://www.pasenategop.com/news/2010/0510/ward-052610.htm

Prescribing methadone in open-ended treatment has been shown to not only help and support the patient in order to return to society as a productive community member, it ALSO PROTECTS SOCIETY by making methadone affordable and addicts less motivated to commit crimes. (Addicts taking methadone are not likely to rob a pharmacy or business to support their habit). Many return to the work force as productive, law abiding citizens.

Well, all we are going to get from our wealthy old senators is some public safety lip service, while his constituents all complain about where to open maintenance clinics ( NIIMBY- Not In My Back Yard).

Most politicians picture methadone patients as bums wearing long coats as we warm our hands; with filthy sleeveless gloves, and taking slugs of concealed flasks of whiskey and Wild Irish Rose. (well, I only wear my homeless outfit once a week now, instead of every day)

We have to face it. Without good lobbyists our maintenance treatment will slowly get legislated away. State governments will make prescribing the drug so difficult that doctors will just stop prescribing it.

I have been sober for close to a year. My clinic helped me to save me. When I went to the clinic I was ADDICTED TO 4 DIFFERENT SUBSTANCES. Now I take Methadone, I am productive and take care of my kids, and I no longer take street drugs, alcohol or any other mood altering substance.

-Chris

Addiction service to be audited by Pennsylvania

from the Pittsburgh Tribune-Review
http://www.pittsburghlive.com/x/pittsburghtrib/news/westmoreland/s_688460.html


By Bob Stiles
TRIBUNE-REVIEW
Thursday, July 1, 2010


An audit of the state's methadone program will be done in time for lawmakers to consider changes to the program before putting together the next state budget, a senator said Wednesday.

On Tuesday, in a 33-17 vote, the Senate passed a resolution that calls for the Legislative Budget and Finance Committee to review the taxpayer-funded methadone program. The resolution, which was introduced by Sen. Kim Ward, a Hempfield Republican, calls for a report to be made back to the Senate within 150 days.

"We'll be able to get the information, get the facts on where to make our decisions to cut waste," said Ward, a critic of the methadone program. "The taxpayers need to know where their money is being spent."

Ward and other lawmakers are considering legislation that could bring changes to the methadone program.

The program under review serves those people who are on public assistance and usually receive the synthetic narcotic for treatment of opiate addition. The use of methadone is increasing, as are the number of clinics dispensing the drug, because of a nationwide increase in heroin use.

The audit will focus on a few areas. It will determine state costs to dispense methadone. The review will examine the average time that a person is on the drug and whether methadone is used as part of a treatment plan aimed at recovery or as a maintenance plan.

The analysis will look at the costs taxpayers shell out for methadone users to travel to clinics and will review how other states handle their methadone programs, Ward said.

Methadone users involved in the state program either receive a reimbursement for use of their private vehicles, at a minimum of 25 cents per mile, or receive rides through public transportation, according to the resolution. Both state and federal funds are used to foot the transportation tab.

A Tribune-Review analysis in April showed that 15 percent to 50 percent of the medical assistance transportation program funds that come to Westmoreland, Fayette and Indiana counties typically covers methadone transportation.

Ward requested some of the information sought in the resolution from the state Department of Public Welfare, which oversees the methadone program.

Ward said she was informed by the welfare agency that in fiscal year 2008-09, methadone cost the state $42.48 million, but she said she did not receive figures for the transportation costs.

"That's why I sponsored this resolution," Ward said. "We're going to get the numbers on our own."

Hi Ruthann
I want to thank you for the Information you have given. This is a very scary thought, or even so, if They take away MMT, I have been on the MMT for 4 yr's and when I first went there I was a mess, My mind was on drug's" For Instant" My husband went first to the MMT, when he came home he had told me all about it, before my husband got to continue to talk about the MMT, I said can you get me a bottle of the methadone, I was not in reality, I was really Lost in my mind and body, I thought my husband could go up there and bring me some home, Like I said I was in bad shape, and so was my husband, But not as far w/the mind, Thank God He took me that same day up to the Clinic, and I looked Horried LOL, Anyway's I knew I was in because the doctor had told my husband to bring me there, The Doctor is very smart and Explain thing's to me, He also ask me when was the last time you used? Anything? Hydro's Darvocet's? etc What? I told the truth I said I had taken 4 Darvocets, which did help alil, BUT I understand it wouldn't Help me get out of the rutt I was in well The doctor said since u used today I cannot dose you till tommorrow, I was like darn, But I was in, and that was the good Part, I couldn't wait till the next day, anyway's 4 yr'slater here I am, Detoxing off the methadone, my choice, But I know it saved my family, My husband, me and our son who was 13 yr's old at the time,My oldest son is in the Marine's, anyway's, I was on at 1 time 190 mg's because I took my seazure med's, I didn't like being that high up, so I got to 160mg, anyway's at 145 mg's I started comming down 5 mg's a week, Today I'm on 57 mg's and I figure I come down 3 mg's a week, I'm thinking if I do it this way Once I am Completly off it won't be such a shock to my body, I would love to hear your advice on that if you don't mind, I know we all r different n all, But I do like to hear what other's think, I met this 1 lady and she had told me a good way to come off methadone safe and fast, ok This is how it go's, Let's say someone is on 100 mg's of methadone, you go down 10 % of what you are on so 100-10%=90, then 90mgs -10%=81, and so on, so if I was on 60mg's I take away 10 % which = 54mg's, So a easy way if you don't know math Like me My husband explained to me, Ok let's say I'm on 50 mg's you would - 5 mg's, 60 mg - 10% = - 6 Mg's from 60 which leave you on 54%, Anyway's I myself didn't go that route ONLY because I am concern of my body being shock once I am completly off, So can you let me know, if you heard of this way, also doing it my way from 60 mg's I won't do the Yo-Yo thing, because my goal is ONLY going down, My husband Jump off at 5 mg's But he didn't have the health Insurance anymore, because his income, is a few dollar's off the cost of living, I am gratful I have the State Insurance, Anyway's Ruthann Thankyou very much for sending me Information, PS do u know anyone that go's into the Chat Log? and if so what time? Have a great day My friend, Hug's Sincerely Sammy.

