Rating: 
Summary: excellent, even ground breaking book
Review: Baldino's book in a single writing appears to include evey misconception of the methadone patient that might be written. The book is more to the fear of the writer than would allow her to write an effective treatment of the patients she should have served. Stigma, fear and and a failaure to understand are the driving forces of this book. And, the patients are made to suffer still again because of it.
Rating: 
Summary: Honestly written by a confused social worker.
Review: 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.
Rating:
Summary: Honestly written by a confused social worker.
Review: 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.
Rating:
Summary: a parade of white elephants
Review: 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.
Rating: 
Summary: What Lack of Training Means in Methadone
Review: One of the greatest problems in methadone treatment today is that many professionals that work in the field do not have the adequate training to work in methadone treatment. Patients look to their counselor for direction and it only confirms to the patient that they unworthy when their counselor shows fear towards them. Most social workers who come from graduate school are taught that methadone is not real treatment. For example Drug Abuse: An Introduction by Howard Abadinsky (Hardcover - February 1993) attacks the integrity of Drs. Dole and Nyswander. "Eventually, the bad news came out. Methadone was not the "magic bullet." Neither Dole or Nyswander ever inferred that methadone was a magic bullet. They were scientists and would never have even used such a term. Unfortunately this is the typical textbook that socials workers learn about methadone from. No wonder they are not prepared with a basic understanding of methadone. But another dynamic is also working -- stigma. Who would want to work in a methadone program? Very few. At the start of methadone when the salaries in methadone were higher than other areas of non medical health workers (i.e. social work) then the professionals working in the field were the top in their area of expertise. However as methadone treatment expanded and salaries in other areas increased along with stigma, HIV infection and all the other problems that come in addiction treatment methadone treatment has gone to the bottom of the list for a counselor or social worker to work. Thus, the majority of counselors do not want to work in methadone and are only there to gain experience as Ms. Baldino did. Within a year they are gone and hoping to move up to child welfare or some other area. This book would be an excellent lesson in teaching the new counselor what not to do, or political scientists about the impact of stigma on the health system. It should be a call to professionals working in methadone treatment to improve training and treatment. Clearly Ms. Baldino was afraid of the patients that she was their to serve and she was afraid because she never received adequate training and saw her patients as different than she (Ms. Baldino wanted a button under her desk to call the guards). Perhaps Ms. Baldino should have been told to find work elsewhere since the supervisor of the clinic attempted to correct her fears a number of times. Not everyone is suited to work in a methadone clinic and perhaps this was the problem. This author suggests as an alternative Dr. Herman Joseph's thesis on Stigma...>In particular Chapter 10 The Patient's Speak -- shows a very different picture of methadone patients. As a patient advocate I can only recommend that other books are far better than this one and that this book should remain in shipping...
Rating:
Summary: Little Girl's First Book
Review: 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 ...
Rating:
Summary: If I was dope sick, I wouldn't shoot this book!
Review: 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.
Rating:
Summary: Highly recommend this honest book
Review: This book is an honest account of what is was like to spend a year as a counselor in a methodone clinic. For the majority of graduate students of social work who are not heroin addicts, this tale is a must read. The author's candid recounting of her fears and feelings working at the clinic makes this book indispensible for anybody considering working in the field. Anybody who has ever dealt with addicts, and are not an addict themselves, can relate to and learn from the author's experience. I was quite moved by the frankness with which Rachel Greene Baldino shared her story and her recommendations for system changes. Read this book, it will not disappoint.
Rating:
Summary: Fear of MMT Patients?
Review: This book told more about the fear the counselor had of being alone in her office with her patients than the actual purpose of methadone. I understand that Ms. Baldino obviously worked in what she thought was a very rough clinic. This sadly makes people think that ALL clinics are like this, they are not.
I would like to reiterate what a reviewer above stated, "It goes to show that anyone can get a job in a methadone clinic." Let's just be grateful that Ms. Baldino is no longer employed by an MMT clinic!
Objectivity is not her strong suit! What about all of the MMT patients who have been successfully using methadone for 10 or more years, where were they profiled in this book? And the social worker friend of hers who said all MMT patients with children should have them taken away should have her license taken away! I know many, many, GREAT parents who have gotten their lives back on track with the help of MMT.
If you really want info. about MMT visit ARM and/or NAMA!
Rating:
Summary: This book should be used for toilet paper
Review: This woman sounds like some of the counselors I've had to contend with during my years on Methadone. With absolutely no qualifications, they are given life or death authority over Methadone patients, people who have been abused for years and still are being held to scrutiny like few other members of our society. An alcoholic is "sick" - has a "disease" which can wind them up in jail true, but generally only overnight till it can be determined which hospital to send them to where they can dry out. A Heroin addict however - is charged with a crime and left to withdraw cold turkey in jail, that is, with no medication or medical attention. Then finally came Methadone which is a life saving medication for those who were born with this condition - a low pain tolerance (yes, that's all it's really about you see - an anemia of endorphins). Of course, there are those who, because of too many years of poor health, hard living and being mistreated, can not return to normal. This is a small percent of patients and these are the people it sounds like Ms Baldino is speaking of. And to tell you the truth - it sounds like these are the same kind of people I've seen being abused by counselors like Ms Baldino. If anybody is interested - I could tell you stories you wouldn't believe about some of the abuses of Methadone patients that go on at these clinics when counselors like Ms Baldino work there, counselors who have obvious disdain for these people they're supposed to be helping. Just recently, I watched the janitor at my program drop paper towels all over the floor and then pick them up and put them in the machine for patients to use. When I complained to my counselor - he told me he didn't think it was such a big deal. I don't consider this to be a "patient friendly" counselor. When Ms Baldino says she's afraid of her patients - perhaps it's a result of being paranoid. All paranoia stems from guilt you know - be it deserved or imagined - and in Ms Baldino's case - I could see where there would be guilt - and most surely deserved. If I had such a low opinion toward a group of people, I don't wonder that I might find myself uncomfortable around them too. In fact, now that you mention it, I'm not comfortable around most Methadone counselors. Anne Lombardo Ardolino[url]
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