CT experts: Methadone ‘works’ to save lives, as fentanyl use becomes more prevalent

CT Insider – Thursday, January 2, 2025
By Emily M. Olson

TORRINGTON — Many who are addicted to narcotics and opioids can’t envision a life without drugs. But those who provide treatment for addictions say those people can find recovery, as long as those who are helping them don’t give up.

Methadone, a drug used to curb the cravings of opioid abuse, is the most commonly-used treatment, giving people with substance abuse disorder a chance to break away from their addiction.

“Sometimes when a person comes to us, they’ve taken the courageous step in the beginning, and then they go back to using drugs again,” said Maria Coutant Skinner, executive director of McCall Behavioral Health & Wellness in Torrington. “It’s difficult, especially the treatment they need, and it can take a long time to stabilize someone’s opioid use disorder.”

Fentanyl, a powerful and dangerous drug, dominates the street drug market in greater Torrington, according to Lauren Pristo, director of community engagement at McCall. She leads the Litchfield County Opiate Task Force, a collaborative team of caregivers who help people with substance abuse disorder find help.

Those who choose fentanyl, said Skinner, are dealing with a drug so potent that it makes their opiate use disorder even more dangerous. That’s where methadone comes in.

“It can take a long time to stabilize someone’s opioid use disorder. So they’re taking steps to stabilize themselves, but with fentanyl being so potent, it’s very difficult to transition to a point where they’re comfortable,” Skinner said. “It’s a slow process, finding the correct dose (of methadone). What we find is that a lot of times, people starting out in a methadone treatment program still have to supplement themselves with illicit substances, so they don’t feel sick. … We don’t want them to go cold turkey.”

Drugs and stigma

Methadone “works” when treating someone addicted to opioids, but the biggest hurdle in the treatment option is the stigma often associated with substituting illicit drugs with a legal medication, according to the leading public treatment specialists in Litchfield County.

“In all my years working here, the deadliest component of addiction is shame,” said Skinner. “It’s the deadliest part, because it drives people to use drugs alone.”

Leah K. Walker, with the American Addiction Centers, writes that people feel judged or criticized for exchanging an illicit opioid drug for a prescription.

“Unfortunately, people on methadone have reported stigma from friends, health-care workers, and the general public, mostly accusing them of taking methadone as a way to get high or substituting one drug for another,” Walker says in her blog, “The Stigma of Methadone Treatment.”

“Other people report accusations of being weak, of being told that they should be tough and use abstinence-based treatment only. Others report being told that their substance abuse is a choice and that they should get through recovery without assistance. Sadly, many people report that this stigma led them to delay getting methadone treatment. This stigma can also lead people to be reluctant when seeking treatment for addiction,” she says in her blog.

Walker reported that when a person uses an opioid, such as heroin or oxycodone, their dependence on the drug grows over time; once they are physically dependent and try to stop, they can go into withdrawal, with symptoms such as nausea, vomiting, chills, fever, sweating and muscle pain.

Methadone has been shown to be an effective and safe treatment, especially when used with counseling, according to Walker. Medication-assisted treatments are also associated with lowered death rates, as well as less involvement in criminal activity, longer treatment stays and higher rates of employment, she said.

Skinner, with a 26-year career in the field of treatment, said McCall’s clients report the same challenges of painful withdrawal. Although a daily dose of methadone or suboxone can reduce a person’s dependency to opioids, switching from daily use of heroin or fentanyl to a prescription still keeps many from seeking help that could change their lives, she said.

“(Methadone is) the longest-standing medication for opioid use disorder,” Skinner said. “It works, and it helps.”

How it works

Methadone, developed in Germany in the late 1930s and approved for use as an analgesic in the U.S. in 1947, has been used in the treatment of opioid addiction since the 1960s.

A longer-acting opioid drug, methadone is used once daily to replace the shorter-acting opioids such as heroin, oxycodone, fentanyl or hydromorphone, which people with addiction often use three to four times a day, Skinner said. The difference is, methadone quiets the craving, but doesn’t get a person “high” the same way an opioid does.