Sammy,
Way TO GO girl! You are doing really well on your taper it sounds like and you should be proud of yourself. There really is no "set" way to taper. There are several methods that can be used but ultimately it is going to depend on you and your body and your tolerance for w/drawals. The goal is to do it with as minimal withdrawals and possible, but sometimes it doesn't always work that way.

My only actual experience w/taper is when I was pregnant and trying to get down for the birth of our son. At the time they would take me down 5mg every 1-2 weeks, but again, that was during pregnancy so there are different things going on and problems that could arise, not to mention that pregnancy taper or regular taper, each person is going to react differently.

If the method you are using now seems to be working good, I would continue on like you are doing. I do want to caution you about a few things though.

The first being that once you get down to about 45mg or less, things usually become considerably harder. I have heard numerous ppl say that they got down to about 5 or 10 mg and then they couldn't seem to go down any more or that it was considerably harder to go any further. Some ppl have even said that after getting to 5mg they never could seem to go any further than that or had a VERY hard time if they tried. When I was doing the taper during pregnancy, 35mg was as far as I could go and even then I struggled and craved. I wanted so badly to get down even further because I wanted to do what was best for the baby but I realized I was doing more harm than good if I was subjecting myself to possibly using because I got down too low and my cravings and/or w/drawals got to be too much.

Second.....DO NOT be discouraged if this type of thing should happen to you and don't be afraid to tell them at the clinic that you are struggling. This is not an easy thing to go through and you have done so well getting to this point so don't throw it away because you are dissapointed that you are struggling or can't go any further for a bit. Sometimes you may have to stay at a certain mg for several weeks before going down again.

Third......WE ARE HERE FOR YOU GUYS! No matter what, good, bad or ugly we are here for you. If you need to talk and you don't want to post something, send me a private msg and I will get back to you. If you want to talk on the phone, send me your number and I will be glad to call you. Just know that we are here for you to help in any way and we would never judge you or make you feel bad if you are having a hard time.

Something else to consider trying, I have heard some ppl say they did a "blind taper" at their clinic. They would go down on a regular basis on their dose but wouldn't know what day it was being done. So lets say they are tapering you 5mg every two weeks, you would stop being shown your dose before taking it (or whatever verification method your clinic usually uses) and that way you wouldn't know what day it was that the decrease was actually taking place on. Some say it is easier to manage when they don't know that they have been decreased on so that may be something to consider.

Again, there is no set in stone method to a taper. It has to be what is comfortable for YOU at a rate you are ok with. Don't let anyone else hurry you along or make you take longer than you want and most of all, don't be discouraged if it comes to a period where you have to slow it down or stop decreasing all together for another week or so and don't be afraid to reach out and let them or us know you are having trouble if it comes to that.

take care!

The fact that they would even speak about stopping open ended treatment is ludicrous! Wouldn't they rather have all of us addicts getting help instead of breaking into their houses to steal to support our addictions? (I've never done that but i was just using an example). And i LOVE how they talked about methadone related car accidents. 3 years ago my husband and daughter (3 months old at the time plus she was a preemie) and i were driving home from getting groceries when a car crossed the center line and almost hit us head on. My husband was able to get over enough to avoid a head on crash. The guy hit the drivers side rear door and bent the frame and stuff all to hell. We had a 2004 GMC sierra and this was a 2007 impala that hit us. He hit us so hard it totaled our truck. He kept rolling down the wrong side of the road and through people's front yards til he hit an ameritec phone box and came to a stop. I went to check on him. It was an elderly man (I later found out he was 84). He was shaken and incoherent. He didn't know what had just happened or that he had caused an accident.
We all went to the hospital where the old man was treated for minor injuries (My baby was perfectly fine. she got hungry after a while lol). I overheard the man telling the doctor that he just recently started taking coumadin, which is a blood thinner. the doctor was guessing that he had some sort of reaction to it and it caused him to black out or pass out. That COULD have been a deadly accident if he would have hit someone with a small car. I'm thankful he hit us because we had that big truck and no one was killed.
My point is that accidents happen and they can happen no matter what kind of medicine you're on. I think it's ignorant to single out methadone and it kind of makes me feel like they're singling out us addicts in general.

Unfortunately this is happening more and more. I read an article the other day about Tennessee, I will see if I can find it and post it for you to read. It's crazy.

I did find the new article that I was talking about and have posted it here:
https://methadone.forumotion.net/t962-which-state-will-follow-new-rules-for-tennessee-methadone-clinics#2099