SMITHFIELD STREET BRIDGE (PA) Research Paper Example | Topics and Well Written Essays - 3000 words

SMITHFIELD STREET BRIDGE (PA) - Research Paper Example Pittsburgh’s huge need for bridges presented a good opportunity for the engineers to showcase their knowledge and talent .The only form of transport within the town and some sections of the river banks in the early 19th century was the use of skiffs or canoes. As the community developed people realized that it was mandatory to build a ferry service and in 1818 the Jone’s Ferry service was established, in order to improve their business oriented culture. The ferry operated between southern bank of Monongahela and the base of Liberty Street. Stock and goods were carried by boats while passengers were carried by skiffs. In 1840, a more advanced horse ferry was developed which used blind horses as motive power. The blind horses were fitted in horizontal wheels when then propelled the boats (Von 77). A few years later a steam ferry was established by Captain Erwin on the southern bank of Ohio near the section where the rivers formed a confluence. Sadly, the ferry project col lapsed a few years later together with the Jones ferry project.Leaving just one operational steam ferry which operated from Penn Street to Saw Mill Run.The essay will deal with the three bridges elected at the Smithfield Street and how their construction revolutionized the bridge construction technology in the 19th century when civilization was developing at a remarkable speed The first bridge among the Pittsburghs highway bridges was known as the Monongahela Bridge. A bill was passed In Pennsylvania by the state legislative council allowing two bridges to be built at Pittsburg. One would be built over the Allegheny and the other one over Monongahela. Judge Findley, a member of the legislative council was given the task of calculating the overall cost of the structures. His calculations indicated that approximately 1200 feet of the river required chains that were 1590 feet long and four other iron chains weighing 64

The Impact of Social Media on Society Research Paper

The Impact of Social Media on Society - Research Paper Example Social media is highly trendy among college students. According to 2010 research, almost a quarter of students’ time on the web is spent in the social media (Wang, Chen & Liang). Facebook dominates the popularity list of the most widespread social networks, followed by Twitter and YouTube. Globally, Facebook has over 1.55 billion active users, half of whom log in on a daily basis. On average, students spend nearly two hours a day on the social networks. In 2007, a portion of American students who had a Facebook account was already impressive – 92%. By 2008, the number of users reached 99%. Keeping in mind that the service became available only in 2006, this is an amazing statistics. One of the positive sides of social media is that it can be utilized for academic purposes. Being easily accessible, online communities can offer numerous benefits for young individuals, such as providing a virtual platform for sharing thoughts and ideas with colleagues, enabling easy and fa st access to academic support, and enhancing computer knowledge and online communication skills. Moreover, students who are shy to present their thoughts in the class receive an opportunity to participate in discussions via blogs and virtual societies. On the contrary, findings in a number of studies suggest that the time spent in social networks is in inverse relation with academic grades (Wang, Chen & Liang). Jacobsen and Forste revealed that over 60% of the students use electronic media while in college, when studying, or while preparing for the class

Resort World Sentosa And Marina Bay Sands Tourism Essay

Resort World Sentosa And Marina Bay Sands Tourism Essay Though casino was their major way to earn revenue because of high gamblers addict all over the world, both of these resorts also added wide varieties of attractions and amenities for tourist attraction such as skypark, universal studios Singapore, celebrity chefs restaurant, museums, convention and exhibition centre, floating pavilion, etc. to attract not only the gamers but also families and childrens. In total both the resorts offer 33,500sqm of MICE space and more than 4000 hotel rooms. Attractions helped in many ways such as: Universal Studios Singapore- welcomed 13.2 million visitor and 22.3 billion tourism receipts last year (STB 2012). Both resorts support more than 40,000 jobs throughout which includes wide number of sectors such as retail, FB and transportation. Approx. 22,000 employees have been hired by these integrated resorts (Michael 2012). Both the IR hope to achieve 17 million visitors a year and generate about US $21 billion by 2015 (Katie 2011). Singapores both integrated resorts have a total development investment of more than S$13 billion (Iswaran 2010). The IR helped to broaden the range of job and career opportunities for Singaporeans with the bulk of jobs in for them in areas such as theme park operation, retain and Food and Beverage, etc. Both the resorts plan to continue re-invest and enhance their attractions to appeal to visitors an visitorship trends, benchmarks with respect to similar international attractions, industry standards and so on (Israwan 2011). Since both these resorts have done wonder full things for the people as well as tourist such as giving jobs to locals or providing attractions to tourist it also have negative impact on society as gamble addicts are borrowing money from loan sharks and when they are unable to repay the loan money they abandon their wives and children so as to feed their gambling addiction that leads women into forced prostitution to feed their kids (Dinah Lee-Phua 2011). Gambling leads to bankruptcy, imprisonment, family violence/breakdown. Economic Impacts: Singapores decision to build casino-based destination resorts was in part based on that argument, that the country could not ignore the potential economic significance of the IRs as it will not only boost the tourism industry, increase jobs but also the investment of billions of dollars to the economy; in other words growth, as opposed to stagnation (Wong, 2005). Singapores economy is diversified and is not based solely on tourism or the IRs but the income certainly could be useful. Such revenue for the state or country could be used to develop infrastructure and superstructures; essentially an economic development tool for the state or country as a whole. One of the other reasons that states or territories decide to legalize gambling and thus build casinos is to attract tourists to the area. These tourism products can complement and enhance the other tourism products and thus motivate tourist to the state or territory. Tourism is one of the key sectors that contribute to the Singapore economy. The goal is to achieve SDG$30 billion in tourism receipts with 17 million visitors by 2015 (STB, 2010). Proponents of casinos or casino-based resorts argue that the gaming element will increase tourism numbers. When Singapore legalized gambling, it was to increase the demand for and motivate tourists to the island state (Remesh, 2010). Casinos had to be part of the tourism product to be of significant economic value (Eadington, 1999). Families could be attracted to such places and there will be reason for the adults to stay longer. Going by the revenues that Macau received, the argument might be valid. The demand for non-gaming products, services and amenities will subsequently go up; in essence, the casinos could be for the greater good because on the whole the economy will be better off and thus the majority of the people within the gaming jurisdiction will benefit. Social Impacts: When the decision is made to legalize gambling, a state or country will experience not just positive impacts but negative social impacts as well. Petty theft and fraud linking casino employees have arisen. Traffic jams have increased, and environmental conditions have deteriorated. Consumer spending is neither reduced nor substituted. Bankruptcy, suicides, depression, lowered productivity and crime like fraud, are most prevalent with gambling. As if costs to the community like suicides, bankruptcies and lowered productivity are not enough, 5 to 10 other people were affected for every single problem gambler, (Australian Commission, 2009). The carrying capacity of a region could affect how the locals perceive the tourists within the gaming jurisdiction. There was no conclusive evidence that crime increased as a result of the casinos. Crime rates were contained in the initial opening of the casinos due to the increase in staffing by the local law enforcement agencies. However this increase in staff could not be sustained and as a result crime rates increased over time due to the casinos. Increase of child abuse may also occur due tom negligence of guidance from the parents addicted to gambling. As parents who lose money on gambling table often end up taking their frustration out on their kids or abusing them physically. Problems of borrowing from loan sharks are seen in Singapore due to high addiction of gambling. This happens due to people losing everything on gambling table thus deterioting them financially and forcing them to borrow more from loan sharks. They were also concerned that casinos would escalate gambling addition of locals, which would create financial difficulties for families and hence effect the Singapore economy altogether. Family harmony would be affected, while the good Singapore work ethic would be compromised. Social ills would also resurface (Withiam 2011). Resort World Sentosa has led to damaging of environmental effects on the countrys physical resources, ecological resources and terrestrial ecosystem. It has also resulted in the habitat destruction, removal of airshed, soil erosion, loss of biodiversity and water contamination (EIA Abhineet 2011). Bellagio is a luxury resort and casino in Las Vegas in Nevada. It is owned by MGM Resorts International and is famed for its elegance. It has total of 3,950 rooms with three different towers and is home to the most watched and famous Cirque du Soleil aquatic production commonly referred as O. It was