I have a day job. I work as a counselor at a methadone clinic in Wichita. Where I have the stress, honor and joy of working among human beings who are struggling to overcome addictions to opiates, our legal drugs, as well as heroin, and a few other things.

I’ve been doing this work for just over one year now, and while I actually tried to quit the job on at least four occasions in my early days (no need to go into details here), I’ve come to love my work there. I love the work because I work with a team of extremely dedicated, hardworking and highly qualified professionals with whom I share the shifting dances of waltz and mosh pit in the warp and woof of life at the clinic. I also love the work because of the patients, the beautiful souls who range from those fighting for their lives from the streets to the blue collar worker and even those whom most of us consider, at least by appearances, high functioning and button down. All of them with their unique respective arrays of sufferings and struggles. I have to say, too, that I love my work because on the fact that my team embraces me for my skills and my quirks. The patients, too, have embraced me for the same skills and quirks, and they have by a large measure embraced my offerings of mindfulness-based treatment and Dialectical Behavior Therapy (DBT), showing, in many cases, tremendous improvements in their abilities to better regulate their awareness, emotions and recovery. That is to say a little more poetically, they’re becoming better at letting go of emotional suffering. Even if just incrementally.

There are a great number of struggles underway, many of a magnitude that I never would have imagined, in spite of my own life experiences and in spite of my clinical training and experiences over the last twenty years working mostly with chronically suicidal persons, those who self-harm and sundry addictions. My work at the clinic has provided me with an increase in my own mindfulness practices and my devotional life in the Orthodox Church. This work has provided me with encounter upon encounter with hurting souls who grant me, if that’s a fair way of putting it, access to their lives, to their journeys and battles, and this in turn has kindled my love and hope for all of us. This work has deepened my appreciation for myself, for them, for you; a deepened humility where I have been afforded the opportunity to get over myself in ways that are much needed in my own therapy that we call life.

There are quite a few folks out there in the world who think that methadone is nothing more than a replacement addiction that stands in for prescription meds and heroin addiction. I even had an encounter, not too long ago, with an area professional who wasn’t shy about sharing his views about methadone and psychotropics as impediments to effective counseling in a substance abuse treatment setting. In his setting, to be more specific. While he was sharing his views in my earshot, he wasn’t aware of my work at a methadone clinic, and he was speaking freely and audibly to a group of common friends and acquaintances. So he spoke without concern of censoring himself due to my incidental presence. My paraphrase of his remarks go something like this, and this is a paraphrase: “You can’t do effective treatment any more. So many clients are doped out on methadone and psychotropics nowadays that they can’t process counseling. They’re nodding out and it just gets in the way of good treatment. There’s nothing good about methadone.” Remember, this is my paraphrase, but it gets to his negative view of methadone in particular as something deleterious.

Our common friends wheeled toward me and one asked, “Scott, don’t you work at a methadone clinic?” At this point, our encounter was born. I was on the spot. Of course I acknowledged that yes I do indeed work at a methadone clinic. His face shone with obvious disappointment. At that moment, which I like to think of now as the remarkable time of kairos, the opportune time, I, in trepidation, offered this, also a paraphrase, this time of myself: “Actually, methadone is saving lives. And I gotta tell ‘ya, our patients are engaging in counseling, learning mindfulness, emotion regulation and how to deal with their cravings for their old drugs of choice, and their old habits of being, on the whole.” I did hedge a bit with honesty and told him, “We don’t have 100% success rate with all of our patients in any given treatment episode, but that’s no different than substance abuse treatment in general, where you’re working with alcoholism, methamphetamines and say, K2/spice (synthetic pot), and relapse is grist for the mill in the struggle and recovery of many addicts. And I’ve seen all of that. On the whole, I’m proud of our patients and the work we’re doing at our clinic.”

His response to me was this, and this is not a paraphrase: “You’re part of the problem.”

This left me reeling. And I was struck with the truth that to be a methadone patient is to bear the stigma of being classified as an addict, and then doubled-strapped with another stigma. That of being a methadone patient, which is looked down upon by other addicts in recovery and even addictions counselors. I was pushed into a closer identification with my patients when I encountered this professional. I had a clarifying moment in which I could finally understand why most of my patients don’t want anyone to know that they’re participating in becoming well through methadone assisted treatment. And many are becoming well.

