Welcome to Methadonia: A Social Worker's Candid Account of Life in a Methadone Clinic

Methadonia brings to the forefront some very elemental but often overlooked segments of the counselor's journey as well as the client's. As a counselor myself, reading the book was a great relief. The author's candid disclosure of the frustration, heartache and anger she felt in her work bring out the power of countertransference. As the author openly discusses her frustration, the reader also experiences her moving through the frustration and being able to focus back on the client. These normal but unsettling emotions are important to look at because both the client and the counselor can get stuck in the journey of change. Another striking piece to the book is the author's humble tone. People can grow through the quality of being humble. When we are humble, we recognize and value's other ideas. The author notes her opinions in the field of methadone treatment, but clearly recognizes the many types of treatment out there. She reminds us as clinicians how important it is to do our work in the spirit of collaboration for it is through the work of many compassionate individuals that we are able to better reach out to our clients.

Ms. Baldino chronicles a year in the life of a rookie methadone counselor with utmost courage and unrelenting, brutal honesty. Her short vignettes should be required reading for anyone preparing for a career in social work, because Ms. Baldino doesn't ignore the white elephants in the middle of the dosing room; she takes them by the leash and parades them into our consciousness. She addresses the obvious pitfalls of turning drug counselors into virtual police officers; she probes directly into the criminal culture surrounding heroin abuse and how this interferes with the functioning of methadone clinics; she explains why transference is an improbable tool for eliciting change in heroin addicts, and how harm-reduction is not a good enough standard for treatment; she shows how addiction and sometimes its treatment irreparably damages the lives of clients' children; and she reveals the too often repressed emotions that lead counselors to compassion fatigue and eventual burn-out.Ms. Baldino does not discount the positive effects of Methadone Treatment for those clients who are highly motivated. She celebrates recovery and appreciates the incredible strength it takes to battle addiction. Ms. Baldino simply sees a need for change -- a treatment modality that treats those suffering from opiate addiction with compassion and respect.

Rachel Green Baldino has written an honest, objective, and often stunningly written account of a harrowing year as social worker in a methadone clinic. This very personal and compassionate book illustrates the tremendous difficulties faced by professionals who must, every day, handle the incredible array of problems faced by individuals addicted to heroin. And yet the real subject of this important book is how best to help people who live with addiction, how best to move beyond the current situation. Green Baldino does not look for easy answers. Her final chapter "A New Vision of Treatment" should be read by anyone interested in options beyond the current status quo in the U.S. concerning the use of Methadone. A brave book, and one that should be read and studied by teachers, students, and anyone interested in drug abuse in the United States.

I've read this book and have some familiarity with the world it so carefully chronicles, and I'm a bit confused about this last review. There are entire chapters in this book dedicated to the benefits of methadone for certain individuals, and it is in these chapters that Baldino celebrates the personal courage and strength of people who, with the help of methadone, turn their lives around. I think Baldino's criticisms of some of the systemic and physical obstacles surrounding methadone (for pregnant women, for example) comes from a place of great respect, proving once again that the most educated and hopeful people out there are those asking questions and, yes, being critical. One doesn't do addicts nor the system any favors by remaining blindly uncritical of methadone or methadone clinics. Baldino's questioning of the system and even her own participation within it strikes me as a more enlightened, compassionate, and optimistic approach than resorting to personal, misspelled attacks.

I found this book to be an excellent insight into the world of Methadone treatment -- a portrayl from the trenches and not the ivory tower. It not only draws an honest picture of the things a social worker faces, but also some of the treatment problems that addicts endure as a result of the manner in which the methadone treatment is administered. The writing style is refreshingly accessible and candid. The book's content is thoughtful and measured. This book should be required reading for anyone considering work in the field or developing policy recommendations for the treatment of heroin addicts.