opened on October 15 1988 and the total cost was approx US$88 million. It has number of attractions such as Gaming room, Fountains of Bellagio, Conservatory and Botanical gardens, Gallery of Fine Art, etc. with number of famous restaurants such as Le Cirque, Circo, Picasso, etc. Political Impacts: as we all know that Las Vegas is famous for casinos and has lot of casino at a stretch but for it to operate smoothly the casino are to updated with latest trends so as to keep up with the laws in a timely manner. Bellagio has a casino license and runs over more than 50 slot machines and more than 10 tables so as to pay a certain amount in tax per table in a month so as to not violate any laws. Economic Impacts: The casino creates jobs and reduces the level of unemployment. It contributes to improvement in community and infrastructure mainly in the transportation side as well as reducing public spending. The casino development has been targeted where economic development benefits the community and jobs scarcity has been reduced (J.P.Girard 2001). With Bellagio casino being so big it has helped the locals of Las Vegas and also the foreigners to earn their livelihood by working in the casino. Because of gambling, Las Vegas has shown impressive job growth, developed into a major city with a low tax burden that many state and local governments look at with envy, and has spawned significant private and public sector investment. However society would only support this if the benefits outweighs the costs. Social Impacts: But also it has affected the economy as local residents who used to travel outside of the region and gamble now stay within the region. Local residents who used to go to restaurants now spend their money in the casino. Then the casino has no net economic benefit. Tourists who used to spend money on other activities within the region now go to a gambling facility within the region. Still casino plays an important part on society as Bellagio Las Vegas is a testament of the powerful ability of gambling to foster economic development. But casinos leave a negative impact on society causing increase in traffic congestion, increased gambling addiction, drug use and prostitution. Tourists from abroad spend more time and money within the region. It was noted that alcohol and drug use increased between gamblers due to their loss in the casino or for people seeking treatment for gambling problems. Family breakdowns and mental health issues such as depression, psychiatric disorde rs, past histories of sexual or physical abuse and low self-esteem were found among the gamblers. Due to high addiction of gambling there has been an expenditure growth in casino industry than the growth in personal income (Ricardo 2008). It has been researched and proved that profound gamblers often suffer from profound marital difficulties. Gaming has jeopardized the quality of life of individuals and families in past (Burke 2003). A lot of financial difficulties involving money, laundering, paying high interest rates on debts and suicide have been seen so far. Technology: helps Bellagio to offer more luxury, better customer service and an overall increase in customer satisfaction. Fast and easy communication service provides Bellagio with a competitive advantage compared to other hotel. Bellagios website helps the customer to give information about the latest happenings anywhere anytime. Bellagio has full range of services on their website such as customers can take virtual tour, see the rooms and make the reservation online. Environmental Impacts: a casino usually generates about 20,000 to 30,000 customer vehicles and 6,000 or more employee vehicles each day leading to air pollution due to increased traffic. With a casino comes a heavy parking demand and more congestion. It draws down scarce groundwater and also threaten endangered species. Correcting all this cost between $5.5 to$7.7 million per year leading to waste of money and resources. Though Las Vegas is commonly known as Sin City so the crime rates are expected to be high. It was noted that last year fall the crime rates including shop lifting, stealing of casino chips, etc. increased a lot due to proper security management. It was reported that last year December 14, Anthony Michael Carleo stole $1,500,000 worth of Bellagio chips from Bellagio casino and was sentenced to 35 years of imprisonment last month (Pitt 2012). So Bellagio took this this really seriously and did a stringent screening and drug test on its employees to reduce internal threats. It was also noted that there were fake Bellagio chips being sold in the local market at a reasonable price that attracted lot of people and those people even had links with the security guards of the casino so as to take the chips inside (LAPD 2008). So as to avoid all this in future a proper security system was installed in Bellagio that had its eye everywhere. Systems such as 24 hours monitored security alarm, smok e alarms in all non-smoking rooms were installed to ensure the safety of the hotel as well as the customers. Every corner of the casino had a camera with 2 control rooms to look out for thief and to ensure safety of everyone there. There was 24 hours security and the security came from the best security department in USA. Bellagio used proper safety measures in case of emergency such as fire, accidents, deaths, etc. by keeping proper safety measures such as medical kit, qualified doctors in the house, etc. with all such steps/measures. Mixed use development simply involves the addition of residential units to a standard resort concept as a part of a sometimes rather dubious way to finance the whole development (Philip 2009). Bellagio has been using it for years now and everytime when possible tries to upgrade it. It provides customer with a variety of accommodation styles, sporting and leisure activities, security, a lifestyle living experience. Bellagio attracts lot of its customer via the casino as it is home to many professional poker players due to high table limit including high stakes and also because it holds world poker tournament as well. But it does not only attract the gamblers it also succeeds in attracting non-gamblers, family and children while using mixed use development concept as it has a very famous show O by Cirque du Soleil as it has international cast of world class acrobats, divers, swimmers performing on water to create a breath taking experience for its customers. Fountains of Bellagio that is set in 8 acre man-made lake with 4.500 lights and have lot of performance for the people to enjoy at night. The conservatory and botanical gardens is a must watch as it shows five seasonal themes such as Chinese new year from January to march displaying the bromeliads and orchids as well as animal of Chinese zodiac, spring displaying varieties of tropical flower, summer, fall and winter. Along with all this Bellagio has also focused on relaxation and fitness for its customer by providing variety of spa packages along with fitness centre. It is home to many golf lovers and those who wants to learn golf can learn at a reasonable rate at Bellagio with different courses available for different needs. Bellagio is famous in Las Vegas for its nightlife as it has many bar, lounge and clubs for party animals to enjoy the sin city and have a memorable time. Bellagio offers high range of exclusive shops for gifts, accessories, jewellery and fragrances and is a must shopping place for ladies . Though Bellagio use a mixed use development concept but it also takes care of the environment by using reclaimed water and on-site power generation plant and has also constructed a 5.300 space parking garage for the employees as well as customers so as to avoid traffic congestion. In todays date it is very important for any hotel to develop sustainability plan in order to survive in the market and stay ahead of its competitor. Bellagio is committed to conservation efforts that support living in the desert. These practices extend beyond Bellagio and reach the local community by educating employees about conserving natural resources at home as well as partnering with local, eco-minded organizations (Drew 2007). Bellagio is using $70 million alone to refurbish all the guest rooms so as to make it more attractive for the guest and they are changing everything in their restaurants to the exteriors of the hotel. Bellagio has achieved sustainable development and will keep on achieving it by following four most important steps towards sustainable development that is to guide and be guided by a clear vision of sustainable development and goals to achieve highest ranking among all hotels. It reviews the whole system as well as its parts considering the well-being of soc ial, ecological and economic systems, their state as well as the direction and rate of change of that state, their parts and use of these parts. It has adopted a time horizon long enough to capture human and ecosystem time scales to know what they want to achieve and how they want to achieve and also whats best for their customers in terms of needs, necessities, etc. they take in the advice of their customers very seriously to make themselves better and also to outbeat the rest of the hotels. The employees are well trained and educated and provide ongoing support in the decision making process. Bellagio has been home to many events in the casino as well as in the clubs or lounges and has also been shown in many movies. They have kept this tradition alive by calling someone or the other every year to perform in their hotel and this year also they are doing the same but on a large scale as they are inviting the Korean pop dancer/singer PSY to perform in their casino on February 23rd s tarting around 9 pm and there would be lot of songs sung by him and his world famous song Oppa Gangnam Style. Tickets are going at 100, $200 and $300 with lots of surprises for the guest and there would be lot of games as well and the winner will get an autograph t-shirt by PSY himself and an opportunity to dance with him on the stage created in casino. Thus all this helps and will keep on helping the Bellagio hotel to remain on track and be one of the top most preferred hotel of Las Vegas in near future also.

