DNT investigation: Former patient says methadone treatment was ‘just another addiction’In 2010, Josh Bergstedt became one of thousands of people who have dropped out of Minnesota's methadone programs without completing the treatment. From 2007 to 2011, 94 percent of the state’s methadone patients who left the programs did so without completing the treatment.
In 2008, after years of abusing painkillers such as Oxycontin and Lortab, Duluth native Josh Bergstedt enrolled at the Lake Superior Treatment Center. He said he had hoped to be off the methadone treatment program and drug-free within a month.
“But after the first day, I was just lit,” he said. “I’m thinking, ‘This is treatment? Holy cow.’”
Bergstedt, 29, said he wanted to get higher, so he told his counselor he was having withdrawal symptoms to get stronger doses.
“I wasn’t being honest with them,” he said. “But we’re drug addicts. This is what we do. We just want to get higher and higher.”
Two months later, his records show, his dosage had quadrupled. As the months went by, Bergstedt exhausted his savings paying for the methadone before he was put on state health insurance, which then paid for the treatment. He was still on high doses of methadone, but instead of being high, he said he plateaued. The drug, he said, was turning him into a zombie.
“I was living in my parents’ basement, completely depressed,” he said. “Methadone was just another addiction. It was two years of hell. You’re functioning, but with that amount of drugs in your system, how can you be a productive member of society?
“At some point it dawned on me: I’m just going to die like this.”
In 2010, Bergstedt became one of thousands who have dropped out of the state’s methadone programs without completing the treatment. From 2007 to 2011, 94 percent of the state’s methadone patients who left the programs did so without completing the treatment.
That dropout rate puts methadone treatment dead last in successful completion rates among other types of chemical dependency treatments in Minnesota, the News Tribune found.
But that isn’t the only area where methadone trails other treatment options.
Patients discharged from methadone programs also were more likely to be in jail 30 days after being discharged and had more potential for serious to extreme withdrawal symptoms and relapse when compared to treatments such as long- and short-term residential programs.
The results come from a News Tribune analysis of chemical dependency treatment admission and discharge data provided by the Minnesota Department of Human Services. The agency provided the data when the newspaper asked for a way to evaluate the effectiveness of methadone treatment in the state.
Other discharge data provided by the DHS showed that, judging by additional criteria the agency uses to evaluate outcomes of chemical dependency treatment, methadone failed to help patients in areas such as ability to control emotional problems and ability to find housing and jobs.
Dr. Marvin Seppala, chief medical officer for the Center City, Minn.-based alcohol and drug addiction treatment center Hazelden, called the News Tribune’s findings concerning, especially the lack of completed treatment.
Hazelden, which offers abstinence-only treatment for opiate addiction, has about a 53 percent completion rate, Seppala said.
“If success is defined as weaning them off, then absolutely (methadone completion rates) should be higher than 5 percent,” he said.
He said methadone can be an effective treatment, but when its use isn’t effectively monitored and the drug can be easily diverted and given without proper counseling, “you do get much more of the downsides of methadone.”
At the Lake Superior Treatment Center, the only methadone treatment provider in Minnesota that’s north of St. Cloud, about 6 percent of patients completed the program from 2007 to 2010, the News Tribune found. The average for the state during that time was 5 percent.
The director of the Lake Superior Treatment Center did not return repeated phone calls for comment.
A representative for Colonial Management Group, which owns the Lake Superior Treatment Center along with more than 50 other clinics across the country, told the News Tribune from Florida that the company does not speak to the media.
However, Dr. Tom Payte, a corporate medical director for Colonial Management Group did speak with the News Tribune. He said the goal of methadone treatment is not to wean the patients off that drug.
“We want to improve the quality of life for people,” Payte said. “(Addiction) is an incurable, progressive, often-fatal disease. The best results occur for people who stay in methadone treatment long-term.”
Payte, who has worked in the addiction field for 40 years, said thousands of Colonial Management patients have successfully used methadone for years. But even some addicts who seek methadone treatment, he said, won’t be successful with it.
“I see some very positive results; I see some very frustrating situations where change just does not seem to occur,” he said. “They may not want to change. If they don’t want to stop using, then what are we to do? Obviously they’re going to be out of treatment after a period of time.”
On the subject of methadone treatment, the Department of Human Services said the News Tribune’s findings are flawed because they compare programs for opiate addicts to programs for other kinds of addictions.
“It compares apples to oranges,” said Maureen O’Connell, the DHS assistant commissioner for chemical and mental health services.
When asked if DHS had a study measuring the effectiveness of methadone treatment in Minnesota, the agency acknowledged it did not.
“Does the state aggregate that data?” asked Jerry Kerber, inspector general for the DHS. “What you’re hearing us saying is: We haven’t done a lot of it, but it’s something that probably ought to be done.”
