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Why Methadone |
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Methadone's effectiveness, and the absence of any serious, long-term
side effects from using it, have been demonstrated in numerous
studies conducted over the past 30 years. Among the most
commonly cited outcomes:
Consumption of all illicit drugs declines to less than 40
percent of pretreatment levels during the first year and
eventually reaches 15 percent of pretreatment levels for
patients who remain in treatment 2 years or more according
to Ball and Ross, 1991; and Hubbard, et al, 1986.
Crime is reduced substantially:
In the most detailed study of treatment outcomes to date,
Ball and Ross, 1991, showed that during the first 4 months
of treatment, crime decreased from 237 crime days per year
per 100 addicted persons during an average year of their
addiction to 69 crime days per year per 100 patients, a
reduction of more than 70 percent (p. 205), declining further
to only 14.5 crime days per year for patients in treatment
6 years or more.
Fewer individuals become infected with HIV:
A study by Metzger, et al, 1993, showed that over a 3-year
period, 5 percent of patients in methadone treatment became
HIV-positive (over and above those already positive at
admission), while among a cohort of out-of -treatment addicts
in the same neighborhood, 26 percent became HIV-positive
(over and above those already positive at baseline).
Individuals functioning improves, as evidenced in improved family
and other social relationships, increased employment,
improved parenting, etc., according to the Substance
Abuse and Mental Health Services Administrations, Center
for Substance Abuse Treatment, 1994, and Lowinson, et
al, 1992. For example, the 1992 Lowinson study of the
first 15 years of methadone treatment documented employment
rates of patients just below 60 percent. Even in the
1980s, when the economy weakened, crack use increased,
and HIV infection rates increased dramatically, social
productivity levels and employment remained at 40 percent.
Methadone has been shown to be safe.
It produces no serious or long-term
side effects, and may improve immune system functioning
in people who have experienced the deleterious effects
of heroin addiction. Methadone's clinical effectiveness
has been documented in more then 300 published research
studies, Hubbard, et al, 1986; Sells, et al, 1979.
Furthermore, "comprehensive methadone maintenance,
when combined with appropriate prenatal care, can reduce
the incidence of obstetrical and fetal complications…and
there is no reported evidence of any toxic effects
of methadone in the woman, fetus, or child" according
to the Institute of Medicine, 1995. Finally, at an
annual average cost of $4,000.00 /patient, methadone
maintenance treatment is cost effective as stated in
the 1995 Federal Register, 1999. The Treatment Outcome
Prospective Study (TOPS), analyzed the average cost
of treatment; rates of criminal activities; costs to
society of various crimes; economic benefits and costs.
Using these data, Harwood, et al, 1988, found that
for every $1 invested in treatment, $4 is recovered
in social costs.
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References
Ball, J.C; and Ross A., The Effectiveness of Methadone Maintenance Treatment: Patients, Programs, Services and Outcomes. New York: Spring-Verlag, 1991.
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services, Center for Substance Abuse Treatment. State Methadone Treatment Guidelines (Treatment Improvement Protocol Series 1), Mark W. Parrino, Consensus Panel Chair. Rockville, MD DHHS, 1993.
64 Federal Register 39826, July 22, 1999
Harwood, H.J.; Hubbard, R.L.; Collins, J.J., and Rachal, J.V. The costs of crime and the benefits of drug abuse treatment: a cost-benefit analysis using TOPS data. In: Compulsory Treatment of Drug Abuse: Research and Clinical Practice (NIDA Research Monograph Series). Rockville, MD: DHHS 1988.
Hubbard, R.L., and Marsden, M.E. Relapse to use of heroin, cocaine and other drugs in the first year of treatment. In: Relapse and Recovery in Drug Abuse, NIDA Research Monograph 72. Rockville, MD: U.S. Government Printing Office, 1986.
Institute of Medicine. Federal Regulation of Methadone Treatment, edited by Rettig, R.A., and Yarmolinsky, A. editors. Washington, DC: National Academy Press, 1995.
Lowinson, Joyce H., et al, Methadone Maintenance. In: Substance Abuse: A Comprehensive Textbook, Second Edition, Lowinson, J.H.; Ruiz, P; Millman, R.B.; and Langrod, J.G., editors. Baltimore: Williams & Wilkins, 1992, pp. 550-561.
Metzger, et al, HIV Seroconversion among In and Out of Treatment Intravenous Drug Users: An
18th-month prospective follow-up. AIDS (6) 9, 1993: 1049 -56.
Sells, S.B.; R.G. Demaree; and C.W. Hornick. Comparative Effectiveness of Drug Abuse Treatment Modalities, NIDA Services Research Administration Report. Washington, DC NODA, 1979. |
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