Comparing Themes of Lord of the Flies, The Inheritors, and Pincher Martin :: comparison compare contrast essays

Themes of Lord of the Flies, The Inheritors, and Pincher Martin      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A running theme in William Golding's works is that man is savage at heart, always ultimately reverting back to an evil and primitive nature. The cycle of man's rise to power, or righteousness, and his inevitable fall from grace is an important point that Golding proves again and again in many of his works, often comparing man with characters from the Bible to give a more vivid picture of his descent. Golding symbolizes this fall in different manners, ranging from the illustration of the mentality of actual primitive man to the reflections of a corrupt seaman in purgatory.         William Golding's first book, Lord of the Flies, is the story of a group of boys of different backgrounds who are marooned on an unknown island when their plane crashes. As the boys try to organize and formulate a plan to get rescued, they begin to separate and as a result of the dissension a band of savage tribal hunters is formed. Eventually the "stranded boys in Lord of the Flies almost entirely shake off civilized behavior: (Riley 1: 119). When the confusion finally leads to a manhunt [for Ralph], the reader realizes that despite the strong sense of British character and civility that has been instilled in the youth throughout their lives, the boys have backpedaled and shown the underlying savage side existent in all humans. "Golding senses that institutions and order imposed from without are temporary, but man's irrationality and urge for destruction are enduring" (Riley 1: 119). The novel shows the reader how easy it is to revert back to the evil nature inherent in man. If a group of well-conditioned school boys can ultimately wind up committing various extreme travesties, one can imagine what adults, leaders of society, are capable of doing under the pressures of trying to maintain world relations.    Lord of the Flies's apprehension of evil is such that it touches    the nerve of contemporary horror as no english novel of its time has    done; it takes us, through symbolism, into a world of active,    proliferating evil which is seen, one feels, as the natural condition of    man and which is bound to remind the reader of the vilest manifestations    of Nazi regression (Riley 1: 120).

Tyco’s problem Essay

Tyco’s job was a consequence of top executives and members of the board non supervising what was legal and what wasn’t within their company. CEO’s Kozlowski and CFO Swartz failed to unwrap 1000000s of dollars of low involvement and involvement free loans they received from Tyco. The executives unethical behaviour resulted in stockholders benefits being written off which ended the company traveling into a monolithic debt. The top executives displayed greed for money. 1. What do you believe Kozlowski motive for seeking to avoid gross revenues revenue enhancements on his art purchases was? Kozlowski motive was power and greed for money. Kozlowski knew that he was in a top place of authorization. and most likely believed that no 1 was traveling to oppugn his place or the incorrect things that he was going involved in. There was besides no existent answerability nowadays or trueness to Tyco. Kozlowski realized that if he purchased the graphics with Tyco financess and so falsified the records. so he wouldn’t have to pay the revenue enhancements out of his ain pocket and took a great hazard that no 1 would happen out. He abused Tyco’s assets for his ain pecuniary addition. 2. Explain the construct of commingling assets with regard to the Tyco instance Commingling assets is and is the act of blending the financess belonging to one party with those of another party. particularly when one party has duty to maintain the financess separate for the other party. Tyco used this as a manner to travel around the system for its on personal additions. concealing the true purposes of its executives. Commingling personal with concern assets is overall a hapless concern determination. The executives treated the company’s money as if it were your ain. Besides. the executives used Tyco’s concern assets for their ain personal addition by buying graphics. multiple existent estate belongingss. jewellery. and other dearly-won points for personal usage. By commingling assets. the executives caused attending from revenue enhancement governments and SEC and other condemnable probes due to their delusory behaviours. 3. Would it hold been possible for the board of managers to see the accommodations taking topographic point in the different plans at Tyco? The board members could hold found the unlawful accommodations taking topographic point. but non really likely in this instance. In a sense. the board of managers is every bit much at mistake as the piquing executives because if they played a more proactive function in the concern operations. so the executives may non hold gotten away with every bit much as they did for the long period of clip. If they had taken a more active function. they would hold found deceptive paperss and fraud strategies that were go oning manner Oklahoman than when they were finally discovered. As a consequence of the board non taking an active function. the executive’s actions went on for some clip without any notice. The executives knew what they were making was incorrect and illegal. being involved in revenue enhancement equivocation. hyperbolic net incomes and commingling assets. The executives were besides passing out illegal unauthorised fillips. They besides become involved in paying off functionary to be quiet on the affair. Overall. the incorrect actors of the company knew that their actions were illegal. unethical. and dearly-won to Tyco. but they risked all of these things for their ain personal addition. They believed that no 1 would catch on to their actions. but like all offenses that condemnable commit. it finally catches up with them.

