Bill summarizes criticism of MM as follows:
Critics of medication-assisted treatment, many of whom were competing for cultural and economic ownership of the problem of heroin addiction, alleged that MM: 1) substitutes one drug/addiction for another; 2) conveys a societal attitude of permissiveness toward drug use; 3) fails to address the characterological or social roots of heroin addiction; 4) cognitively, emotionally, and behaviorally impairs MM patients; 5) is a tool of racial oppression and genocide; 6) is financially exploitive; and 7) as a result of these factors, is morally unacceptable.
He later states:
We concluded in the first two articles that it was time we as a country and a professional field stopped debating the morality of methadone maintenance and focused our energies instead on elevating the quality of methadone maintenance treatment.
I didn’t see where another kind of objection is addressed. What about the concern that MM is a manifestation of stigma? That it’s based on the premise that drug-free recovery is not possible for opiate addicts (or, certain kinds of opiate addicts)? That it’s a form of treatment that doctors never use for their addicted colleagues? That it’s born from the failure of drug-free treatment of inadequate intensity, duration and quality and, when we choose to address those inadequacies, outcomes for opiate addicts are very, very good.
Whenever I’m talking with a professional helper about a loved one, one of my first questions is, “What are our options?” followed by, “What would you do if this was your child/parent/spouse?” That’s where we determine the ideal course of action and second best options. I’d like to have this conversation with people who have been exposed to the best of both approaches to treatment.