Reader challenges columnist’s views
Regarding “Trading one drug for another doesn’t equal recovery or freedom” (April 8), one can only wonder upon what evidence Steve Wildsmith relied when he expressed the opinion and belief that medication assisted treatment for opioid addiction is trading “one set of chains for another.” His opinion is diametrically opposite to that voiced for many years by the U.S. National Institute on Drug Abuse and the Center for Substance Abuse Treatment (CSAT), as well as the Institute of Medicine, World Health Organization (WHO), the U.S. Department of Health & Human Services (DHHS), the Centers for Disease Control (CDC), the American Society of Addiction Medicine (ASAM) and countless governmental, clinical and academic authorities throughout the world.
I have to wonder how many "facts” Mr. Wildsmith actually knows about methadone. Does Mr. Wildsmith know that the treatment of opioid addiction with methadone is one of the most strongly evidence-based medical treatments in all of medicine? Does he know that we have over 40 years’ of studies that show the treatment of opioid addiction with methadone reduces overdose death rates and suicide rates? Does he know it improves employment rates and dramatically reduces crime rates? Does he know addicts treated with methadone have better physical and mental health? Does he know that for each dollar spent on methadone treatment, taxpayers save $4, mostly in reduced incarceration costs? Does he know that methadone treatment of opioid addiction significantly reduces the incidence of HIV and HCV in intravenous opioid addicts? [1,2,3] Lack of knowledge about methadone does not prevent people in positions of authority, unfortunately, from taking a strong stance against it.
East Tennessee probably has more untreated opioids addicts per acre than anywhere else in the nation. Tennessee has the 13th highest opioid overdose deaths per capita, compared to all other states, and is ranked No. 2 in the kilogram of opioids prescribed per capita.  Of course, all forms of treatment that offer help and hope should be supported to the greatest extent possible, whether they are abstinence-based or utilize medication, residential or outpatient, short-term or extending for months or years.
However, cost, accessibility and affordability put most non-methadone treatment out of the reach of the vast majority of opiate-dependent individuals. Accordingly, rejecting maintenance treatment means abandonment for most who want and could benefit greatly from help. And abandonment, in turn, not only can mean a death sentence for those dependent on drugs, but is a policy whose costs are borne by every member of the community. If we profess to be people who believe in science, medicine and facts the acceptance of medication assisted therapies is non-negotiable. It’s time we accept the reality that “just say no” is not an effective policy in dealing with medical and social problems.
In solidarity with truth and hope,
Zac Talbott, Director and Patient Advocate
NAMA Recovery of Tennessee
National Alliance for Medication Assisted Recovery
4522 Rocky Branch Road
Walland, TN 37886
 http://international.drugabuse.gov .pdf
 California Department of Drug and Alcohol Programs, 2004, California drug and alcohol treatment assessment (CALDATA) California Department of Alcohol and Drug Programs. California Drug and Alcohol Treatment Assessment (CALDATA), 1991-1993 [Computer File]. ICPSR02295-v2. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2008-10-07. doi:10.3886/ICPSR02295
 http://www.asam.org -policy-statements/1methadone-rev-10-061. pdf?sfvrsn=0#search=”methadone
 http://cdc.gov 6043a4.htm?s_cid=mm6043a4_w