Methadone Clinic and Karl Marx

Methadone is an opioid or narcotic drug that helps people who are addicted to heroin and other narcotic substances lessen their withdrawal symptoms without giving them the same kind of high that is associated with drug addiction. Methadone is primarily used to treat pain and as part of programs for drug addiction detoxification and maintenance. Only accredited pharmacies are permitted to sell it. People with severe asthma, respiratory issues, or paralytic ileus, a bowel obstruction, cannot use methadone. This medication has a powerful effect that has been known to stop or decrease breathing, especially in patients who have just changed medications. As a caution, one is prohibited from using this medicine in large quantities. However, this drug is also known to be addictive thus they can be easily abused. The drug is therefore allowed to be used only for the patient it has been prescribed for. The patient is later advised only to swallow the drug because it can be fatal if chewed. Methadone is also not supposed to be shared with another person who has no prescription it is, therefore, advisable to keep the drug away from other addicts or people.
Precautions of Methadone
A person known to be allergic is not supposed to use this medication because it can cause severe breathing problems or even asthma. The drug can also obstruct of the bowel of the person through a condition of paralytic ileus. Despite the allergy, the drug is also life threatening since it can cause a heart rhythm disorder. During treatment, the patient should be engaged in a series of heart check. Some medications like serotonin syndrome tend to cause a severe complication especially when mixed with methadone (Kenneth, 2015). Patients with depression or mental illness must alert the doctors before being given this medication. Patients who also take medicine pertaining severe infections, migraine headaches and nausea should also seek advice from the doctors before changing of any drug. It is still not clear whether methadone can affect a small baby, however, when a pregnant woman takes methadone, it is known to spread through the breast milk thus getting to the baby through breastfeeding. The purpose of this study is about addiction treatment. It later elaborates the effects of lumpen abuse and how cultural methods by use of methadone was used for treatment. Through Karl Marx’s theory, the essay will develop further the treatment of heroin drug users through the methadone clinic method.
The Background Theory
The story embarks on two clients in Denver who were to receive the healing process through methadone maintenance treatment. In the aspect of navigating through the social space of the methadone clinic, the majority of the cases that were brought up was the casual use of heroin in regards to the treatment of methadone (Koester, et al., 2010). However, the issue of this drug addiction still chips in the community as an unresolved issue. The degree of how the issue of the MMT clients behaves is based on how the clinic doctor treats them.  Through the process of urine analysis (UA), there are few group of drug users who have the knowledge about the methadone clinic but are discouraged with a few overlaps of perception. Most of the hard drug’s users who use heroin claim that the use of methadone slows the metabolic rate of one’s body. In other terms, it is felt longer into the body system even through the bones. Most of them say that the methadone clinic violates their rights of being free to use heroin. More clarifications about the methadone clinics were from Bourgois where he stated that the abuse of lumpen (Heroin) produces a three structured violence experience (Bourgois, 2000). The first force evolves around the clients; the second is the vulnerable population that surrounds and the third violence revolves around them.
Karl Marx also has a ground work that pertains the methadone clinic through the abuse of lumpen. In a social class of the German theory, the lumpen proletariat is described as ‘ragamuffins by Marx theory. He later recalls that proletariat is ruined by the state at which it has become incapable of the pressure from the bourgeoisie.  Lumpen as Marx illustrates means symbolic violence (Stephen Parkin, 2016). Analytically, Lumpen is a rag or tatters that are used in the description of lumpen. As Schonberg and Bourgois also describe, lumpen is the inability of a person who is unable to resist from a group pressure through cutting or brushing off ideas. They also so as to cover their camps which are exposed by small employees who call them cheap bodies of labor demand. For Marx, he is not able to resist this theory making him a part of the class that overlaps through the hidden violence.
A good example given in this opinion is the informant called Mark. Before the methadone clinic opened, Mark was given a shot of methadone so as to avoid withdrawals. During treatment, the doctors who were reported to discrete their work through determining the type of dose a patient is going to receive, eventually reduced Mark’s dose because he was responding well to the positive show of benzodiazepines. Mark was also a favorite member of the class group which had minor effects of euphoric when they were given methadone. Euphoric was also derived from the results of the overdose of methadone, and so Mark was categorized as one of the patients who fell, the victim. The reason why the doctor reduced the dose was to save his health. The doctor also scheduled Mark to lessen the use of benzodiazepines since he needed him to adapt to the nature of withdrawal. In the process of withdrawal, the Foucault concept of opiate withdrawal was also called the biopower which integrated the symbolic of violence (Foucault, 2000). He also writes about how the government regulates the biological state of a person from the state of violence or death. In the dichotomy of controlling death, Foucault explains how death can be controlled by life just the way Karl Marx and Bourgois were illustrating through their theories of health and wellbeing.
