“During my second meeting with Dr. Senay, the subject of methadone surfaced. He gracefully allowed me to go on one of my anti-methadone rants. He then calmly confronted me. ‘Bill, your passion about methadone is in inverse proportion to your knowledge,’ Professor Senay told me.” William “Bill” White, like many of his peers at the time, spoke eloquently against methadone treatment with very little knowledge of the research about its clinical effectiveness for people who are trying to recover from opiate addictions.
Professor Senay’s words to Bill marked a critical turning point for his work in addictions recovery. It would be the beginning of a journey to understand how narratives and communities merge with much-needed medications and research in order to help people recover from opiate addictions and live rich, complete lives.
Bill works as a Senior Research Consultant at Chestnut Health Systems. He is known for his leadership, research, and advocacy in the field of addiction recovery, and recovery-oriented methadone maintenance (ROMM) in particular. He recently received the Lifetime Achievement Voice Award from the Substance Abuse and Mental Health Services Administration (SAMHSA) for his outstanding work in this field.
In 1969, Bill worked as a street outreach worker, making daily rounds on the streets and in jails, hospitals, and bars, seeking to engage those struggling with addictions. He worked to move people into detoxification programs and, later, into treatment programs as they emerged in the 1970s. He then worked as an addictions counselor and clinical director before earning a Master’s degree in Addiction Studies.
Early in his career, Bill was influenced by ex-addict-directed therapeutic communities and twelve-step treatment programs. Both models had strong anti-medication and, in particular, anti-methadone biases. “I absorbed these biases by professional osmosis,” recalls Bill, “but two things changed those views: Dr. Senay and my later collaborations with Lisa Mojer Torres, a passionate young lawyer, methadone patient, and recovery advocate.”
After his encounter with Dr. Senay, which revealed the imbalance of his passion to his knowledge, Bill was an open-minded, if reluctant, student who would follow the teachings of his professor.
“He loaded me with stacks of articles and books to read. What followed was a begrudging intellectual acceptance of methadone maintenance. But I still did not accept methadone maintenance in my gut,” said Bill. In the late 90s, Bill met people whose stories about their medication-assisted recoveries deeply changed his views on methadone. “We are not going to change how people view methadone through public education or academic articles. We are going to change how people view methadone the way I changed my own views—through contact with people whose lives have been positively transformed by medication-assisted recovery,” explains Bill.
Lisa Mojer Torres was the first such person Bill came to know and admire. She embodied the success of methadone-assisted recovery. She profoundly changed how Bill felt about methadone as a recovery support. Lisa was a lawyer living successfully in recovery with the aid of methadone, and she was the first person to show him that success was possible.
“[Lisa] was the Rosa Parks of methadone treatment in the United States,” said Bill. “She spoke in front of people who were extreme in their views against methadone and they just melted when they heard her speak. It was amazing to see someone who was not only an attorney, but who also advocated for others. I came to honor her very existence” says Bill. Lisa died of cancer shortly after she and Bill finished their monograph, Recovery-Oriented Methadone Maintenance. This was a devastating loss to the community that she had served with such compassion.
There is a vanguard of people in medication-assisted recovery who are stepping forward to tell their stories. Methadone is the most stigmatized of all the medications used in addiction treatment, and not all methadone treatment programs are recovery-oriented. “Many,” Bill says, “are only interested in the symptoms that are subtracted from patients’ lives, rather than what is added in terms of quality of life. So we see this tension between harm reduction and recovery advocacy philosophies.”
Bill is currently concerned about developing more effective responses to continued drug use during methadone treatment and addressing the larger numbers of patients who drop out of treatment in the first year. The latter groups are of particular concern because of the high risk of rapid relapse and the increased risk of death and addiction-related health problems. While there is a subset of people who can successfully taper off methadone and sustain recovery without medication support, it is difficult to determine who can taper off successfully and who cannot. Some people with diabetes, for example, must remain on insulin for life. It is the same for some people with opiate addictions—they will need prolonged, and possibly lifelong, medication support.
Bill believes it is the power of human stories that give momentum to recovery-oriented methadone maintenance. Stigma is present for many people in recovery from substance use and mental illness. The difference, explains Bill, is that for people who are recovering from heroin addiction, it is more difficult to find a supportive community. “The person in methadone-assisted recovery is highly marginalized. They are separated from addiction subcultures and often are not fully accepted within mainstream recovery mutual aid groups. They are not accepted in the community at large if he or she has disclosed,” he says.
For many people in this position, the answer to finding support lies within themselves and within their families. More medication-friendly support groups are being offered, and medication-assisted recovery is more visible within the growing recovery advocacy movement led by Faces and Voices of Recovery. Stories of methadone patients challenge the myths and misconceptions about methadone treatment and its role in long-term recovery from opiate addiction.
Bill finds hope in the increasing acceptance of medication-assisted recovery, and he is grateful for the opportunities he’s had to listen to patients’ stories and gain knowledge about this recovery movement. He carries these stories and this knowledge with him as he continues to advocate for addressing the needs of those in recovery.
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