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Top 5 Questions
- 1. Does methadone make patients "high"?
- Answer
- 2. Is methadone treatment "trading one addiction for another"?
- Answer
- 3. Is long-term methadone maintenance harmful to the patient?
- Answer
- 4. Is methadone treatment cost-effective?
- Answer
- 5. What does former Drug Czar Barry McCaffrey think about methadone therapy?
- Answer
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! Please Read The Entire 27 Point Fact Sheet !
1.
According to the National Institutes of Health (NIH), “Methadone maintenance
treatment is effective in reducing illicit opiate drug use, in reducing crime,
in enhancing social productivity, and in reducing the spread of viral diseases
such as AIDS and hepatitis.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 4.
2.
According to the National Institutes of Health (NIH), “All opiate-dependent
persons under legal supervision should have access to methadone maintenance
therapy...”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 2.
3.
“The unnecessary regulations of methadone maintenance therapy and other
long-acting
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 2.
4.
“Whatever conditions may lead to opiate exposure, opiate dependence is a
brain-related
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 4.
5.
“The safety and efficacy of narcotic agonist (methadone) maintenance treatment
has been unequivocally established.” Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 4.
6.
“Although a drug-free state represents an optimal treatment goal, research has
demonstrated that this goal cannot be achieved or sustained by the majority of
opiate-dependent people.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 5.
7.
“Of the various treatments available, Methadone Maintenance Treatment,
combined with attention to medical, psychiatric and socioeconomic issues, as
well as drug counseling, has the highest probability of being effective.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 7.
8.
“Twin, family, and adoption studies show that vulnerability to drug abuse may
be a partially inherited condition with strong influences from environmental
factors.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 8.
9.
“Of the estimated total opiate-dependent population of 600,000, only 115,000
are known to be in methadone maintenance treatment programs.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 11.
10.
“The financial costs of untreated opiate dependence to the individual, the
family, and society are estimated to be approximately $20 billion per year.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 11.
11.
“Over the past two decades, clear and convincing evidence has been collected
from multiple studies showing that effective treatment of opiate dependence
markedly reduces the rates of criminal activity.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 12.
12.
“Methadone's half-life is approximately 24 hours and leads to a long duration
of action and once-a-day dosing. This feature, coupled with its slow onset of
action, blunts its euphoric effect, making it unattractive as a principal drug
of abuse.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 14.
13.
“Prolonged oral treatment with this medicine [methadone] diminishes and often
eliminates opiate use, reduces transmission of many infections, including HIV
and hepatitis B and C, and reduces criminal activity.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 16.
14.
“Opiate-dependent persons are often perceived not as individuals with a
disease but as ‘other’ or ‘different.’ Factors such as racism play a
large role here but so does the popular image of dependence itself. Many people
believe that dependence is self-induced or a failure of willpower and that
efforts to treat it will inevitably fail. Vigorous and effective leadership is
needed to inform the public that dependence is a medical disorder that can be
effectively treated with significant benefits for the patient and society.”
Source:
Effective Medical Treatment of Opiate Addiction. NIH Consensus Statement 1997
Nov. 17-19; 15(6): 18.
15.
“Methadone maintenance treatment (MMT) has been shown to improve life
functioning and decrease heroin use; criminal behavior; drug use practices, such
as needle sharing, that increase human immunodeficiency virus (HIV) risk; and
HIV infection.”
Source:
Sees, Karen, DO, et al., “Methadone Maintenance vs. 180-Day Psychosocially
Enriched Detoxification for Treatment of Opioid Dependence: A Randomized
Controlled Trial”, Journal of the American Medical Association, 2000,
283:1303.
16.
A recent study reported in the March 8, 2000 edition of the Journal of the
American Medical Association shows that traditional methadone maintenance
therapy is superior to both short-term and long-term detoxification treatment as
a method to treat heroin dependence.
Source:
Sees, Karen, DO, et al., “Methadone Maintenance vs. 180-Day Psychosocially
Enriched Detoxification for Treatment of Opioid Dependence: A Randomized
Controlled Trial”, Journal of the American Medical Association,2000,
283:1303-1310.
17.
A study in the March 8, 2000 Journal of the American Medical Association
reviewed the Scottish model of methadone distribution to patients through
doctors’ offices versus the US model of methadone maintenance clinics. The
study concludes:
Source:
Weinrich, Michael, MD, and Stuart, Mary, ScD, “Provision of Methadone
Treatment in Primary Care Medical
18. The
Journal of the American Medical Association notes in an editorial in its March
8, 2000 edition that following the Scottish example, and allowing primary care
physicians to dispense methadone, could provide a three- to five-fold increase
in access, as well as reducing the cost per patient.
Source:
Rounsaville, Bruce J., MD, and Kosten, Thomas R., MD, “Treatment for Opioid
Dependence: Quality and Access”,
19. The
Treatment Outcome Prospective Study (TOPS)—a long-term, large-scale
longitudinal study of drug treatment—found that patients drastically reduced
heroin use while in treatment, with 10% using heroin or other narcotics weekly
or daily after just three months in treatment.
