Methadone maintenance is a way of stabilizing someone who is addicted to heroin or has severe pain problems.

Methadone Maintenance Treatment

Methadone is the most widely studied medication and treatment for any disease in the world. Opioid treatment programs provide the dependent individual with an array of rehabilitative services. Therapeutically prescribed doses of methadone and LAAM relieve withdrawal symptoms, eliminate opiate craving and allow normal functioning. The efficacy of these medications increases significantly with counseling and on-site medical and other supportive treatment services. Medical personnel supervise treatment and nurses administer the medication to patients, most typically on a daily regimen until the individual is stabilized. Patients also provide toxicology samples, which are tested for the presence of methadone and drugs of abuse.

Methadone has been used to treat opioid dependence for thirty-five years and like all medications, therapeutic dosing is contingent upon individual patient needs. The therapeutic dosage range is generally between 80 - 120 mg. Methadone is taken orally and is rapidly absorbed from the gastrointestinal tract, appearing in plasma within thirty minutes of being ingested. Methadone is also widely distributed to body tissues where it is stored and then released into the plasma. This combination of storage and release keeps the patient comfortable, free from craving, and feeling stable.

The General Accounting Office reported in 1990 that "The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, the federal government's two primary agencies for researching drug and alcohol abuse issues, respectively, have concluded that methadone is the most effective method available for treating heroin addiction."

The Center for Substance Abuse Treatment has found, as of October, 2001, that more than 205,000 individuals are being treated in methadone treatment programs. The National Institutes of Health Consensus Development Conference on "Effective Medical Treatment of Opiate Addiction" (November 1997) concluded that it is necessary to increase access to methadone treatment services throughout the United States and to increase funding for methadone treatment, including providing benefits to methadone patients as part of public and private health insurance programs.

The Pharmacology of Methadone Treatment

Some critics of methadone treatment believe that it represents substituting one drug for another. Such critics see no distinction between heroin as an illicit drug and methadone as a medication, which is used in conjunction with other treatment services. Research has proven the drug substituting assertion to be false. Heroin and methadone have completely different pharmacologic properties.

Heroin has an immediate onset of action with a four to six hour duration. The route of administration is typically through injection, snorting or smoking several times each day. Very few individuals can achieve any kind of neurochemical stability through such a short-acting opiate.

Methadone is taken once per day and has a duration of action of between 24 and 36 hours. It is orally ingested and is released into the body over the course of time through the liver. This is why methadone maintenance does not cause euphoric effects in the stabilized patient.

Other critics of methadone treatment include people in recovery from other drugs of abuse, including alcohol. They claim that since they are able to be abstinent without pharmacotherapy that methadone maintenance does not represent a "true" state of recovery. Once again, science does not support this view. The National Institute on Drug Abuse has found through years of research that there are profound changes in the chemistry of the brain as a result of chronic use of exogenous opiates such as heroin. The biology of the brain changes and may never revert back to its pre-heroin use state for a number of heroin-dependent individuals. While this may not apply to all heroin-dependent persons, it has been found that more than 80% of methadone maintained patients will relapse to heroin use when methadone maintenance is withdrawn within the first 12 months of treatment being terminated.

The National Institutes of Health Consensus Development Conference on "Effective Medical Treatment of Heroin Addiction" (November, 1997) concluded that it is necessary to increase access to methadone treatment services throughout the United States and to increase funding for methadone treatment, including providing benefits for methadone treatment as part of public and private health insurance programs.

http://dpt.samhsa.gov/ According to the Office of National Drug Control Policy, there are over 900,000 heroin dependent individuals in the United States. Drug Enforcement Administration data indicate that heroin is increasingly available at purer levels throughout the nation and the National Institute on Drug Abuse has cited an alarming increase in the number of young people using heroin in suburban and urban areas. Approximately 210,000 patients in this country are treated with methadone on any given day. CSAT A comprehensive examination of the economic benefits and cost of methadone treatment reveals the benefits to cost ratio of 4:1; $4.00 in economic benefits accrue for every $1.00 spent on methadone treatment.

Harwood, et. al., The Costs of Crime and the Benefits of Drug Abuse Treatment. NIDA Monograph Series 86, DHHS, 1988 Research indicates that methadone treatment has significantly decreased the rate of HIV infection for patients in continuous methadone treatment. Ball, John. The Effectiveness of Methadone Maintenance Treatment, Springer-Verlag, 1991 Studies have continually demonstrated that more than 70% of the people enrolled in methadone maintenance reduce or eliminate criminal activity during their first year in treatment.