By using Marx theory to develop a theory of lumpen abuse, it will describe the population of the study as a social class by introducing all the power dynamics of class conflict. It will then discuss the compounding of individuals outside of the means of production to create the lumpen class like humanization or lumpen objectification as it is referred by the Bourgois (Bourgois and Schonberg 2009). Karl Marx also refers to the lumpen proletariat as ragamuffins and ruined proletariat. A German edition of the text puts a distinction between these two terms. The lumpen proletariat is described as a class and the process of humanization. Reinserted Proletarian and Lumpen are used by Marx to distinguish between what is commonly translated as ruined proletariat and ragamuffins.  The significance of this distinction to the text is evident when Marx says that the lumpen has existed in all the ages and predate to the information of the proletariat. In using the two terms to describe the lumpen the both of them can be ruined proletariat and ragged even though the both of them are regarded as being part of the lumpen proletariat. This indicates that there is some fluidity in class borders no matter how high the fluidity might be. As the lumpen predates, the mass formation of the proletariat and the ruining of the proletariat lumpen is then created.
The entire proletariat involves destroying bourgeois and ruined proletarians from a collection of ragamuffins that have existed in every epoch of which their existence on a large scale after the decline of the Middle Ages paved the way for the mass formation of the known proletariat. Marx also suggests that this movement when he refers to it as the state of the ruined proletariat, the lowest level that the proletarian sinks have become unable to resist the pressure of the bourgeoisie. Because of this movement, there is a process of lumpenization whereby persons acquire a disposition which causes a person to be predisposed to the misrecognition of the cause of violence against them which is similar to the symbolic violence (Bourgeoisie, 2013). Though these examples, they seem to suggest particular enigma regarding Marx’s’ attitude toward the lumpen class. Marx understood the lumpen as the historical fall-out of large-scale, long-term transformations in the economy of the organization. The historical context and current social structure lead a person to be socially vulnerable and keep them in that state.  
One can have the ability to study socially vulnerable populations, but it is not right for one to just focus on the lumpen without examining the process which led to their condition. The United States bio-politics of Methadone and Heroin is criticized by Bourgois as he says the system of MMT shifts the unruly heroin addict to a productive subject through the criticizing of the stigma placed on the pleasure in western biomedicine. The difference in the perceptions between methadone and opiates that work faster like heroin and morphine is a pleasure. Methadone as a metabolizing drug is very slow, and it is introduced into the body in a very slow metabolizing fashion, oral consumption, and unlike heroine that stimulates three sites in the opiate receptors, it only stimulates one which results in a significant loss of pleasure. Methadone has the therapeutic value to allow MMT clients to only consume one dose per day, unlike heroin addicts that require several injections so as not to withdraw and it reduces the process of increasing tolerance over time (Helena Knotkova, 2013). Because this drug has slow metabolization, it means that the withdrawal process will be prolonged. Methadone generally lasts longer in a person’s system longer than heroine as it is estimated to last, as it takes 59 hours while heroin is 4-6 hours. Research that has been conducted on methadone treatments by tracking individuals who have been in treatment for an extended period show that they stopped using drugs, their criminal activity reduced, and their social, psychological, and occupational function improved. Methadone has been proven to decrease drug use and criminal behavior and enhance participation in behavioral therapy. The treatment outcome for the individual will depend on the extent and state of their problems, the suitability of the treatment and the services that are used to address those issues, as well as the quality of interaction between the patient and their treatment providers.
Addiction just like chronic diseases can be managed successfully. Treatment usually gives a person the ability to counteract addiction’s powerful disruptive effects it has on the brain and behavior and to help an individual regain control of their lives. The relapsing to a drug is possible and more likely because of the chronic nature of the disease. Symptoms of reoccurrence are similar to those that are related to chronic medical illness like hypertension, diabetes, and asthma which also have both behavioral and physiological components. Most of the time when a relapse occurs many tend to view it as a sign that the treatment has failed, but it is usually not the case. Most of the time for a treatment to be successful it will require a continual evaluation and modification and appropriate which is similar to the approach that is taken with other chronic diseases. Treatment should not stop when the symptoms decrease as it is not yet successful as symptoms might recur if the treatment is stopped. When a relapse occurs for an addictive person, it is not because the treatment has failed but because it signifies that the treatment needs to be adjusted or an alternate treatment should be applied.
