Methadone Maintenance Treatment in the U.S.: A Practical Question and Answer Guide
The abuse of heroin and other opiates is a serious and growing public health problem. According to the 2004 National Survey on Drug Use and Health, an estimated 166,000 Americans use heroin. In addition, 4.4 million use opiate pain relievers (including Vicodin, Percodan, Percocet, and OxyContin) without a prescription. Abuse of legal pain relievers represents a growing category: in 2004, approximately 2.4 million Americans abused prescription pain relievers for the first time. In total, about 1.9% of Americans are abusing illegal or legal opiates. Furthermore, opiate dependence is increasing worldwide, and significantly exacerbating the HIV/AIDS pandemic. Methadone maintenance treatment (MMT) has been the primary form of treatment for opiate dependence in the U.S. for over 40 years. It involves providing drug abusers with a less addictive opiate (methadone) in a clinical setting, and then gradually tapering the methadone dosage. While on methadone, patients receive counseling and other medical treatments (i.e. hepatitis screening) as needed. The ability to provide all of these treatments in one location has made MMT the most effective treatment for opiate dependence to date. In the United States alone, there are more than 1,200 MMT programs, with an estimated staff of 20,000, serving more than 200,000 patients annually yet, to date, there has been no comprehensive, user-friendly professional reference book on these programs. This book fills the gap. It is written for a diverse audience, including clinicians, program administrators, substance abuse treatment researchers, and other health service professionals who want to learn about all aspects of MMT. Policy makers interested in establishing new programs, domestically and internationally, will find the information useful. The book offers insights into the effectiveness of methadone, and the characteristics of successful methadone treatment programs (budgets, services, staff, etc.), as well as regulation and accreditation issues. The information presented is based on a study of nearly 150 MMT programs in 15 states.