Methadone Maintenance

Opiate addiction is a chronic disease that affects millions of people in the Unites States. This deadly epidemic is one that in most cases requires some form of medical treatment. There are many treatment options available to those struggling with addiction. The three most well-known options are rapid detect, jukeboxes, and methadone maintenance (Medication-Assisted Treatment for Podia Addiction Facts for Families and Friends).Though each form of treatment has its own advantages and disadvantages, they all have one common goal; drug freedom. Research has shown that those receiving treatment are nearly twice as likely to achieve their goal of drug freedom (Mayo Clinic). Opiates are highly addictive powerful drugs that are derived from the poppy plant and are generally used to relieve pain (mayo clinic). There are two types of opiates, natural and man-made. Though both are prescribed by physicians with the exception of heroin, often times when dealing with someone that has become addic ted they are obtained illegally.Because of the potential for prescribed opiates to end up being sold or traded on the streets, stricter regulations have been put in lace for physicians to prescribe them (samara). Where they were once a little quicker to write a prescription for a schedule II narcotic, they are now telling patients to â€Å"take a Ethylene or Motoring† (Levied). These regulations have become a necessity in the war against opiate addiction. Deciding to enter into treatment for opiate addiction is one that requires much thought. Generally when one decides that it is time for them to enter treatment, they have hit rock bottom (Levied).However, rock bottom is different for every person. For some, treatment may be court ordered and they are in a situation where their form of retirement is being chosen for them. For some, they are on the verge of losing everything that is important to them, or they may have already lost it. Whatever the reason may be, getting the tr eatment needed is a life changing decision. The best form of treatment varies from person to person. For some, the idea of a rapid detect would be the best. It is a quick process that only requires a short stay of usually 2-4 days in a detect facility or a hospital (mayo clinic).In most cases, the person will be given medication to assist them in dealing with the side effects of withdrawing from opiates. During a rapid detect, patients are monitored around the clock for a period of time for signs life-threatening withdrawal symptoms such as cardiac distress and seizures (ASSAM). Those that choose a rapid detect can expect to be sedated to keep them as comfortable as possible during this time period. Prior to sedation, they are generally given Maltreatment, to block the effects of opiates. Other medications may also be given during this time as withdrawal symptoms increase.In many cases medication to help control blood pressure and seizures become necessary. Jukeboxes has become popu lar because it does not require one to report to a clinic lily, but rather are given a prescription to be filled at a pharmacy. Jukeboxes comes in two forms, a tablet and a film, both are administered subliminally (jukeboxes). Though there are regulations governing the prescribing of jukeboxes, they are not nearly as strict as those in place for methadone (FDA). In order for a physician to begin prescribing jukeboxes, they are required to complete online training that is very limited (Manson).For many, that is the only training they have in addiction. Methadone is a synthetic drug that acts in a similar way to narcotics. Methadone moms in the form off tablet, powder, or liquid. The tablet and powder form are dissolved prior to administering the medication. When methadone is taken on a regular schedule, it will build up in the tissues making the effects last longer (samara). Methadone will not provide the same effects of opiates such as sedation or euphoria; it will instead block the se effects if other opiates are used (Catatonia 8). A stable dose will vary from person to person.Generally once someone achieves a stable dose of methadone it will hold them for 24-48 hours without them feeling dope sick (Levied)† Medication-assisted treatment has proven to be the most successful form of treatment for someone wishing to become drug free. However, these forms of treatment face tough criticism. It has been said that treating opiate addiction with medication is simply trading one addiction with another. However for those dealing with the daily struggle of addiction, they depend on these forms of treatment to gain control of their lives.For those people, the daily routines, the counseling, the referrals, the support of others and the consequences is what gives them hope; the pop that they will beat this disease that plagues them (in my own words). Methadone Maintenance treatment is the one form of treatment available that offers all of those things and more. When properly used, I feel that methadone maintenance treatment is the safest and most effective way to treat opiate addiction. There are many reasons that I feel methadone maintenance is the safest form of treatment available to someone battling opiate addiction.Contrary to what some may think, or some of what has been reported, these facilities can have a life changing effect on those who are committed to the program (Methadone Maintenance Treatment Facts). These programs are not only a place for someone to come in, pick up a prescription and leave. Instead these programs require patients to report daily for their medication, at least until they are able to meet all requirements for take home privileges. While there, patients interact with office staff, nursing staff, and clinical staff on a daily basis.Patients are monitored for any changes in their appearance, attitude, alertness, and overall demeanor (Levied). This helps to ensure that if someone is having an issue that staff is th ere to offer assistance right away. For many that battle addiction, Just knowing someone is there to listen and offer as much assistance as possible is enough to get them headed on the right path (In My Own Words). The guidelines set by the federal and state governments are much stricter for methadone maintenance that those set for jukeboxes (samara).For instance, in jukeboxes clients walk into a clinic to sign up and within a matter of a couple of hours they are able to walk out with at the very least medication that should last them a week. When people struggling with addiction first make the choice to enter into a retirement program, they are scared, sick, and in many cases about to lose everything important to them (In My Own Words). These patients are still using illicit drugs daily, and are at this point willing to do whatever it takes to avoid being â€Å"dope sick. Jukeboxes often ends up being sold illegally on the streets because people that have been lying, cheating, and stealing for a long period of time are now given a large amount of medication to take home with them (Levied). Methadone maintenance has a lengthy set of requirements before one is able to obtain the privilege of taking home medication (Blanchard and Crappy). One must be in treatment for 90 days, and produce at least 3 illicit free urine drug screenings before earning the privilege of one dose of medication to take home.In order for someone to have a full week worth of medication to take home with them at one time as they do in jukeboxes treatment after one day, they must be enrolled in the program for a minimum of three years and produce at least 12 illicit free urine drug screenings (SMASH). That is Just one of many requirements for one to earn the privilege of taking home their medication. They also have to participate in regular counseling sessions. The amount of time required for each session varies from patient to patient depending on the amount of time they have been enrolle d in the program as well as their use of illicit substances.Patients are required to sign releases for every physician that they see so that care can be coordinated properly. It is very important that medication that physicians prescribing other medications are aware of the patient being on methadone. By the time patients in methadone maintenance are able to start taking home doses of their medication, they have started on the right path (Levied). They are on a stable dose that effectively holds hem without the use of opiates, and they like the freedom of not having to report to the clinic to be dosed for the day.These take home bottles that are so hard to obtain, are so easy to have revoked as well. If someone produces an illicit urine drug screening, or does not get their required amount of counseling time in for the month among other things, they will have to start earning their take home privileges all over again. Those that receive take home bottles are also subjected to  "call backs (Medication-Assisted Treatment for Podia Addiction. )† This is when the client is allied and given a short notice of when they will have to report to the clinic with all of their used and unused take home bottles.At this time, the bottles are thoroughly inspected to be sure that their medication is in fact being administered the correct way (SAMARA). Because of these guidelines being as strict as they are, less methadone is sold illegally in the streets making it a safer choice. Methadone is also the safest form of treatment for pregnant women who happen to be struggling with opiate addiction (Practical Approach). In fact, it