NCJ Number
57810
Date Published
1979
Length
8 pages
Annotation
CLINICAL ASPECTS OF METHADONE MAINTENANCE TREATMENT ARE DISCUSSED, INCLUDING REQUIREMENTS FOR PROVIDING ADEQUATE TREATMENT, CHARACTERISTICS OF GOOD PROGRAMS, AND DEFINITION OF CONTROVERSIAL ASPECTS.
Abstract
METHADONE MAINTENANCE TREATMENT SHOULD BE CARRIED OUT IN A WELL-ORGANIZED, ATTRACTIVE AND SPACIOUS CLINIC CAPABLE OF ENCOURAGING THE DEVELOPMENT OF A THERAPEUTIC MILIEU (A TOTAL AREA OF 2,000 SQUARE FEET FOR 100 PATIENTS WOULD BE IDEAL) WITH ROOMS FOR EXAMINING AND FOR COUNSELING. STAFFING PATTERNS SHOULD MEET THE PSYCHOSOCIAL NEEDS OF PATIENTS (IDEALLY A PATIENT-STAFF RATIO OF 50 TO 1) AND EACH PATIENT SHOULD BE ASSIGNED TO A PRIMARY THERAPIST TO SEE ON A REGULAR BASIS. ADMISSION POLICY AND PROCEDURE PARTLY ARE PRESCRIBED BY FEDERAL DRUG ADMINISTRATION REGULATIONS WHICH SPECIFY THAT APPLICANTS MUST BE AT LEAST 16 YEARS, MUST HAVE A VERIFIED 1-YEAR HISTORY AS AN ADDICT, AND MUST DIVULGE A THOROUGH HISTORY OF DRUG USE. SEVERAL MEDICAL EXAMINATIONS ARE REQUIRED AS PART OF ADMISSION. FORMS AND AMOUNTS OF METHADONE ADMINISTERED TO PATIENTS IN THE INDUCTION AND MAINTENANCE PHASES VARY ACCORDING TO PATIENT NEEDS--PREGNANT WOMEN SHOULD BE KEPT AT THE LOWEST POSSIBLE DOSAGE LEVEL--BUT SHOULD BE SUFFICIENT TO PROVIDE RELIEF FROM CRAVING FOR HEROIN AND ABSTINENCE SYNDROME SYMPTOMS. CAREFULLY REGULATED AND SUPERVISED 'TAKE-HOME' PROVISIONS ARE ALLOWED RESPONSIBLE PATIENTS TO ENCOURAGE INDEPENDENCE. CONTROVERSY EXISTS ON THE EFFECTIVENESS OF LOW AND HIGH DOSES OF METHADONE, WITH THE MAJOR DIFFERENCE BEING IN THE DEGREE OF TOLERANCE TO OTHER NARCTOICS. PREPARATION AND DISPENSING OF METHADONE, MONITORING TASKS, AND MEDICAL SIDE EFFECTS OF METHADONE ARE DISCUSSED. REFERENCES ARE PROVIDED. FOR RELATED ARTICLES, PLEASE SEE NCJ 57805-57809 AND 57811-57834. (DAG)