efficacy and ethics or morality what is your own personal viewpoint on the efficacy and ethics or morality of using chemical substances in the treatment of opioid dependence.
There is something to be said for going cold turkey; many people report that after going through withdrawal pains, they are able to resist cravings in the future because they don't want to repeat the withdrawal. However, others cannot overcome their own desires -- Mind over Matter can only do so much. I myself think that if one is determined to get off drugs, they have the power to do it entirely by themselves, but I realize that not every person has that depth of personal resolve, and so chemical methods become a useful tactic. (I have not ever had to go through this myself, so I cannot say if I would have the resolve to quit.) I also know a few people on methadone who are not addicts, but use it to control pain instead of the more addictive opiates.
In any case, I don't have a problem with "medically-controlled" drug therapy to remove addiction from a more harmful drug. The only way it would be ethically wrong is if the controller (dealer) deliberately uses the therapy to keep the patient dependent.
I think doctors are ethically bound to help their patients. The Hippocratic oath states "and first you do no harm." If these chemical substitutes are proven to be harmful, then of course doctors shouldn't use them. Currently, this is not the case. These chemical substitutes are often the only way to help a patient. Drug addiction is an extremely difficult thing to break. Many patients wouldn't be able to stop taking drugs like opiates without specific treatment. Doctors must weigh the side effects of the substitute chemicals against the side effects of the patient continuing in a drug addiction. In most cases, the chemical substitutes are a far better option than addiction.
As stated by #3, it is surely better for a person to have chemicals administered using sterile equipment in a doctor's clinic that do not have any proven side effects other than the fact that a person could get addicted to them.
Also, it is essential for the doctor to educate the patient that the medication they are being given is not a substitute for the drugs they took earlier. It is only being used to reduce the withdrawal symptoms and make it easier to quit. It wouldn't be incorrect to say that a patient who is eager to give up his/her addiction and has decided to take up treatment for it will understand and not trade one addiction for another.
When administered by a professional, doses can be controlled, and individuals aren't left to manage their addiction on their own. I think the important point was made in post #9. These drugs are not substitutes, but used to ameliorate the withdrawal symptoms. My suspicion would be that individuals recover from addictions in different ways, and that "cold turkey" is not for everyone. It would be tragic, and I'd argue unethical, not to make treatments available if they could help people overcome a terrible disease like addiction.
It makes sense to use drugs like methadone to combat a dependency on opioids such as heroin. It may seem that giving someone drugs is immoral, but we have to think about what is worse for the person. If the person is going to go out and take drugs that are really harmful in an uncontrolled way, it would make more sense for us to give them a drug that is less harmful and to do so in a more medically controlled way.
I agree with the other posters and the stipulations which parallel the use of chemical substances to treat opioid dependence. When examining this issue, one must consider which is "the worst of two evils." To combat addiction, sometimes other medications/substances are required to help the addict. If the new medication/drug is taken correctly and not abused, I see no moral or ethic problems with the treatment.
My own view is that if chemical substances are effective and safe in the treatment of opioid dependence, there is no ethical or moral problem in using them. Of course, that is a huge "if," and I have not explored the issue sufficiently to know whether either of those conditions can be met. It's hard, however, to imagine few addictions worse that opioid addiction.
Therein lies the key - "in a more medically controlled way." If drugs can be given that will support an addict to reduce and eventually overcome the dependence upon the illegal substance, I see no ethical problem with the provision of the drug. Of course, if the user becomes addicted to the substitute drug, that condition may then require attention.
I agree with other editors. At the end of the day, perhaps what needs to be considered is what will be the best for the patient. The use of methodone and other such substances enables addicts to combat addiction more successfully than just going cold turkey, and therefore it is something that we should support.