If you or a loved one had a life-threatening disease and knew there were two types of medication available for treatment – one with serious risks and one without those risks – which would you choose?

I am writing to express my concern about the emphasis being placed on methadone treatment in our state. I realize that in years past, methadone replacement therapy has played a crucial role in treating opiate addicts. However, more recently, alternative medications have been developed, allowing individuals suffering from addiction to get the same relief from cravings without the many drawbacks of methadone.

Why would any facility, private practice or hospital continue to prescribe methadone – a drug that can be abused, is extremely difficult to detox from, and has a history of causing overdose deaths? Why would a state advocate for the continued use of one high-risk medication over another without these risks?

Suboxone is a drug that, like methadone, can be used to satisfy the body’s craving for opiates without producing a high. It also contains a substance that blocks the effects of other opiates, reducing the likelihood of relapse. Suboxone is prescribed for up to a month at a time, eliminating the need for daily visits to a methadone clinic. It has few side effects and is generally easier to discontinue than methadone.

But Suboxone is pricey – it costs $12 to $15 a day, while methadone treatment costs only a fraction of that. I am concerned this higher cost is hindering Maine’s transition from methadone to Suboxone as the primary replacement therapy method. I believe it is, in part, the job of providers, politicians and concerned citizens to make sure that the safest, most effective form of treatment be the primary resource available for those suffering from addiction.

Considering that addiction is a physical, mental and spiritual disease, the treatment of it must consist of several components. These include:

. medical interventions, which may include detox and opiate replacement therapy;

. support for developing coping skills, healthy attitudes and positive behaviors regarding drug use;

. education about drugs and the disease of addiction;

. ongoing involvement in a process that nurtures and encourages the development of the mental and spiritual self.

At Open Door Recovery Center, we have found that by combining these components simultaneously, many individuals have the opportunity to heal, focus and commit to both short-term and long-term recovery. Therefore, we contract with a local hospital and physician for outpatient detox, including the use of Suboxone, also known as buprenorphine, when appropriate. During this detox period, each client begins treatment in our Intensive Outpatient Program for 10 weeks followed by one year of “aftercare.” This process includes mandatory involvement in 12-step meetings with the support of an individual sponsor.

We require a minimum of two random drug screens per week and include as part of treatment the eventual tapering and discontinuation of Suboxone, because we believe that true freedom lies in having no drug dependencies.

Open Door has used this approach to treat opiate addicts for almost two years. In that time, our client load has tripled, and we have seen many individuals regain their lives and many families heal and reunite.

Barbara Royal, director,

Open Door Recovery Center, Ellsworth

Please join our weekly conversation about Maine’s substance abuse problem. We welcome comments or questions from all perspectives. Letters may be mailed to Bangor Daily News, P.O. Box 1329, Bangor 04401. Send e-mail contributions to findingafix@bangordailynews.net. Column editor Meg Haskell may be reached at (207) 990-8291 or mhaskell@bangordailynews.net.