Q. Is being prescribed methadone or suboxone considered being clean, even though they are addictive, abusable substances?
You’ll get different answers to this question from different people. Generally the division lies between those who are on maintenance drugs and those who are not. Both sides of the discussion have their valid points. However, I believe you answered your own question when you used the expression “addictive, abusable substances.”
The consensus among most professionals and recovering addicts is that “clean”, when used in the context of recovery, means drug-free. Having all mood-altering substances out of our systems is necessary before the changes that addiction creates in our brains can be repaired. As long as drugs that modify the reward system (which includes all recreational drugs) are in our bodies, repair and normalization cannot begin. When we are on Suboxone or methadone maintenance, we are still addicted¹, and our brains are essentially in the same condition as when we were actively using other opioid drugs. It would seem to be pushing things to call us clean.
That is not to say that there are no benefits to drug maintenance programs. To the extent that they allow people to cease other drug use and begin to take care of themselves and fulfill their responsibilities, they have some validity. The problem is that the addiction remains in full force, and relapse — whether to other drugs or simply recreational doses of the maintenance drugs — is only a hair’s breadth away. Adherence to maintenance programs rests squarely on our willingness to continue to follow them. That is an extremely dangerous place for an addict to be.
Here at Sunrise, we believe that the proper uses of these drugs are as short-term substitutes for the drugs being abused, with a relatively rapid taper to a completely drug-free condition. If we wanted, we could easily become licensed to provide maintenance services. However, we do not believe that is in the best interest of our patients, their families, and the other people in their lives.
¹If you don’t think we remain addicted on maintenance doses of opioid substitutes, just try quitting. Both Suboxone (when used for long periods) and methadone have withdrawal syndromes that are worse than the drugs for which they’re being substituted. Truth.