Staying on Methadone for life
Other health experts on chemical dependency say it’s a mistake to equate effective methadone treatment with completion.
“The successes of methadone are those who stay on it,” said Dr. Gavin Bart, the director of the division of addiction medicine at Hennepin County Medical Center.
To Bart, successful methadone treatment might mean the patient is on the drug for life.
“It’s not controversial in the world of addiction treatment,” he said. “There are societal controversies, and it’s related to stigma. But no one says, ‘My God, you’ve been on high blood-pressure medicine for this many years? You need to stop.’”
By that measure, Duluth resident Sharon Mix is a methadone success story who wouldn’t show up in the discharge numbers.
The 56-year-old said she started abusing narcotic prescription medications such as Percocet when she was 23. In 1980, she was arrested as part of a large sting of narcotic drug sales in Duluth and narrowly escaped prison time. She went to treatment but continued to abuse narcotics, which eventually saw her do time in the state prison in Moose Lake, where she said she continued to use and sell drugs such as painkillers and heroin.
“Even after all of that, I didn’t learn a lesson,” she said. “My kids were taken away from me.”
The drug abuse continued, getting to the point, she said, where she would often spend hundreds of dollars a day on drugs. One night while at a motel in the Twin Cities with her husband, Mix said she did her “last blast.”
“It was like nothing,” she said. “We looked at each other. I believe we both started crying. We sat and prayed for a while, went to bed, woke up the next morning, and went to the methadone clinic down in the Cities.
“That was 18 years ago.”
Mix said she’s been on methadone ever since, often driving down to the Twin Cities each day until a clinic opened in Duluth.
She said she now takes a high dose of methadone each day and has no plans to get off the drug.
“I’m an addict; I’ll always be an addict,” she said. “I would rather have methadone there and be on methadone than have any chance in hell of going back to that lifestyle.”
‘It’s a fog’
Mix said she doesn’t get high from the methadone; rather, it allows her to function normally “the majority of the time.”
“It isn’t something you really get high from,” she said. “It takes away the need to feel like you want to get high, but it levels you to the point where your body says you are.”
Bart of Hennepin County Medical Center said proper dosing of methadone patients should prevent euphoria and relieve withdrawal symptoms.
Getting high from methadone provided at a clinic “should be prevented,” he said.
But local chemical dependency treatment experts and law enforcement officials say patients they see on methadone act as if they’re high.
Richard Colson, supervisor of the Tegwii Recovery Center on the Fond du Lac Reservation, said many of the people he treats have left methadone treatment and describe getting high from the drug.
He said treating patients with a drug that can keep them in that altered state for the rest of their lives is wrong.
“You have a prison without bars,” he said. “You have addicted these people, and their lives essentially get flushed into some mutant reality. It’s a fog. Some of the best years of their lives won’t amount to anything other than a walk on a soggy beach on a foggy day.”
Seppala of Hazelden said he doesn’t believe people should be on methadone for the rest of their lives.
“We don’t know who should be on methadone long-term,” he said. “We don’t have a good test or predictor that could tell me today that this person should take methadone for the rest of their lives, and this person should be off of it in a year or two.
“When they get really good recovery, they should be able to come off these maintenance treatments.”
Payte of Colonial Management said because he views addiction as a disease, he believes that even people who enter methadone treatment to abuse that drug should still be kept on the treatment.
“I don’t believe in terminating patients for noncompliance if we can keep them in the system,” he said. “I seldom see patients that benefit from being kicked out onto the streets. If we can continue to work with them, we have a better chance of establishing a relationship and making a difference.”
For methadone patients who want to withdraw from the drug, clinics are supposed to supervise that withdrawal and have it done gradually over the course of weeks, or even months, experts said.
Methadone users who have gone through withdrawal unsupervised describe it as far worse than coming down from other narcotics. Dan Stanius, who spent time in jail for being caught with illegal methadone, said withdrawing from methadone was extremely painful.
“It’s right down to the bone: Everything hurts,” he said. “(I) just had just horrible pain. I wouldn’t eat at all, just hated life. You wish you wouldn’t wake up; you didn’t care whether you brushed your teeth or combed your hair or did anything like that. It’s like a super-bad flu. You just hated life.”
“The withdrawals from methadone are 10 times worse than any street drug I’ve ever taken,” he said. “It’s the worst thing you could possibly go through.”
When Bergstedt left the Lake Superior Treatment Center, he enrolled in Minnesota Teen Challenge, where he said it took a year before he was able to get sober and feel normal again.
Now he’s studying to become a pastor at the Inter-Lutheran Theological Seminary in Hancock, Mich., and gave his first sermon in June.
Reflecting on his time as a methadone patient, he said the treatment never worked for him because it was just another drug to abuse.
“It was a hopeless cycle for me,” he said. “You’re giving drug addicts a license to be drug addicts.”