Methadone is part of a larger process in a person’s journey to recover; Skinner said a person’s level of success is measured by their ability to get their life back in order, not becoming “drug free.”

“If you’re only thinking about using, how can you move forward?” she said. “If you get into treatment, we can get to the root causes of substance abuse disorder, and help a person begin healing. Methadone can help them stabilize themselves so they can focus on that healing process. It can take a long time, but it works.”

The task force can help

In the greater Torrington community, the work of preventing drug overdoses and getting those with drug addiction into treatment is led by the Litchfield County Opiate Task Force, a collaboration of paid facilitators and volunteers. The task force was formed in December 2013 after “an alarming increase of overdose deaths in the local community,” according to the group’s mission statement on its website at lcotf.org.

The task force is led by members of McCall and Charlotte Hungerford Hospital, both based in Torrington. Its members represent behavioral health providers, medical providers, residents and their families, government officials, law enforcement, first responders, the faith-based community, social services, youth organizations and volunteers. Its goals are to improve access to care, address addiction in the community, and share information about addiction, prevention, harm reduction and treatment.

Pristo leads the task force, whose members go out into the community, and engage with people who use drugs. They provide them with clean syringes and wound care supplies, and coach them to find alternatives — mainly, a treatment program — to escape the often fatal consequences of substance abuse.

“The nice thing about what the task force has done, and what McCall has done, is that people can engage in treatment, using whatever’s right for them,” Pristo said. “The team is very well-trained, and prepared to help folks build up what we call recovery capital. If they enter a treatment program, they can focus on the root causes of their addiction, and the things that drive it. It’s finding out why they’re using drugs.”

Identifying the root cause of why a person is abusing opioids can’t be addressed, Pristo said, until a person has stable housing. Inpatient treatment puts the man or woman in a safe environment to begin that treatment. Outpatient treatment is also an option, so that the person can continue to work, live at home and be with their families.

“If they want inpatient treatment, they can find it,” Pristo said. “If they want to initiate treatment, they can go to the emergency room at Charlotte Hungerford Hospital. Then they’re referred to a case manager, and they can start suboxone or methadone.”

Trust and time

McCall works with the Root Center, a methadone clinic in Torrington, with patients who have taken that step toward recovery.

“Treatment used to be very restrictive, punitive, as far as daily doses of methadone. But since then, we’ve learned that some folks are successful with a trust-based process; by recognizing that continued substance abuse is part of that process,” Skinner said.

According to a study by health professionals including Yale epidemiology professor Robert Heimer, treating substance abuse disorder with medications is more successful than no treatment at all. The study, “Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17,” is a comparison between treated and un-treated addicts.

The study showed that methadone and buprenorphine, a synthetic opioid developed in the late 1960s that is used to treat pain and opioid use disorders, reduced the risk of death by 38 percent and 34 percent, respectively.

“However, non-medication-based treatments increased the risk of death compared to no treatment by over 77 percent,” wrote Heimer. “There are plenty of studies that show medication-based treatment is better than abstinence-based treatment. Now we can also say patients are no better off getting abstinence-based treatment compared to no treatment at all.”

Pristo agreed, saying, “Those who were prescribed a drug as part of their treatment are more likely to succeed.”

“As a society, it’s easy for us to blame someone for their own condition, rather than look at the society and how it’s lent itself to that outcome,” she said. “It’s harder for us to look within and reckon how our own culture and our society are making it harder on people.”

Success with treatment

Since 2022, agencies like McCall have seen a 27 percent drop in fatal overdoses.

According to state Department of Public Health data, 1,338 people died of a drug overdose in 2023, including 1,008 men and 330 women. In 2024, that number dropped to 563, with 387 men and 176 women. In Litchfield County, the number of overdoses in 2023 was 52; in 2024, the site reports 21 overdoses since January.

Pristo and Skinner attribute the drop in overdoses in Litchfield County to their partnerships with law enforcement and other agencies, the task force’s work, and the education and opportunities they provide.

“It takes a whole community,” Skinner said. “It’s still really tough because of the potency and the amount of drug supply out there, but we are unequivocally saving more lives than we ever imagined.”

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