Access to narcotic addiction treatment and medical care: prospects for the expansion of methadone maintenance treatment
by
Lewis DC
Brown University Center for Alcohol and Addiction Studies,
Providence, RI 02912, USA.
J Addict Dis 1999; 18(2):5-21

ABSTRACT

Methadone maintenance treatment (MMT) for opioid addiction is safe and effective but underutilized because of inaccessibility, under-financing and the stigma generally attached to maintenance therapies. In addition, cumbersome regulation of methadone prescription and treatment impedes the delivery of care and retards expansion of methadone maintenance into office practice settings. Exaggeration of the problem of methadone diversion further hinders development of MMT. Despite obstacles, methadone maintenance has been successfully expanded and extended into primary care settings abroad. Initial trials in the U.S. have shown that methadone maintenance in physician office-based settings yields positive results with some advantages over care in large methadone clinics. Alternatives to methadone, such as buprenorphine, are also being explored in primary care settings. With implementation of the NIH Consensus Statement on Effective Medical Treatment of Heroin Addiction, including training of primary care physicians, methadone maintenance treatment could reach many more patients, achieve higher success rates, and substantially reduce the deleterious effects of opioid addiction in the U.S.

Pain
LAAM
Arousal
Fentanyl
Tramadol
Tolerance
Nociceptin
Methadone
Remifentanil
Endomorphins
LAAM v methadone
Methadone in the UK
Methadone and heroin
Opioids and depression
Methadone: "killer drug" etc
Buprenorphine v methadone
Methadone, politics and power
Methadone, morphine and heroin

Refs
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