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Methadone Maintenance Treatment
It is important to note that methadone maintenance programs are not cures or rehabilitation. They simply maintain a patient's addicted status, just under the acceptable terms of society.
Nonetheless, methadone is a rigorously well-tested medication that is considered safe and efficacious for the treatment of narcotic withdrawal and dependence. For more than 30 years this synthetic narcotic has been used to treat opioid addiction. It is not, however, an effective treatment for other drugs of abuse. The patient is freed from the uncontrolled, compulsive, and disruptive behavior seen in heroin addicts, but ultimately remains physically dependent on the opioid. Withdrawal from methadone is much slower than that from heroin. Many MMT patients require continuous treatment, sometimes over a period of years or even a lifetime
History of MMT Programs
Until 1963, doctors and public health workers had concluded that there were no treatments known which could cure more than a small fraction of long-term opiate addictions (heroin, morphine, etc). Every imaginable option had been tried, from lobotomies and insulin shock to psychoanalysis and the threat of lifetime incarceration. In every case, between 70 and 90 percent of these chronic addicts would return to opiates within a short time. As a result, several prestigious panels examined the problem and by 1963 had come to the conclusion that it was time to re-examine nearly fifty years of prohibition and consider allowing doctors to prescribe addicts the opiates they needed.
At Rockefeller University in New York City, Dr. Vincent Dole, an expert in metabolic disorders, and Dr. Marie Nyswander, a psychiatrist who had worked at the U.S. Public Health Hospital/Prison for addicts in Lexington, Kentucky, began experiments with several chronic heroin addicts. In attempting to determine if addicts could be maintained on stable doses of pharmaceutical opiates, the volunteers were given access to the spectrum of opiates available to medical practitioners. The researchers tried everything from morphine to dilaudid, but found that it was extremely difficult to stabilize the subjects. The addicts were either over sedated or in mild withdrawal most of the time, and spent their days either "on the nod", waiting for their next shot, or comparing the relative merits of the drugs used. Reluctantly, Drs Dole and Nyswander concluded that the experiment had been a failure, and decided to "detox" the addicts and release them from the hospital.
To accomplish the withdrawal, they turned to a synthetic narcotic called methadone. Methadone had first been synthesized by German chemists before World War II, and after the war it was used to withdraw addicts at Lexington. It had the advantage of being cheap, significantly orally active, and longer lasting than opiates like morphine. For the researchers at Rockefeller, it seemed merely a convenient and humane means of ending the experiment with maintenance. As the addict volunteers had been built up to large doses of narcotics by street standards, they were given relatively large doses of methadone to stabilize their "habits" before beginning the reduction.
A few days after the subjects had been switched to methadone, and before the "detox" had begun, they began to exhibit very different behavior. Whereas for weeks they had spent their days either feeling the effects of the narcotics or complaining of their need for more narcotics, suddenly the focus of their days turned away from drugs. One subject asked the researchers for supplies so that he might resume his long neglected hobby of painting. Another inquired after the possibility of continuing his interrupted education. In short, the addicts- who when admitted to the hospital had looked and behaved very much alike - now began to differentiate. They began to manifest the potential that each had obscured during years of chasing street narcotics.
Despite these encouraging signs, it is worth repeating:
Methadone maintenance programs are not cures or rehabilitation. They simply maintain a patient's addicted status, just under the acceptable terms of society.
Related Information: Methadone Addiction
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Addiction Facts |
- Untreated heroin addiction and its link to crime and illness cost society some $20 billion a year, according to the National Institutes of Health. The estimated cost of treating AIDS, hepatitis B and C, and other illnesses linked to dirty needles and heroin addiction accounts for $1.2 billion of that total.
- In 2002, taxpayers funded an estimated $1.5+ billion nationwide for methadone and other medication-based treatment programs and an additional $1.36 billion to maintain the incarcerated in an addicted state through methadone or other medication-based treatment programs.
- Recent scientific research finds that a dose of 60 to 120 mg is preferable over the standard 20 mg on which budgets are figured. Therefore, based on $290 per month, the actual cost of methadone maintenance is likely to cost $870 to $1,740 per month ($10,440 to $20,880 per year/per person). This significant cost is only for the medication, not for the required ancillary services that go with the maintenance program.
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