ENG 102 MA2 Final

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Rhetorical Analysis of Public and Academic Arguments Regarding Access to Methadone Treatment Opium is a highly addictive non-synthetic narcotic that is extracted from the poppy plant and is the key source for many narcotics including heroin and morphine. Not only are these drugs highly addictive, but they are deadly, with over 75% of drug overdose deaths being due to opium. Since 1999, over half a million people have died from an overdose of opium, usually as a result of abuse of this life-taking narcotic. Thankfully, there is a solution, methadone. Methadone is a long-acting opioid agonist that reduces opioid cravings, and withdrawals, and blocks the effects of opioids in the system. The use of methadone to treat opium abuse disorder has been around for over 50 years, saving countless lives and allowing millions of addicted individuals to transition into normal lives. In the United Kingdom, Australia, and Canada, clinicians have been using methadone to treat opium abuse disorder in primary care settings, but the United States is far behind. The federal and state regulations in the United States discriminate against, stigmatize, and dehumanize opioid users, making it difficult to seek out treatment. Throughout my research on this topic, I have found many who believe that access to methadone treatment needs to be expanded to help solve the rising opium crisis. I will analyze four scholarly articles regarding this topic by Madden et. Al, Calcaterra et. Al, Simon et. Al, and Adams et. Al. By analyzing the rhetorical strategies employed by these authors, we can identify that increased availability of methadone treatment is essential for effectively addressing the opioid crisis, providing a lifeline for individuals struggling with addiction. Transportation, cost, and strict regulations are just some of the limiting factors to methadone treatment. Each of these articles discusses the limitations of methadone treatment in varying ways. Simon’s article is a collaborative effort from the Urban Survivors Union, also

known as the American National Drug Users Union, and comes from the perspective of people who have gone through and are currently going through, methadone treatment. They use a combination of Logos and Pathos to get their point across, using real-life testimonies and providing a better way forward. Simon feels that “in-person dosing impedes patient well-being” due to strict limitations of access and guidelines. These limitations include a majority of clinics only being open during working hours and transportation to and from the clinics being anywhere from 50-200 miles. According to one Urban Survivors Union member, “The basic day-to-day functioning of life is obstructed by going daily…Maybe you’ll be late for work, you’ll lose your job since you can’t predict how long you’ll be in a clinic line.” (Simon et. Al). Simon also delves into the discriminatory nature of the cost of methadone treatment. Not only is it unaffordable on its own, but it doesn’t give any leeway for those who are homeless, who have dependents, or who are unable to get a job due to other reasons. Beyond that, for those who cannot pay, the treatment becomes dangerous as they put them on what is called a “financial detox” in which they taper the dose dramatically. The use of real testimonies allows the reader to personally connect to the issue at hand and gives a deeper understanding that there are real people who are suffering from these strict policies. Knowing that the article is from a collective group who are trying to improve their life but face so many challenges, helps us to better understand why we need better access to treatment. Adams, a graduate of Yale School of Medicine, also incorporates personal testimony into her argument. She begins her article with a story about a woman named Eliza. Eliza was in her mid-twenties and homeless with an opioid use disorder, she enrolled in a methadone program and was doing well until she gave birth. Afterward, the strict visit requirements became an issue as she was taking multiple trains across the city with a newborn. Many describe these strict

requirements as a form of “liquid handcuffs” (Adams et. Al). Adams believes that the current model of methadone delivery can inhibit autonomy, stifle treatment capacity, and perpetuate stigma among an already marginalized population. Beyond her use of Pathos, she also incorporates a “What next?” section, detailing exactly what she believes SAMHSA (Substance Abuse and Mental Health Services Administration) and Congress should do. She backs up these next steps with evidence and reforms to current legislation surrounding methadone treatment. Adams returns to her appeal of Pathos in her finishing statement saying that people will continue to die prematurely from overdose deaths without an equitable methadone treatment system that works for patients. Adam’s switching from logos and pathos builds an emotional investment in a heavy topic. It gives the reader a sense of responsibility as they know now what needs to be done, who it affects, and what happens in the absence of reform. Regarding reform, Calcaterra, who works in the Department of Medicine at the University of Colorado, uses a more logos-focused approach to her argument. She compares the current United States policies to international policies on methadone treatment. Calcaterra compares statistics of overdoses and addiction between the UK, Australia, Canada, and the United States. Her main point is the implantation of pharmacy-driven methadone dispensing like in other countries. In the countries mentioned previously, dispensing at pharmacies has proven to be an effective way of making methadone treatment more accessible. However, she also uses counterargument points to make her claim more reliable. She delves into the possibility that there is a lack of training among physicians, nurses, and pharmacists that would limit these healthcare professionals from taking on the challenge of pharmacy-dispensed methadone. However, she responds to this idea with the proposition of new educational guidelines and criteria. She also

asks a range of questions and provides answers to them such as “Are pharmacies sufficiently located in rural areas to provide methadone to a broad range of people” (Calcaterra et. Al). Madden, who is a Chief Executive Officer of the APT Foundation, takes an entirely different approach to her argument. She relies solely on logos, using a research-based model to get her point across. Implementing an “open-access model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options” (Madden et. Al), she found that it appears to improve treatment access, capacity, and financial sustainability. This research study mainly focuses on the cost issue of methadone treatment. Methadone treatment usually comes with a hefty price tag that a lot of insurance companies will not pay for, resulting in limited access to those who can afford to get treatment. Not only does Madden do a great job at addressing this issue, but she also gives insight into what can be done besides just an open-access model. Her use of logos in this study is very persuasive, giving data-driven proof of a possible solution while also showing how it improves accessibility to the public. While each of these articles agrees that methadone treatment should be more accessible, they go about saying it in different ways. For example, Simon and Adams using personal stories and Madden using data. While is not explicitly stated, each of the authors conveys ethos through their names and publications. All of the authors have some form of a doctorate and most work in the field of addiction, making them very credible sources on methadone treatment. All four authors, whether directly or indirectly, convey a strong opinion on methadone treatment, that it needs to become more accessible to the public. Whether it’s through cost-effective strategies, availability of take-home doses, or changes in legislation, it’s clear that something has to be done here in the United States. With more research and proof, we may be able to convince legislators

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