Clinical diagnosis
I really appreciate the article on Addiction Recovery Services’ Pantops Clinic in your June 7 issue [“Road to recovery”]. I am writing to ask if you could note two corrections.
1) On page 22, the article states that the methadone program costs $500 per month (it should be $320 per month), but later on page 23 it is correct with the figure of $80 per week. I am concerned that addicts may be deterred from seeking treatment, or others may not make referrals to the clinic due to the high cost.
2) On page 21 it is noted that a starting dose “is so low (usually starting around 80mg…).” By State and federal law we start out at only 30mg. My concern here is that someone may read this and believe that 80mg is a low dose—that is a very high and potentially lethal dose for most people. Addicts, of course, have developed a tolerance to opioids and need the higher doses for maintenance. The initial dose of 30mg (or a total of 40mg on the first day) is enough to stop the progression of the withdrawal symptoms, but we will gradually increase the dose in increments of 10mg to achieve a maintenance dose. Our maintenance doses range from about 60mg to 220mg, but can be more or less.
Finally, although John Borgmeyer did a very good job of pulling a lot of material together, some of the information on methadone was misleading in that it does not produce a “high,” because of its slow onset of action. Methadone is an effective medication for opioid dependence because it stops the craving, stops the continued need for higher and higher doses, and allows the patients to function normally, by stabilizing the physical need for an opioid drug.
Mary Lynn Mathre
Executive Director
ARS Pantops Clinic
Charlottesville
Special delivery
After reading your recent article “Road to recovery,” about the use of methadone (which I fully support), I was disappointed to discover that you failed to mention in your list of conditions that release endorphins one of the very most important: laboring and lactating women!
Natural childbirth leaves regulation to the body’s own painkillers, endorphins. These natural hormone levels rise during active labor contractions and reach their highest peak immediately following delivery. Simultaneously, oxytocin, another hormone commonly referred to as the “love drug,” also aids the stimulation of the milk ducts and boosts bonding and interaction between the mother and child.
Unlike the narcotics often administered to women in pain, endorphins present during childbirth grant a more natural ebb and flow of feelings and original painkillers that the body has to offer. They are a perfect example of the human body taking care of itself. The release of endorphins during childbirth has long been studied among humans. The new data we have has radically changed the basis of debates, which were commonplace 40 years ago: Is pain during labor and delivery physiological, or is it the result of cultural conditioning?
Considering that the epidural rate in the United States is between 70 percent and 80 percent, and that our C-section rate is heading up to one-third of all births, and that we rank 27th in infant mortality, we ought to take notice of other countries and most of Europe, which have better infant mortality rates than the United States. Doctors are becoming more wary of being sued and really aren’t asking (or telling) anymore why they do things. They do things a certain way because “they have always been done that way.” Unfortunately, childbirth has become an illness that needs to be managed.
Finally, endorphins create no harm to mother or baby! Women ought to know the truth about this magnificent hormone that is intelligently built into our design. But this information regarding a women’s ability to manage birth normally is not made known in our mainstream culture. As a former drug addict myself, I cannot tell you enough how incredible the high was following the natural birth of my own daughter, in which I discovered a very valuable secret. To quote the writer Laura Stavoe Harm, “We have a secret in our culture, and it’s not that birth is painful. It’s that women are strong.” All said, nothing compares to my own personal meth lab.
Michele Wheaton
Afton
CLARIFICATION
In last week’s Government story [“Big hole to fill”], City Council was reported to be concerned about the escalating price tag for the bus transfer center, now $4 million over budget. We did not mean to imply that the Pavilion, a project that adjoins the bus transfer center, is over budget.
CORRECTION
We misidentified the subject of last week’s Big Picture. It was actually Evan Smith who was testing the voting machines at City Hall.