The cross-suppression between heroine and methadone gives methadone the ability to prevent or reverse withdrawal symptoms making a person’s need to use heroin significantly reduce (Ricarda Cruciana, 2014). Methadone is known to reduce harm thus making it an appropriate goal for treatment. It has also been related to the reduction of HIV infection rates among those who use injecting drugs. After commencement of methadone treatment the physical health of addicts gradually starts to improve. Health problems that are associated with drug use include poor nutrition, dental caries, menstrual irregularities, and complications related to injection that may occur while one is intoxicated. During the first dose of methadone treatment, an individual might experience psychological problems that are sometimes severe psychiatric disorders. Injecting drug users commonly experience disturbance of moods and personality disorders. Treatment should be able to reduce and stop these problems with time and promote good health psychologically. When the psychiatric disorders are severe such as depressive disorders, psychotic disorders, and anxiety disorders it is advised that well researched psychiatric interventions should be applied. The primary goals for treatment usually include improved relationships of the drug users with family, friends, spouse or colleagues, domestic stability, successful parenting, gainful employment, and a strong finish of studies. When individual’s social functioning improves, they can become financially dependent on themselves and detach themselves from any criminal activity.
Methadone maintenance treatment has been rated to be the best treatment for opioid dependence. Methadone is rarely given to patients as a take home drug it is only administered in the clinics after one enrolls and it is usually accompanied by the group and individual counseling. Individuals are also subjected to random urine tests so as to ensure that those who are using methadone are not also using other intoxicating and illegal drugs like cocaine, benzodiazepines, and other opiates. These random urine tests that are accompanied by individual and group counseling, as well as medication, will prevent a patient from abusing methadone and having a potential overdose that might lead to death. Methadone will help a person to be comfortable and prevent withdrawal and cravings, and these will allow the patient to go through counseling which will help them gain tools and ways to keep off heroin and other opiates. Some of the strategies to overcome drug addiction might include changing their daily routines, taking care of their health and hygiene, getting enough sleep or rest, practicing proper eating habits, and finding a job.
The treatment of methadone usually takes 3 to 5 years, but one can choose to be apart of it for a while longer. At times those patients who stay in the methadone treatment for long are seen as abusing this drug. This could be true but there methadone patients who require longer treatments than others while others might need it for the rest of their lives. A methadone patient is usually in control of their recovery, but under the guidance of a licensed physician and with time they are able to decide what amount of dose is best for them. An abrupt stop to methadone treatment usually causes unwanted side effects that are similar to those of heroin and opiate withdrawal. The advised quantity of methadone reduction per week is 1 to 3 milligrams. By lowering the amount of methadone gradually, patients slow their taper down, and this will minimize or prevent the unwanted side effects and withdrawal symptoms.
Methadone has a possibility of being addictive especially with patients who are allowed to take it at home. Thus it should be used with the ultimate care and under the medical supervision of an OTP. It should never be shared with or given to another person as it is fashioned to be used by individual patients. Before commencement of the methadone treatment, patients should share their complete health history with the health providers so as to ensure that it is safe for use because methadone can react with other medications that might lead to adverse effects. Methadone can be utilized as a short-term detoxification, but it gives the best results when used as a long-term maintenance medication for heroin addiction. Most of the time methadone withdrawal can prove to be tough, but its treatment ensures that it keeps a person stable, free from pain and craving of drugs as one tries to rebuild their life. While methadone is used to treat addictions, it can be addictive if it is administered poorly. The doses that are given to an individual must be adapted, and periodic adjustments must be made. One should not stop taking it abruptly, take double doses when one is missed or change their dose without the permission of a doctor. But even with its risks methadone medication still, stands as the best treatment for drug addicts. Regardless of the type of therapy that one chooses it is best to choose one that provides the best comprehensive care that is needed.

Bourgeoisie. (2013). Solidarity in Individualized Societies: Recognition, Justice and Good Judgement. Routledge.
Bourgois, P. I. (2000). Righteous Dopefiend. University of California Press.
Cruciani, R. A. (2014). Handbook of Methadone Prescribing and Buprenorphine Therapy. Springer Science & Business Media,.
Foucault. (2000). Visions of Addiction: Major Contemporary Perspectives on Addiction and Alcoholism. Lexington Books.
Knotkova, H. (2013). Handbook of Methadone Prescribing and Buprenorphine Therapy. Springer Science & Business Media.
Koester. (2012). Goldman’s Cecil Medicine,Expert Consult Premium Edition — Enhanced Online Features and Print, Single Volume,24: Goldman’s Cecil Medicine. Elsevier Health Sciences.
L, K. (2015). Oxford Textbook of Correctional Psychiatry. Oxford University Press.
Parkin, S. (2016). Habitus and Drug Using Environments: Health, Place and Lived-Experience. Routledge.

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