is currently the only FDA approved medication for treating opiate addiction during pregnancy Methadone Maintenance Treatment (MET): A review of Historical and Clinical Issues. When properly prescribed, methadone has proven to provide an environment that is less stressful on a developing fetus (Catatonia, 19). While a proper dose of methadone w ill help to prevent miscarriage and pre-mature labor, other forms of treatment seem to cause these issues. The use of maltreatment has been proven to cause spontaneous abortion, fetal distress, premature labor, and stillbirth Issues. ) Because methadone is a long acting medication, it is able to provide the fetus with an environment that promotes development.Though methadone during pregnancy is considered to be the safest of the options available, it comes with side effects (About Methadone). Babies born to mothers prescribed methadone are at risk for low birth weight. This is a very small risk to take when compared to risks faced with other forms of treatment such as jukeboxes or rapid detect. Some of those risks include fetal distress and miscarriage. During pregnancy, women are monitored very closely by the physician at the clinic and are also required to provide proof of prenatal care from an BOGGY (Levied).Studies have shown no long term effects on babies that are born to mothe rs prescribed methadone during their pregnancy. At birth, these babies will test positive for methadone in their systems, however are able to be weaned in a timely manner (Catatonia, 20). When compared to a rapid detoxification and jukeboxes, methadone maintenance is the safest choice. When a rapid detect lasting 2-4 days in most cases is completed, the patient is left without any aftercare other than what they obtain on their own. They are given a stack of paperwork that in most cases will contain a few referrals for mental health providers and a list of AN meetings.At this time, the patient may be wrought the worst part of the withdrawal process, but they are still unstable (ASSAM). These patients still need the support of clinical and medical personnel, but sadly many will not get that support. Those that do not will most likely find themselves in the same situation they were in previous to the rapid detect. Though patients in jukeboxes treatment have more of a clinical and medic al support than those choosing rapid detect, they still do not have the same support as those in methadone maintenance.Those Just starting out in treatment, whatever option they may choose, are at the lowest points in their lives. It is because of that I feel that they are in need of the most support that is available to them. To me, that support comes from a friendly smile when they walk into the clinic every day that reminds them that they are Just another Junkie, they are a person. They are a person that deserves to be monitored daily, given referrals for housing, food, clothing, medical care, and anything else that they could possibly need. For many addicts, the clinic is the safest place that they are in all day (In My Own Words).The goal of any form of treatment is to improve the patient's health as well as their laity of life (Marion). For many struggling with addiction, their health has come last while obtaining opiates in order to avoid feeling â€Å"dope sick† has c ome first. For many, this low point in their lives will lead them to participate in high risk behaviors. Those that find themselves addicted to opiates will often turn to theft or prostitution in order to fund their habit, while others will share needles used to administer drug such as heroin.These high risk behaviors not only put them at risk for many other infectious diseases such as Hepatitis and HIVE, but for legal troubles as well (Marion). Though the long term results of any treatment lays largely on the person in treatment, studies show methadone maintenance to be the most effective form available at this time (Medication-Assisted Treatment for Opiate Addiction). Drug freedom is a long term commitment that has to first be taken seriously by the person in treatment. If the dedication on their part is not there, the efforts of clinic staff will not be enough to help them (Pogo).Research has shown that that rapid detect treatment has a high rate of relapse (Medication- Assisted Treatment for Podia Addiction). Those that choose a rapid text as a form of treatment often have difficulty transitioning into a lifestyle of recovery. Often times, they are still living in the same places, with the same phone numbers, and associating with the same people making abstinence from opiates even harder to maintain (Mayo Clinic). For most choosing this form of treatment, it only takes one poor decision to be back in the same situation they were before.These poor decisions have devastating effects on their sobriety making this form of treatment the least effective of the three most well-known forms of medication assisted treatment. Psychosocial counseling has proven to be very beneficial to those dealing with addiction. Those enrolled in both Jukeboxes and Methadone Maintenance is required to participate in counseling. However for those that has chosen a rapid detect, this counseling is not a requirement. . Referrals are given to the patients upon discharge from the facili ty, but not everyone follows through with it .For some it is simply because they feel they do not need it, for some it is because they are unable to afford it (Mayo Clinic). Jukeboxes treatment does require some counseling though the guidelines for this is not nearly as strict as those set for ethanol maintenance. For those enrolled in a methadone maintenance treatment program, there are strict rules for clients to obtain this counseling (Pogo). Clients enrolled in a methadone maintenance program are required by state and federal regulation to have a minimum of 2. 5 hours of counseling time per month (ASSAM).Clients will usually meet with their counselors once or twice each week to discuss progress in treatment as well as the goings on in their lives. By discussing issues that the client is dealing with, the counselors are able to teach them skills that will be useful to the client as they continue on the path to drug freedom. During this counseling, clients are taught many ways to recognize triggers that were once their excuse to use illicit substances so that they are able to refrain from using (Pogo). Counselors discuss in depth the things that seem to be holding the clients back from achieving their goal of drug freedom.By doing this, they are able to form treatment plans for the client. These treatment plans list goals as well as steps needed in order to achieve the goals. If needed, clients are given referrals during this time. When referrals are given to a client, the counselor will check in with the client to see if they ere able to get the assistance they were in need of (Pogo). The fact that the counselors take the time to follow-up on things discussed during these sessions hold the client accountable for their treatment. Because they are held accountable, I feel that it helps to make methadone maintenance a more effective form of treatment.The goal of methadone maintenance treatment is to stabilize the patient. A stable dose of methadone with effect ively block the craving for one to use illicitly while avoiding withdrawal symptoms which in turn permits one to function â€Å"normally. † When taken properly, methadone will not create sedation or euphoria. It should have no adverse effects on mental capacity, motor skills, or the ability for one to maintain employment. A stable dose of methadone will hold a person for 24-48 hours which will allow them the time and energy to devote to making improvements in their lives.However, methadone maintenance treatment is a long term commitment. It can take up to a month to achieve a stable dose in order for a patient to get the most benefits out of treatment. A stable dose of methadone varies from person to person (Levied). There are many factors that will affect the dose that one would require to become stable. For many, the tolerance that they have built up over years of illicit use will require them to have a much higher dose of methadone in order to remain stable.For others, hea lth factors and other medications will affect the way their body is able to metabolize the methadone requiring them to have a higher or lower dose. Once a stable dose is achieved, one is usually able to begin the process of getting their lives back on track by dealing legal obligations, following up on medical care that has been pushed to the side, and mending broken relationships with family members (Pogo). The longer one remains committed to treatment; they will have a greater success rate for maintaining their goal of drug freedom.It is recommended that one remain in a methadone maintenance program for a minimum of one year. For many, once they achieve a stable dose and they are able to provide illicit free urine drug screenings, they feel that they will be able to effectively remain drug free on their own. In these cases, the rate of relapse is much higher than those who remain committed to the program for a year or in many cases longer (Methadone Is an Effective Treatment for H eroin Addiction). Those who remain in treatment for at least year are nearly three times as likely to remain drug free than those who are only in treatment for a short period of time.In a methadone maintenance program, the patient along with the influence of clinical and medical staff decide when they have reached a