Long-term methadone use is form of ‘State-sponsored social control’

Some addicts had been on the methadone treatment programme for 20 years

Dispensing methadone doses. Photograph: Eric Luke

Maintaining drug users on the heroin-replacement drug methadone is a form of State-sponsored social control that substitutes one addictive opiate drug for another, the head of one of Dublin’s biggest drug-free rehabilitation projects has said.

Irene Crawley, director of the Hope project based in the north inner city, said some addicts had been on the methadone treatment programme for 20 years.

“The irony is methadone is an opiate like heroin and you’re addicted to it,” she said.

Dispensing methadone doses. Photograph: Eric Luke

“It is just as hard, if not harder, to come off it as it is heroin. It was only ever intended for short-term use – to detox people and get them stable.”

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She said if methadone were used in that way, those in treatment “would not appear stoned” and would become stable and be in a position to work and re-engage with their lives.

“But the problem, in my experience, is that people are going and getting methadone in clinics but they’re also taking other drugs. Especially tablets; benzos. The streets are awash with benzos, zimmovane.”

She said a negative street culture had grown up around the HSE-run clinics, where methadone was dispensed daily to drug users registered with the State’s methadone treatment programme, or protocol. “For someone who wants to get clean, it’s very difficult. They’re going down to the clinics, congregating there. They’re bringing their children in prams, they’re selling tablets.”

The Garda conducts frequent operations, especially along the boardwalk on the north side of the river Liffey, to prevent drug deals and the bartering of drugs.


Negative cycle
However, Ms Crawley said it was inevitable that people would become trapped in a negative cycle if prescribed a heavy, heroin-like drug long-term by the State for the full span of their adult lives.

“It’s basically saying ‘you will go this far, but no further; this is all you are capable of’. It’s telling people ‘there is something deficient in you, you are not capable of living a normal life like the rest of us, you have to stay medicated’.”

Ms Crawley was speaking to The Irish Times on the occasion of the 10th anniversary of Hope – Hands-on Peer Education. It is based on Buckingham Street, Dublin 1, at the centre of the area hardest hit by the heroin problem, especially in the 1980s. Hope is underpinned by an ethos of clients becoming completely drug free.

Clients are supported in a positive environment and offered places on courses in areas including literacy, computer skills, returning to work and personal development.

Ms Crawley said she was not criticising staff who worked at clinics where methadone was dispensed. They were “doing their very best”.


'Tied' to methadone clinic
"What's wrong with the clinic is that you are tied to that clinic," she said. "You can't go on holidays. You have to take drug screening tests all the time. You have to be at the clinic all the time. You are tied to it. It's not freedom."

Coming off methadone had been an “awakening” for some of her group’s clients. “They’re fully in touch with their feelings, with their senses. They feel free; it’s freedom from active addiction. They’re no longer tied to doctors, clinics, prescriptions, medication. Methadone is a heavy medication, it’s an opiate. It dulls your senses.”

Ms Crawley added: “Some of our clients have gone on to do things like get PhDs and become solicitors.”

She said there was a system in place of testing the urine of people on methadone for signs of illegal drugs. But in cases where addicts were found to be using other drugs, there was no additional support offered to aid their recovery. “What they do a lot of the time with [people testing positive] is that they raise their level of methadone.”

Conor Lally

Conor Lally

Conor Lally is Security and Crime Editor of The Irish Times