Methadone Clinic Paperback – July 8, 2005

Methadone Clinic provides a glimpse into the darker, seamier side of heroin addiction and methadone clinics. Although the author, David Steier, said he has worked as a methadone clinic counselor, he does not claim this book is non-fiction. The New York methadone clinic discussed in the book primarily serves heroin addicts, with very few chronic pain patients. The heroin addicts, in this book, have almost no interest in becoming addiction free and are mostly dishonest, manipulative, inconsiderate, abusive and profane. The addicts realize that they will not be denied treatment, despite disobeying clinic rules, since clinic methadone prevents them from committing even more crimes, to obtain more expensive, illegal black market heroin.The book overflows with profanity, which will offend some readers. The author, David Steier, describes how he frequently offered cigarettes to patients and how he smoked cigarettes, with patients, in his counselors office, with methadone clinic patients. Offering patients cigarettes would be prohibited, by most counseling programs, which would also prohibit cigarette smoking, on the premises.Problems with methadone and other drug dealing, on and adjacent to the methadone clinic, are given a face, by descriptions of counselors being required to patrol the immediate neighborhood and facility grounds, and patients being prohibited from "loitering," in the vicinity of the methadone clinic. You would not want this methadone clinic in your neighborhood.The underqualification, lack of education and experience,low pay and high turnover of methadone counselors are described, along with the ineffective supervision, lack of support and extreme pressures they face from management and patients. This book puts a human face on the abusive client and how they abuse and manipulate counselors.The low pay and high counselor turnover, at Methadone clinics helps explain the following alarming information:149 staff in U.S. methadone clinics were surveyed about their knowledge of methadone toxicity. Only 14% knew that a methadone maintenance patient's risk of dying was highest in the first two weeks of treatment, and only 15% knew that starting new maintenance patients on daily doses of 30 mg. to 40 mg. of methadone could be unsafe. (Maxwell, J.C., Pullum, T.W. & Tannert, K (2005).Deaths of clients in methadone treatment in Texas: 1994-2002. Drug and Alcohol Dependence, 78(1), 73-81).There appears to be no justification for the low pay and shortage of counseling and medical staff, at Methadone clinics, since the clinics appear to be highly profitable, with profits reported, from 16 to 50 percent of revenue, after taxes. CRC, treating over 20,000 methadone patients daily, reports daily profits per Methadone patient of $10.91 to $11.07.This book mostly overlooks chronic pain patients, who are not abusing clinic methadone and may need methadone pain treatment, until they receive more effective pain treatment, with transdermal prescription pain creams, electroauriculotherapy, prolotherapy, or effective treatment of Lyme Disease, Lupus, fibromyalgia, Bartonella, Babesia, migraines, etc. These pain patients tend to be honest, self supporting, contributing members of society, to the extent their disabilities allow them to be. Without talking to the author, it is unknown whether his methadone clinic had patients like this or whether almost the entire caseload consisted of heroin addicts.Since this is a novel, it is difficult to determine if some methadone clinics are as horrible, as the one described, in this novel. A very grim, depressing picture of methadone clinics is portrayed, in this novel.I am rating this book a 2, since I feel it may portray a more negative picture of methadone clinics than they deserve. If the author is a whistleblower and some methadone clinics are this terrible, the book deserves a 4.Steven Sponaugle

This is a completely inaccurate portrayal of a methadone clinic. I was almost immediately appalled by the way the author described some of the characters. I kept reading hoping to find some redeemable qualities only to find out it ended up being a narcissistic rant about his own judgmental experience.

Not a very interesting book. I'm still wondering if it had any kind of plot??

This book is EXACTLY how a methadone clinic runs on a daily basis...it is exactly how the people who work and operate the clinic act and are~ their lack of education described in this book is " Right on " totally correct ~ I felt I was reading something someone had written that was at the clinic downtown!

A sophomoric effort, with no clear story in sight. One dimensional characters, with no redeeming values. A wasted read.

A completely ignorant and judgmental loAd of shite. And form someone who claims they were a counselor this is alarming. He has taken every single possible aspect that can go wrong and amplified it and made a very innacurate picture. Do not use this book as anything but a fake story. And please do not judge methadone Maintenence on its portrayal. For instance at my local, there have only been a few patients like the ones described in this book, and they are always expelled quickly for lack of progress. For the most part the people at the clinic are stand up members of society, I am a patient myself studying to become a counselor, I am a patient with police officers, nurses, school teachers, grandparents, young mothers who are doing all they can to give their babies a good life free of their addiction. You can not just act the way people in this book do, and stay a patient (or counselor) for very long. Methadone saves lives, and you would be surprised who in your life is on it. Things like this book only serve to push myths and stigma and ignorance about methadone that is keeping out of the hands of those who will die without it. And from a supposed "counselor" that is even more worrying. Please quit your job.