point in their treatment that they are ready to begin decreasing their dose in order to discharge from the treatment program. There is no set time frame to this process. When one decides they are ready to begin decreasing, they have generally been on a stable dose for an extended period of time and have shown that they are able to effectively manage heir new abstinent lifestyle.Patients that decrease their doses slowly have proven to have the most success in remaining drug free. The slow taper allows their bodies time to adjust to the change in medication so that they are able to refrain from having withdrawal symptoms. These withdrawal symptoms are what will push a pers on into illicit opiate use again. Once a decrease in a person's methadone dose is taken, they are encouraged to remain at that lower dose for a period of at least 2-4 weeks.During this time, the clinical and medical staff is able to monitor the patient o ensure that they are handling the decrease in medication with no adverse effects. This process for tapering will continue until the patient has reached a dose of OMG when they will be able to â€Å"walk off' from the treatment. After the patient has been able to discontinue the use of methadone, they will still receive after care. Clinical staff will make phone calls to check in on the patient and offer them resources that will assist them in remaining drug free.Methadone and Jukeboxes clinics face tough criticism from many. People living in communities where these clinics are located are often unpleased with having a clinic n their neighborhood. Many feel that it will bring drug addicts and crime into their otherwise peaceful neig hborhoods (Swisher). What they fail to realize is that these addicts are a part of their communities regardless of if they are enrolled in a treatment facility or not (In My Own Words). It is a common misconception that it is very easy to â€Å"pick out† an addict (Mayo Clinic).However, that could not be more untrue. There are people everywhere that struggle daily with addiction. Some of these are doctors, lawyers, teachers, actors and actresses, and professional sports figures to name a few (Mayo Clinic). These are people that are clean, well dressed, well groomed and well spoken. Not every addict lacks personal hygiene and an education. There are certain risk factors that may be a factor in opiate addiction. For many who suffer from addiction, the environment that they are in plays a large role in them remaining dependent on illicit substances.There are also inherited traits that will influence one's addiction. Those that have immediate family that suffers with addiction ar e at a higher risk of also having addiction issues themselves. Research has also shown that males are nearly twice as likely to have addiction problems as males (Mayo Clinic). Methadone was approved by the FDA in 1972 for the treatment of opiate addiction. Methadone is considered to be the most effective treatment available to those addicted to opiates (Methadone Maintenance Treatment (MET): A Review of Historical and Clinical Issues).It is estimated that upwards of 170,000 individuals in the United States currently are enrolled in a methadone maintenance program. It has been proven that illicit drug use has decline by over 60% for those that have been enrolled in a methadone maintenance program for a year. For those that main committed to the program for at least two years, the use of illicit opiates declines by nearly 85% (Accreditation Of Methadone Maintenance Treatment: Assuring Quality of Care. ) Furthermore, crimes committed by these individuals are also significantly reduced. After lengthy research, I am confident is saying that methadone maintenance treatment is not only the safest method of medication assisted treatment available to those battling opiate addiction, but it is also the most effective Accreditation of Methadone Maintenance Treatment: Assuring Quality of Care). The regulations overriding methadone maintenance are much stricter than those for other forms of treatment. Methadone maintenance is the only form of medication assisted treatment that is approved by the FDA for pregnant women.It also remains the form of treatment that has the most thorough requirements for admission, and for supplemental and after care. As with any form of treatment, there are pros and cons, however it has been proven that for someone struggling with this disease that the pros far outweigh the cons. This form of medication has assisted thousands of people in getting their lives back. It has made it possible for patients to function successfully in society. These pe ople will be able to maintain employment and be productive. The counseling that they receive will help them to recognize triggers and effectively avoid them. Methadone Maintenance Opiate addiction is a chronic disease that affects millions of people in the Unites States. This deadly epidemic is one that in most cases requires some form of medical treatment. There are many treatment options available to those struggling with addiction. The three most well-known options are rapid detect, jukeboxes, and methadone maintenance (Medication-Assisted Treatment for Podia Addiction Facts for Families and Friends).Though each form of treatment has its own advantages and disadvantages, they all have one common goal; drug freedom. Research has shown that those receiving treatment are nearly twice as likely to achieve their goal of drug freedom (Mayo Clinic). Opiates are highly addictive powerful drugs that are derived from the poppy plant and are generally used to relieve pain (mayo clinic). There are two types of opiates, natural and man-made. Though both are prescribed by physicians with the exception of heroin, often times when dealing with someone that has become addic ted they are obtained illegally.Because of the potential for prescribed opiates to end up being sold or traded on the streets, stricter regulations have been put in lace for physicians to prescribe them (samara). Where they were once a little quicker to write a prescription for a schedule II narcotic, they are now telling patients to â€Å"take a Ethylene or Motoring† (Levied). These regulations have become a necessity in the war against opiate addiction. Deciding to enter into treatment for opiate addiction is one that requires much thought. Generally when one decides that it is time for them to enter treatment, they have hit rock bottom (Levied).However, rock bottom is different for every person. For some, treatment may be court ordered and they are in a situation where their form of retirement is being chosen for them. For some, they are on the verge of losing everything that is important to them, or they may have already lost it. Whatever the reason may be, getting the tr eatment needed is a life changing decision. The best form of treatment varies from person to person. For some, the idea of a rapid detect would be the best. It is a quick process that only requires a short stay of usually 2-4 days in a detect facility or a hospital (mayo clinic).In most cases, the person will be given medication to assist them in dealing with the side effects of withdrawing from opiates. During a rapid detect, patients are monitored around the clock for a period of time for signs life-threatening withdrawal symptoms such as cardiac distress and seizures (ASSAM). Those that choose a rapid detect can expect to be sedated to keep them as comfortable as possible during this time period. Prior to sedation, they are generally given Maltreatment, to block the effects of opiates. Other medications may also be given during this time as withdrawal symptoms increase.In many cases medication to help control blood pressure and seizures become necessary. Jukeboxes has become popu lar because it does not require one to report to a clinic lily, but rather are given a prescription to be filled at a pharmacy. Jukeboxes comes in two forms, a tablet and a film, both are administered subliminally (jukeboxes). Though there are regulations governing the prescribing of jukeboxes, they are not nearly as strict as those in place for methadone (FDA). In order for a physician to begin prescribing jukeboxes, they are required to complete online training that is very limited (Manson).For many, that is the only training they have in addiction. Methadone is a synthetic drug that acts in a similar way to narcotics. Methadone moms in the form off tablet, powder, or liquid. The tablet and powder form are dissolved prior to administering the medication. When methadone is taken on a regular schedule, it will build up in the tissues making the effects last longer (samara). Methadone will not provide the same effects of opiates such as sedation or euphoria; it will instead block the se effects if other opiates are used (Catatonia 8). A stable dose will vary from person to person.Generally once someone achieves a stable dose of methadone it will hold them for 24-48 hours without them feeling dope sick (Levied)† Medication-assisted treatment has proven to be the most successful form of treatment for someone wishing to become drug free. However, these forms of treatment face tough criticism. It has been said that treating opiate addiction with medication is simply trading one addiction with another. However for those dealing with the daily struggle of addiction, they depend on these forms of treatment to gain control of their lives.For those people, the daily routines, the counseling, the referrals, the support of others and the consequences is what gives them hope; the pop