| View Larger Image | Welcome to Methadonia : A Social Worker's Candid Account of Life in a Methadone Clinic | Paperbackby Rachel Greene Baldino (Author)
| List Price: | $15.95 | |
| | Binding: | Paperback | | Publisher: | White Hat Communications | | Page Count: | 210 Pages | | Publication Date: | November 01, 2000 | | Sales Rank: | 1,563,923st |
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EDITORIAL REVIEWS |
Product Description
With her Master of Social Work diploma still fresh in her hands, Rachel Greene Baldino embarked on a year-long journey as a new professional in a methadone clinic. She was ecstatic that she would be starting her career in a full-fledged counselor's position. But was she prepared for what lay ahead? Her personal account of the year that followed will give you an eye-opening glimpse into the sights, sounds, smells, and emotions she experienced. The author honestly and openly describes her feelings about the work and the people, and describes in graphic terms what she observed during her year in a methadone clinic. This is a personal account of one person's story--that of a neophyte professional. As such, it does not describe all methadone treatment or all methadone clinics--only one person's observations in one setting. While it does outline the benefits of methadone treatment and its life-saving effect on many people, it is not a research-oriented book and does not present the many years of research findings on this treatment. It does provide insight into one new professional's experience, including such issues as vicarious traumatization, and it bravely reveals her weaknesses as a new professional in a highly specialized field. Besides chronicling her year as a counselor in a methadone setting, Baldino makes recommendations for changes to the treatment system--recommendations she sees as a "starting point" for discussion among those who are in and associated with the field. A glossary is provided to help readers quickly identify and define key terms associated with heroin addiction and methadone treatment. |
CUSTOMER REVIEWS (Average Customer Rating: 3.0 based on 19 reviews)
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Thoughtful, compassionate, empathic, insightful view of Methadone Maintainence Therapy by Steven Sponaugle  4 Stars
November 17, 2007
Welcome to Methadonia is a thoughtful, compassionate, empathic, insightful view of Methadone Maintainence Therapy at a methadone clinic, which appears better managed and staffed than many.
It is difficult to understand why this book has received so many derogatory reviews, which appear to be written by people who have only read a fraction of the book. This book describes a range of methadone patients, who were treated, at the methadone clinic. Baldino describes some high functioning methadone patients who were actually able to not only cease using any other drugs, but eventually became free of methadone. Some were able to work, study or take care of their families. Many clinic patients were unable to become self supporting members of society, but were able to reduce or eliminate the criminal acts, previously necessary to maintain expensive heroin habits. "Chippers" who deliberately used other drugs, including heroin, cocaine, Xanax, Klonopin, Valium, marijuana or alcohol in addition to methadone comprised a lower functioning patient group.
Baldino explores the issue of whether children of methadone patients should be allowed to accompany their parents to methadone clinics, where they might witness vulgarity, profanity, oversedated or strung-out patients and drug dealing outside the clinic.
Baldino also advocates for detoxing pregnant patients from methadone to avoid addicting the newborn. She explains pregnant methadone patients could be gradually detoxed over the nine month pregnancy.
Welcome to Methadonia was published in 1967 and copyrighted in 2000, before Buprenorphine became approved for treatment of opiate addiction. Buprenorphine, available as Suboxone, or Subutex offers a much safer, less addictive alternative to Methadone, for patients addicted to doses of 30 milligrams or less of Methadone daily. Buprenorphine is considered 10 percent as addictive as methadone and thirty percent as addictive as heroin.
Methadone deaths have skyrocketed, since this book was copyrighted. The National Center for Health Statistics reports 3,849 poisoning deaths, involving methadone, in 2,004. Methadone kills more people than heroin, in the United States and is the deadliest painkiller drug. It is time to look at safer treatments.
Baldino proposed a more humane, opiate maintainence program based on LAAM, which possesses a longer half life, than methadone. LAAM could be dosed every three days, unlike methadone, which requires daily dosing. After this book was published, LAAM fell into disfavor due to prolonged QT heart arrthymias, although methadone also causes prolonged QT arrthymias. A 1973 study found QT prolongation arrthymia occurred in 34% of methadone-treated individuals compared with only 3% of heroin addicts who were not treated with methadone. Lipski J, Stimmel B, Donoso E. The effect of heroin and multiple drug abuse on the electrocardiogram. Am Heart 1973; 86: 663-68. Potentially fatal prolonged QT arrthymias appear far more often in high dose methadone patients and appear infrequent, in patients taking less than 40 milligrams daily. LAAM was removed from the European market in 2001 and has received a black box warning from the FDA.
