Expert: Peter L. - 11/4/2009

Question
My friend has been sober from heroin for two years (in jail).
She is getting out in two months. She said she is afraid of using again and said she wants to go on Methadone for a while.
Is this a good idea?

Answer
I would first advise her to get some relapse prevention counseling immediately after she gets out.  That could be individual counseling or in a group.  She could also enter an intensive outpatient treatment program if she has a lot of cravings that are threatening relapse.  That's what she should do from the counseling end in my view, which is just as important, if not more so than the medication assistance you're speaking of.  In that regard, she has two choices: Methadone or Suboxone.  But, not being a recent user of opiates (heroin) she might not be considered appropriate for either.  Nevertheless, if I were her I'd check out if she can be prescribed Suboxone.  Methadone is a more heavy duty drug and very addictive.  Also, it cannot be given by an independent physician, like Suboxone can.  Methadone is dispensed (at least in my area of northeastern US) by a methadone program.  Suboxone is overall an easier process and very effective with little of the downsides of Methadone.

Best,
Peter