Sources:
Hubbard, R.L., et al., “Treatment Outcome Prospective Study (TOPS): Client
Characteristics and Behaviors before,
20.
Methadone treatment greatly reduces criminal behavior. The decline in predatory
crimes is likely in part because methadone maintenance treatment patients no
longer need to finance a costly heroin addiction, and because treatment allows
many patients to stabilize their lives and return to legitimate employment.
Sources:
Hubbard, R.L., et al., “Treatment Outcome Prospective Study (TOPS): Client
Characteristics and Behaviors before,
21.
In support of methadone as
an effective treatment for heroin addiction, Drug Czar Barry McCaffrey issued
the following statement: “Methadone is one of the longest-established, most
thoroughly evaluated forms of drug treatment. The science is overwhelming in its
findings about methadone treatment’s effectiveness. The National Institute on
Drug Abuse (NIDA) Drug Abuse Treatment Outcome Study
Source:
McCaffrey, Barry, Statement of ONDCP Director Barry McCaffrey on Mayor
Giuliani’s Recent Comments on
22.
Methadone is cost effective. Methadone costs about $4,000 per year, while
incarceration costs about $20,200 to $23,500 per year.
Sources:
Institute of Medicine, Treating Drug Problems (Washington DC: National Academy
Press, 1990), Vol. 1, pp. 151-
23.
Methadone
does not make patients “high” or interfere with normal functioning.
Source:
Lowinson, J.H., et al., (1997), “Methadone Maintenance,” Substance Abuse: A
Comprehensive Textbook, (3 rd
Ed.)
24.
Methadone
maintenance treatment helps clients to reduce high risk behaviors like needle
sharing and unsafe sex.
Source:
Rosenbaum, et al., “Treatment as Harm Reduction, Defunding as Harm
Maximization: The Case of Methadone Maintenance,” Journal of Psychoactive
Drugs, 28: 241-249 (1996).
25.
In support of methadone as an effective treatment for heroin addiction, former
Drug Czar Barry McCaffrey quoted Drs. Adam Yarmolinsky and Richard A.
Rettig,
chairman and director of a recent National Academy of Sciences study of
methadone treatment, who wrote: “Methadone treatment helps heroin addicts free
themselves from drug dependency, a life of crime in support of their habit and
the risk of adding to the AIDS population by sharing dirty needles…[Methadone
therapy] is more
Source: McCaffrey, Barry, Statement of ONDCP Director Barry McCaffrey on Mayor Giuliani’s Recent Comments on Methadone Therapy, (Press Release) (Washington, DC: ONDCP), July 24, 1998.
- 26. The MMT patient is DEPENDENT on their medication. Not "addicted"!
- The term "addiction" is currently used as a psychological term referring to the loss of control over drug use or other behaviors such as eating or gambling. By these criteria as laid out in the Diagnostic and Statistical Manual of Mental Disorders IV, the methadone patient is not addicted to his/her medication.
- In fact, the experts in this field have taken to comparing an individual on methadone maintenance therapy to a diabetic who is dependent on their daily dose of insulin. We would never label a diabetic an "insulin addict"! Even the former Drug Czar, General McCaffrey uses this comparison.
- In terms of physical dependence, double blind studies done at Lexington have demonstrated that when comparing the withdrawal symptoms of patients maintained on equivalent doses of methadone and short acting opioids like heroin, those of the former group were _less_ severe than those of the latter group. Withdrawal from methadone _does_ last significantly longer than that from short acting opioids, however, and this clearly contributes to the patient who withdraws "cold" perceiving methadone as the more uncomfortable. Most patients coming into MMT today have relatively heavy habits due to the high quality and low cost of street opioids in the US since the early 90s. After having been built up to a blockading dose of methadone, if they are subjected to sudden withdrawal (ie in jail) they would likely not experience the withdrawal syndrome any more intensely than they had on the street. Also, gradual withdrawal from methadone, when properly done, is virtually free of discomfort.
- Finally, some patients tend to forget that the whole reason they came into MMT in the first place was because they were unable to remain abstinent from opioids. When they attempt to leave MMT and fail, they blame the methadone rather than the heroin which deranged their brain chemistries in the first place.
- Source: Isbell, H. and Vogel, V.H.: The addiction liability of methadone (Amidon, Dolophine, "10820") and its use in the treatment of the morphine abstinence syndrome. American Journal of Psychiatry, 105:12 (June) 1949.
- 27. There is ample scientific evidence that the long-term administration of methadone in a properly adjusted dose to a tolerant individual results in absolutely no physical or psychological impairment of any kind that can be perceived by the patient, observed by a physician, or detected by a scientist. More specifically, there is no impairment of balance, coordination, mental abilities, eye-hand coordination, depth perception, pyscho-motor function, or moral judgment.
-
- Source: J. Thomas Payte, M.D. - Founder and Medical Director of Drug Dependence Associates, an outpatient chemical dependency treatment program blending pharmacotherapies with self-help and behavioral concepts since 1970. Dr. Payte is one of the world's leading authorities on opiate agonist treatment of addiction.