The author obviously was extensively trained to believe unconditional positive regard is essential for successful counseling and psychotherapy. Many counselors, trained in client centered psychotherapy or attempting to maintain a "turn the other cheek" approach, struggle with confronting abusive, disruptive or dishonest behaviors of severely traumatized, addicted or criminal clients. Many counselors eventually realize modeling appropriate boundaries to clients and confronting inappropriate behavior can be therapeutic to clients and feel comfortable setting and maintaining appropriate boundaries, with clients. Ms. Rachel Baldino, MSW, LCSW, struggled with confronting inappropriate, abusive behaviors, of methadone patients, at the methadone clinic where she worked and described her struggles with honesty, humility and respect for her clients. Many students graduate from counseling programs, with little experience confronting inappropriate or abusive client behaviors. Frequently, counselors without formal counseling training, learn effective boundary setting faster than degreed counselors, and their ability to effectively confront and manage inappropriate client behaviors is an asset to the entire treatment program. Many counseling students would benefit from some front-line, in-the-trenches exposure to mentally ill, addicted or court ordered clients, before commiting to studying counseling.
This book could be helpful to counseling students or potential counseling students, who have not paid their dues, on the front lines of addiction treatment. Addiction is present in almost every segment of society and every counseling client population. Counseling students would benefit from more exposure to the realities of addiction counseling.
This is easily the best of the three books about methadone clinics, which I have reveiwed, so far.
Steven Sponaugle
Research Director, Florida Detox
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Honestly written by a confused social worker. by Lisa Marie (Southern New Jersey, USA) 4 Stars
December 02, 2003
I know alot of people disagree with me, but I don't think Ms. Baldino meant any harm or had any idea what sort of impact this kind of a book could have on things. The fact of the matter is that there is nothing wrong with the book if you don't know a thing about methadone or addiction. But if you do, this poor woman looks like the devil. (And let's be realistic here: most addicts don't like non-addicts in the field of addiction in any capacity anyway, right?)As a former heroin addict and current methadone maintenance patient, I can attest that SOME of her book is accurate. But many of the suggestions and observations she makes are a result of just plain inexperience and ignorance. In the book, she said herself that she was freshly out of college when she got this job. I think she only remained in the methadone treatment field for a year or so. How much could she have really learned to write a 200-some page book? The bottom line? Take all of what she says/writes with a grain--no make that a BLOCK--of salt. The book has the tendency to make methadone patients--and the clinic she worked at--look REALLY bad.
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A Worthy Contribution of the Field of Addiction Medicine by Cristin (Winston-Salem, NC USA)  5 Stars
July 19, 2003
What is most striking about this well-written work by Ms. Baldino in the bravery and honesty with which she descibes her experience as a young therapist working in a methadone clinic. Where other reviews have criticized Ms. Baldino for the feelings of fear and sadness she describes in working with methadone patients, I praise her for this honesty. She describes the emotions she experienced in working with these patients with such openness, not to condem patients of methadone clinics, but rather to facilitate the reader's understanding of her subjective experience. What's more, she uses her experience as a therapist, particularly the challenges that she faced in providing treatment to patients, to illustrate where many drug treatment programs are lacking in the services that they provide. Along these lines, one of the most valuable contributions that Ms. Baldino makes through this work are the specific and thoughful policy changes she recommends that would improve the effectiveness of treatment programs.
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If I was dope sick, I wouldn't shoot this book! by Hollis (Phnom Penh, Cambodia)  1 Stars
March 09, 2003
Poor Rachel, she has no idea of what harm she is doing with her privileged white guilt. This is the worst piece of writing I have ever had the misfortune of reading. Not only does it reinforce society's stereotypes about heroin users, it misleads future healing professionals to believe that heroin users are all hopeless losers, violent, criminal and anti-social freaks of nature. Well, we are not. And as both an addict and masters degreed mental health clinician I am sorry to know that one of my colleagues is out there writing such dishonorable work. I would like to let Rachel know that Methadone is a form Harm Reduction! And, furthermore, harm reduction is health care! Without harm reduction, all of her "clients" would have had HIV, Hep-C, or even worse, would not be "clients" at all due to overdose. I am out in the street having meaningful, therapeutic relationships with heroin users almost everyday. Drug users are the most creative, resourceful, passionate, intelligent, sensitive people I have ever met. They are funny, curious, intuitive, flexible, thriving, self-healing, crisis managing, competent, energetic, resilient survivors. And, most importantly, they demonstrate faith, vision and hope. Please, if you are a graduate student, don't give up on heroin users, or miss the awesome opportunity to work with one because of the book. Thanks Rachel for leaving my community, it is professionals such as yourself that keep users mistrustful of traditional service providers and isolated from life saving health care and the healing that one can find in relationship with a therapist who knows what they are doing.
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Little Girl's First Book by henry levine (Boston, Ma) 1 Stars
February 14, 2003
People probably don't realize that Ms. Baldino was fresh from college and the Boston Methadone Clinic where she worked was her first job. That alone should lead to cautious review of her opinions concerning a very important problem. Personally I thought she was just one more of the terrible, ill prepared, and notoriously subjective social workers who stop in at one of these facilities as a starting position on the way up. She was terribly frightened of her clients, and obviously unsuited for the job she had. So I would absorb her comments ...
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