I don’t want to idealize methadone. There is the fact that methadone can be/is addictive itself, although it works to block the brain’s opiate receptors preventing both cravings for opiates and the ability to get high on opiates. It provides a biologic edge that helps many in their journey toward sobriety. There are patients who want methadone treatment for pain management, where injury from work accidents, illness or surgery form the etiology of their dependence on medically well-intended prescribed opiates. There can be a great fear among patients who don’t know how to otherwise relate to their addictions, or their physical pain, which is not only real, but often extraordinarily intense. And still, there are the stories I hear from patients who tell me that thanks to methadone they no longer steal from their loved ones to make a score. They stopped exchanging their integrity for drugs. Some of them are completing college degrees so that they can pursue vocations and meaningful work. Many of them are more present as spouses and/or as parents to their children.

There are two points I want to make in closing this little Sprad-ramble. First, methadone is intended to be a transitional medication, assisting the opiate dependent persons to better manage cravings as they move toward a drug-free life, including a methadone-free life. Especially where sound and effective counseling services are offered, to help patients learn skills in relating more healthfully to their physical pain, emotions and thoughts, which has the potential of changing the psychological edifice that supports addictive behaviors and identity. Second, those of us who are not drug or substance dependent experience and live out daily, exactly the same processes and problems that drug addicts face. Many of us are caught in a web of addiction to negative and catastrophic thinking. Or wallowing in misery. Compulsive shopping, pornography or internet usage. Some of us are captured by a slavish need to be approved by others, or we hold onto an entirely hostile view of others. Some of us are workaholics or try to prove ourselves through relentless multitasking. Perhaps we have to “keep up with the Joneses,” to prove our value or superiority. Maybe it’s chronic judgmentalness of others and self. Nationalism, racism and sexism come to mind. Changing any behavior that in anyway controls us, and diminishes us or our relationship to friends and family, is ridiculously difficult. We are all subject to our habits of thought and behavior in some way or another, which we all need to take time to attend to, to wonder over, and to find space to step away from to find meaningful change.

I have no clever way to end this entry. I want to say something like this, to my friends and family who have authentic intentions to love and to be generous human beings. Keep your minds open. When you have trouble understanding the addict, ask yourself this question: “What am I leaving out?” I gently challenge you to ask yourself what is it that you don’t know about a person’s history. What is the abuse or neglect a person has suffered? What are the circumstances under which the person I’m judging came into their way of being? Even if there was no abuse or neglect, how did this other person become acquainted with a medication or a drug that grabbed their brain and body in such a way that they became a slave to it? The word addict literally means to be enslaved (from the Latin). Ask yourself how are you like the drug addict? What are you addicted to? Food? Shopping? Sex? Reputation? What separates you from others or diminishes your power to apprehend love, beauty or wonder?

I hope that such questions will assist you to expand your capacity for compassion for the addict, and for yourself. To see that there is little to no difference between the drug addict and the compulsions that confront all us.

Thank you, readers, for indulging this Sprad-ramble. In closing I think it’s best to leave you with this excerpt from the work of Gerald G. May:

“A certain asceticism of mind, a gentle intellectual restraint, is needed to appreciate the important things in life. To be open to the truth of love, we must relinquish our frozen comprehensions and begin instead to appreciate. To comprehend is to grasp; to appreciate is to value. Appreciation is gentle seeing, soft acknowledgement, reverent perception. Appreciation can be a pleasant valuing: being awed by a night sky, touched by a symphony, or moved by a caress without needing to understand why. It can also be painful: feeling someone’s suffering, being shocked by loss or disaster without comprehending the reason. Appreciation itself is a kind of love; it is our direct human responsiveness, valuing what we cannot grasp. Love, the life of our heart, is not what we think. It is always ready to surprise us, to take us beyond our understandings into a reality that is both insecure and wonderful.”

~ Gerald G. May, The Awakened Heart: Opening Yourself to the Love You Need