that they will beat this disease that plagues them (in my own words). Methadone Maintenance treatment is the one form of treatment available that offers all of those things and more. When properly used, I feel that methadone maintenance treatment is the safest and most effective way to treat opiate addiction. There are many reasons that I feel methadone maintenance is the safest form of treatment available to someone battling opiate addiction.Contrary to what some may think, or some of what has been reported, these facilities can have a life changing effect on those who are committed to the program (Methadone Maintenance Treatment Facts). These programs are not only a place for someone to come in, pick up a prescription and leave. Instead these programs require patients to report daily for their medication, at least until they are able to meet all requirements for take home privileges. While there, patients interact with office staff, nursing staff, and clinical staff on a daily basis.Patients are monitored for any changes in their appearance, attitude, alertness, and overall demeanor (Levied). This helps to ensure that if someone is having an issue that staff is th ere to offer assistance right away. For many that battle addiction, Just knowing someone is there to listen and offer as much assistance as possible is enough to get them headed on the right path (In My Own Words). The guidelines set by the federal and state governments are much stricter for methadone maintenance that those set for jukeboxes (samara).For instance, in jukeboxes clients walk into a clinic to sign up and within a matter of a couple of hours they are able to walk out with at the very least medication that should last them a week. When people struggling with addiction first make the choice to enter into a retirement program, they are scared, sick, and in many cases about to lose everything important to them (In My Own Words). These patients are still using illicit drugs daily, and are at this point willing to do whatever it takes to avoid being â€Å"dope sick. Jukeboxes often ends up being sold illegally on the streets because people that have been lying, cheating, and stealing for a long period of time are now given a large amount of medication to take home with them (Levied). Methadone maintenance has a lengthy set of requirements before one is able to obtain the privilege of taking home medication (Blanchard and Crappy). One must be in treatment for 90 days, and produce at least 3 illicit free urine drug screenings before earning the privilege of one dose of medication to take home.In order for someone to have a full week worth of medication to take home with them at one time as they do in jukeboxes treatment after one day, they must be enrolled in the program for a minimum of three years and produce at least 12 illicit free urine drug screenings (SMASH). That is Just one of many requirements for one to earn the privilege of taking home their medication. They also have to participate in regular counseling sessions. The amount of time required for each session varies from patient to patient depending on the amount of time they have been enrolle d in the program as well as their use of illicit substances.Patients are required to sign releases for every physician that they see so that care can be coordinated properly. It is very important that medication that physicians prescribing other medications are aware of the patient being on methadone. By the time patients in methadone maintenance are able to start taking home doses of their medication, they have started on the right path (Levied). They are on a stable dose that effectively holds hem without the use of opiates, and they like the freedom of not having to report to the clinic to be dosed for the day.These take home bottles that are so hard to obtain, are so easy to have revoked as well. If someone produces an illicit urine drug screening, or does not get their required amount of counseling time in for the month among other things, they will have to start earning their take home privileges all over again. Those that receive take home bottles are also subjected to  "call backs (Medication-Assisted Treatment for Podia Addiction. )† This is when the client is allied and given a short notice of when they will have to report to the clinic with all of their used and unused take home bottles.At this time, the bottles are thoroughly inspected to be sure that their medication is in fact being administered the correct way (SAMARA). Because of these guidelines being as strict as they are, less methadone is sold illegally in the streets making it a safer choice. Methadone is also the safest form of treatment for pregnant women who happen to be struggling with opiate addiction (Practical Approach). In fact, it is currently the only FDA approved medication for treating opiate addiction during pregnancy Methadone Maintenance Treatment (MET): A review of Historical and Clinical Issues. When properly prescribed, methadone has proven to provide an environment that is less stressful on a developing fetus (Catatonia, 19). While a proper dose of methadone w ill help to prevent miscarriage and pre-mature labor, other forms of treatment seem to cause these issues. The use of maltreatment has been proven to cause spontaneous abortion, fetal distress, premature labor, and stillbirth Issues. ) Because methadone is a long acting medication, it is able to provide the fetus with an environment that promotes development.Though methadone during pregnancy is considered to be the safest of the options available, it comes with side effects (About Methadone). Babies born to mothers prescribed methadone are at risk for low birth weight. This is a very small risk to take when compared to risks faced with other forms of treatment such as jukeboxes or rapid detect. Some of those risks include fetal distress and miscarriage. During pregnancy, women are monitored very closely by the physician at the clinic and are also required to provide proof of prenatal care from an BOGGY (Levied).Studies have shown no long term effects on babies that are born to mothe rs prescribed methadone during their pregnancy. At birth, these babies will test positive for methadone in their systems, however are able to be weaned in a timely manner (Catatonia, 20). When compared to a rapid detoxification and jukeboxes, methadone maintenance is the safest choice. When a rapid detect lasting 2-4 days in most cases is completed, the patient is left without any aftercare other than what they obtain on their own. They are given a stack of paperwork that in most cases will contain a few referrals for mental health providers and a list of AN meetings.At this time, the patient may be wrought the worst part of the withdrawal process, but they are still unstable (ASSAM). These patients still need the support of clinical and medical personnel, but sadly many will not get that support. Those that do not will most likely find themselves in the same situation they were in previous to the rapid detect. Though patients in jukeboxes treatment have more of a clinical and medic al support than those choosing rapid detect, they still do not have the same support as those in methadone maintenance.Those Just starting out in treatment, whatever option they may choose, are at the lowest points in their lives. It is because of that I feel that they are in need of the most support that is available to them. To me, that support comes from a friendly smile when they walk into the clinic every day that reminds them that they are Just another Junkie, they are a person. They are a person that deserves to be monitored daily, given referrals for housing, food, clothing, medical care, and anything else that they could possibly need. For many addicts, the clinic is the safest place that they are in all day (In My Own Words).The goal of any form of treatment is to improve the patient's health as well as their laity of life (Marion). For many struggling with addiction, their health has come last while obtaining opiates in order to avoid feeling â€Å"dope sick† has c ome first. For many, this low point in their lives will lead them to participate in high risk behaviors. Those that find themselves addicted to opiates will often turn to theft or prostitution in order to fund their habit, while others will share needles used to administer drug such as heroin.These high risk behaviors not only put them at risk for many other infectious diseases such as Hepatitis and HIVE, but for legal troubles as well (Marion). Though the long term results of any treatment lays largely on the person in treatment, studies show methadone maintenance to be the most effective form available at this time (Medication-Assisted Treatment for Opiate Addiction). Drug freedom is a long term commitment that has to first be taken seriously by the person in treatment. If the dedication on their part is not there, the efforts of clinic staff will not be enough to help them (Pogo).Research has shown that that rapid detect treatment has a high rate of relapse (Medication- Assisted Treatment for Podia Addiction). Those that choose a rapid text as a form of treatment often have difficulty transitioning into a lifestyle of recovery. Often times, they are still living in the same places, with the same phone numbers, and associating with the same people making abstinence from opiates even harder to maintain (Mayo Clinic). For most choosing this form of treatment, it only takes one poor decision to be back in the same situation they were before.These poor decisions have devastating effects on their sobriety making this form of treatment the least effective of the three most well-known forms of medication assisted treatment. Psychosocial counseling has proven to be very beneficial to those dealing with addiction. Those enrolled in both Jukeboxes and Methadone Maintenance is required to participate in counseling. However for those that has chosen a rapid detect, this counseling is not a requirement. . Referrals are given to the patients upon discharge from the facili ty, but not everyone follows through with it .For some it is simply because they feel they do not need it, for some it is because they are unable to afford it (Mayo Clinic). Jukeboxes treatment does require some counseling though the guidelines for this is not nearly as strict as those set for ethanol maintenance. For those enrolled in a methadone maintenance treatment program, there are strict rules for clients to obtain this counseling (Pogo). Clients enrolled in a methadone maintenance program are required by state and federal regulation to have a minimum of 2. 