Expert: Jacqui - 11/19/2008

Question
My son got addicted to methadone on the street - has never even tried heroin.  He began going to a methadone clinic earlier this year to get it under control but requested inhouse treatment to get off of it completely. He is currently detoxing from methadone at an inhouse clinic.  When he entered on 47 days ago he was at 140 mg and is down to 50 mg as of last week.  He also began having panic attacks about a month before he entered treatment and was prescribed Ativan and Valium.  So he is currently taking all three medications. The treatment center is telling him that they will not decrease his methadone any further - i believe because he is taking the other meds for the panic disorder.  any suggestions ... is there another med he should be taking for the panic disorder?  he prefers to get off the methadone first and then try to stop the other meds.  what are your suggestions?  i to at least be able to suggest something ...

Answer
Hi C,

You have probably asked the wrong person about taking medication for panic disorder.  As a trainee clinical psychologist I would recommend that he engage in psychotherapy for the panic disorder.  I do worry about the over use of benzos (valium, etc) because they are addictive and when people get a tolerance to them, the side effects are ... guess what ... increased anxiety!  So, they are much better as short term treatment option.

I am interested whether he suffered from panic disorder before the methadone dependency.  If not, then I would wonder about the diagnosis and if it is perhaps more related to methadone withdrawal.  I understand that he wants to come off the methadone, and this isn't impossible, but I would strongly suggest some kind of supportive (non drug) therapy as well.  

Hope this helps.

Jacqui