Why won’t they let me off methadone?

Readers Question Readers Question: (Name changed for privacy)
Stanton Peele Response by: Dr. Stanton Peele
Posted on February 18th, 2010 - Last updated: January 31st, 2014
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Guest response by Robert Newman

Further Reading

Dear Mr. Peele,

I was addicted to H for about 3 years. Then I knew it was time to get off the train, so I got on methadone which worked well for me. I have been clean for about 2 years, nothing but methadone, I’m still on the methadone and I have been slowly decreasing my dose because I want to get the hell off methadone now. Soon I will be completely drug free and I will do it. The problem is that I am running into major resistance from the clinic. I have a private doctor also who supports my wanting to get off methadone. It seems now the only people who want me to remain on methadone are those at the methadone clinic. They are refusing to take my dose down for no reason, they say going down 2 mg a week is against medical advice because it is too much of a decrease. (If you miss a payment they will immediately take you off going down a harsh 5-10 mg a day until your on 0.) I could just use this method by just not paying and they will automatically take me down immediately, but 5 mg a day is too much too fast of a decrease for me.

Is there any action I can take? I have been pleading with them for months to no avail. There are no medical doctors in this facility only medical assistants. What do you think I should do? When I’m off methadone I’ll never use again. I hate drugs so much, they ruined my life, but methadone served its purpose but now it’s time to get off the methadone. How could any clinic in their right mind want to stand in my way on the road to total sobriety? I think its money, and that angers me quite frankly. Do you know if there is anyone I can call to put pressure on them to take me down.

Thank you,

This answer is provided by Dr. Robert Newman, of Beth Israel Hospital. Stanton notes: Observe that strict adherence to informed consent is outlined by Dr. Newman – why does this not prevail in general in the addiction treatment field, where so much treatment is coerced?

Dear Frank:

The story, as presented here, is an outrage. Patients retain their autonomy in this as in all treatment of disease and can decide whether and when to discontinue treatment, regardless of the physicians’ views. If the physician explains that the patient’s decision is in conflict with medical advice, fine – then have the patient sign an AMA form and get on with the detox. The consent to proceed AMA can be in terms as stark as the physician feels appropriate: e.g., “I have been advised that proceeding with detoxification at the rate I am requesting has a high likelihood of relapse, and that it can lead to severe illness and to death. Nevertheless, I have instructed my physician, notwithstanding these dire warnings of potentially fatal outcome, to proceed . . . . ”

So what to do? Plenty of options. I suggest first and foremost that you ask for a complete copy of his medical record – and express a willingness to pay copying charges if needed. I’d submit such a request immediately. Second, review the chart and ensure it conforms to reality – if not, write a contrary summary and insist it be placed in the chart. Third, and best after the chart is in hand, tell the clinic you are going to report its refusal to detoxify to both the single state agency that licenses methadone clinics, and also the accreditation agency (Joint Commission on Accreditation of Healthcare Organizations or whichever other – a clinic is supposed to post such accreditation, but if not, ask, and if there’s no answer, ask the single state agency or the federal agency that’s responsible).

Finally, I would suggest the patient demand to see the physician in charge, and if threatened with discontinuation of treatment, then I’d get a lawyer immediately and let the lawyer deal with it. Again, few programs are so stupid as to fight a determined patient when their entire operation hangs in the balance.

Bob Newman

Thank you Mr. Newman, your email was Extremely Helpful, some really good info. It’s a breath of fresh air for me, because I’ve been having to deal with this damn Methadone clinic. I am going to do just what you were saying in the email, I really want to get a copy of my whole chart, I will pay them upfront for copying charges. That will scare them, I know they will resist this so bad, they will say no, I know it, they’ll say we can’t make copies of these and they can’t leave the building, or something to that affect, but if I know that they have to do that for a patient then they will do it. At some point they are going to realize it’s not worth fighting me, I will contact some of the organizations that you mentioned, they would have to be complete morons to want to escalate the issue to that level and still fight my decision just as you eluded to in the email.

Many thanks,

Good luck – and if you want a lawyer to help intimidate them, or a physician to review the char t when you get it, let me know. If we can’t help, we’ll tell you at once; if we can, there’d be no charge – then it’s a privilege to do so.


Stanton Peele

Dr. Stanton Peele, recognized as one of the world's leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions. Dr. Peele is the author of 14 books. His work has been published in leading professional journals and popular publications around the globe.


  • Derek says:

    I asked nicely twice now to start tapering off but they keep wanting to move me to a better status with more take homes. Making excuses to keep me in the program. I’m done with drugs. I didn’t want to be a slave to another chemical

  • Maria says:

    My son has MS diabetes and is on methadone. I keep telling him to get of of it but he says his counselor/doctor tells him is not a good idea and want to explain it to me but I don’t see trust the clinic at all. Everything I read on this page is just like my sons story is like you’re talking about him.

  • brock says:

    I also requested a dose reduction.
    I get take homes and have been on clinic 4 months at 45 mg. and have requested to be dropped 3 weeks ago and no drop ..first asked to be dropped to 30 mg and they did nothing. Then I spoke to a “counselor” and came to agreement to drop 5 mg a week but no drop on my last weekly visit ..I know about methedone and will not allow myself to get hooked on it ..Im about ready to walk away from this clinic and kick it on my own.
    Ive managed many times in past to kick on my own. Its just incomprehensable that a clinic acts like they are here to help but really want to just keep you hooked on their medication for the money. Im on the BAART clinic in Concord Ca ..I go in next Wednesday and if my weekly pick up doses aren’t 40 mg (5 mg drop) I’m thinking about contacting a attorney.
    At 30 mg Im walking away ..3 weeks from next Wednesday I’m done with this horrible place ..I quit using to quit using not to switch seats on the titanic!

  • Greg Demeter says:

    I must say, that issue is very common, yet in Pa., those Agencies work to protect the Clinics from liability, to the point of denying a Client’s Record requests and even fabricating lies, to fit their narrative about treatment.
    In this democratic State, the evils of established money Makers (Methadone Clinics, Hospitals…Rehabs…etc.) are protected by a little known and relatively new agency that focuses on how to avoid liability, yet be able to run the organization corruptly.
    I am working on my own case now, due to being held Hostage at New Directions methadone Clinic, Bethlehem, Pa. Brodhead Road…not only for myself, but all the other Clients stuck under their Gun. I will get to actually see whether people like us, do have any standing to file Criminal Charges, and/or Sue (Class action?), because the State dept. of drug & Alcohol Licensing, are just as corrupt, for allowing the Clinic to get away with actual Murders…In the 8 1/2 years I been there, I know of 4 People who have died, due to their dosing practices…Christ, I did NOT even get to see their doctor, until 6 years into the program, only to find out that, he only shows his face on Video. So, Dr. Peele, if you actually do care about People, you MUST expand your Topics to include this type of grave concern and get it out there; so it is addressed in the Medical field…not shoved under the rug, due to corporate payoffs and kickbacks! I for One, will be on the front lines, exposing this corrupt organization…18 Pa. C.S.A. 911…Look it up…At the very least, it IS definitely Reckless Endangerment…If you want to follow up with my story, please feel free to contact me; i’d be more than happy to share my tale of Woe! 610-484-1564…
    I can write a book about my Exp. and be a Best seller, under Non-Fiction..

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