5 hours of counseling time per month (ASSAM).Clients will usually meet with their counselors once or twice each week to discuss progress in treatment as well as the goings on in their lives. By discussing issues that the client is dealing with, the counselors are able to teach them skills that will be useful to the client as they continue on the path to drug freedom. During this counseling, clients are taught many ways to recognize triggers that were once their excuse to use illicit substances so that they are able to refrain from using (Pogo). Counselors discuss in depth the things that seem to be holding the clients back from achieving their goal of drug freedom.By doing this, they are able to form treatment plans for the client. These treatment plans list goals as well as steps needed in order to achieve the goals. If needed, clients are given referrals during this time. When referrals are given to a client, the counselor will check in with the client to see if they ere able to get the assistance they were in need of (Pogo). The fact that the counselors take the time to follow-up on things discussed during these sessions hold the client accountable for their treatment. Because they are held accountable, I feel that it helps to make methadone maintenance a more effective form of treatment.The goal of methadone maintenance treatment is to stabilize the patient. A stable dose of methadone with effect ively block the craving for one to use illicitly while avoiding withdrawal symptoms which in turn permits one to function â€Å"normally. † When taken properly, methadone will not create sedation or euphoria. It should have no adverse effects on mental capacity, motor skills, or the ability for one to maintain employment. A stable dose of methadone will hold a person for 24-48 hours which will allow them the time and energy to devote to making improvements in their lives.However, methadone maintenance treatment is a long term commitment. It can take up to a month to achieve a stable dose in order for a patient to get the most benefits out of treatment. A stable dose of methadone varies from person to person (Levied). There are many factors that will affect the dose that one would require to become stable. For many, the tolerance that they have built up over years of illicit use will require them to have a much higher dose of methadone in order to remain stable.For others, hea lth factors and other medications will affect the way their body is able to metabolize the methadone requiring them to have a higher or lower dose. Once a stable dose is achieved, one is usually able to begin the process of getting their lives back on track by dealing legal obligations, following up on medical care that has been pushed to the side, and mending broken relationships with family members (Pogo). The longer one remains committed to treatment; they will have a greater success rate for maintaining their goal of drug freedom.It is recommended that one remain in a methadone maintenance program for a minimum of one year. For many, once they achieve a stable dose and they are able to provide illicit free urine drug screenings, they feel that they will be able to effectively remain drug free on their own. In these cases, the rate of relapse is much higher than those who remain committed to the program for a year or in many cases longer (Methadone Is an Effective Treatment for H eroin Addiction). Those who remain in treatment for at least year are nearly three times as likely to remain drug free than those who are only in treatment for a short period of time.In a methadone maintenance program, the patient along with the influence of clinical and medical staff decide when they have reached a point in their treatment that they are ready to begin decreasing their dose in order to discharge from the treatment program. There is no set time frame to this process. When one decides they are ready to begin decreasing, they have generally been on a stable dose for an extended period of time and have shown that they are able to effectively manage heir new abstinent lifestyle.Patients that decrease their doses slowly have proven to have the most success in remaining drug free. The slow taper allows their bodies time to adjust to the change in medication so that they are able to refrain from having withdrawal symptoms. These withdrawal symptoms are what will push a pers on into illicit opiate use again. Once a decrease in a person's methadone dose is taken, they are encouraged to remain at that lower dose for a period of at least 2-4 weeks.During this time, the clinical and medical staff is able to monitor the patient o ensure that they are handling the decrease in medication with no adverse effects. This process for tapering will continue until the patient has reached a dose of OMG when they will be able to â€Å"walk off' from the treatment. After the patient has been able to discontinue the use of methadone, they will still receive after care. Clinical staff will make phone calls to check in on the patient and offer them resources that will assist them in remaining drug free.Methadone and Jukeboxes clinics face tough criticism from many. People living in communities where these clinics are located are often unpleased with having a clinic n their neighborhood. Many feel that it will bring drug addicts and crime into their otherwise peaceful neig hborhoods (Swisher). What they fail to realize is that these addicts are a part of their communities regardless of if they are enrolled in a treatment facility or not (In My Own Words). It is a common misconception that it is very easy to â€Å"pick out† an addict (Mayo Clinic).However, that could not be more untrue. There are people everywhere that struggle daily with addiction. Some of these are doctors, lawyers, teachers, actors and actresses, and professional sports figures to name a few (Mayo Clinic). These are people that are clean, well dressed, well groomed and well spoken. Not every addict lacks personal hygiene and an education. There are certain risk factors that may be a factor in opiate addiction. For many who suffer from addiction, the environment that they are in plays a large role in them remaining dependent on illicit substances.There are also inherited traits that will influence one's addiction. Those that have immediate family that suffers with addiction ar e at a higher risk of also having addiction issues themselves. Research has also shown that males are nearly twice as likely to have addiction problems as males (Mayo Clinic). Methadone was approved by the FDA in 1972 for the treatment of opiate addiction. Methadone is considered to be the most effective treatment available to those addicted to opiates (Methadone Maintenance Treatment (MET): A Review of Historical and Clinical Issues).It is estimated that upwards of 170,000 individuals in the United States currently are enrolled in a methadone maintenance program. It has been proven that illicit drug use has decline by over 60% for those that have been enrolled in a methadone maintenance program for a year. For those that main committed to the program for at least two years, the use of illicit opiates declines by nearly 85% (Accreditation Of Methadone Maintenance Treatment: Assuring Quality of Care. ) Furthermore, crimes committed by these individuals are also significantly reduced. After lengthy research, I am confident is saying that methadone maintenance treatment is not only the safest method of medication assisted treatment available to those battling opiate addiction, but it is also the most effective Accreditation of Methadone Maintenance Treatment: Assuring Quality of Care). The regulations overriding methadone maintenance are much stricter than those for other forms of treatment. Methadone maintenance is the only form of medication assisted treatment that is approved by the FDA for pregnant women.It also remains the form of treatment that has the most thorough requirements for admission, and for supplemental and after care. As with any form of treatment, there are pros and cons, however it has been proven that for someone struggling with this disease that the pros far outweigh the cons. This form of medication has assisted thousands of people in getting their lives back. It has made it possible for patients to function successfully in society. These pe ople will be able to maintain employment and be productive. The counseling that they receive will help them to recognize triggers and effectively avoid them.