The Fix has an article arguing that methadone maintenance gets a bad rap and hints that critics should check their motives. (It’s noteworthy that the writer has been pretty hard on drug-free treatment providers. Bill White has also voiced support for methadone but also strongly criticizing the poor quality and lack of recovery orientation.)
There’s a lot that could be said, but I’m just going to offer a couple of observations.
- Opioid replacement therapy (ORT) is readily available to most opiate addicts. In fact, the most recent U.S. Treatment Episode Data Set reports that 29% of heroin addicts received ORT while only 7.7% received long term residential and only 6.2% received intensive outpatient. Which services are the red-headed step children of the American treatment system?
- Addicts in countries that emphasize ORT are not satisfied. 60% of Scottish MMT patients would prefer drug-free treatment if offered.
- Doctors don’t treat their peers with methadone and have great outcomes, so why the push to increase methadone utilization for other opiate addict addicts? Why isn’t more high-quality, long-term, recovery-oriented, drug-free treatment offered? (Not forced, offered.) It’s had to see it as something other than an issue of class.
I do like the article’s emphasis on engagement and the ability of patients to be engaged in one service and move into another.
Just a reminder of my position from a previous post:
Just to be sure that my position is understood. I’m not advocating the abolition of methadone.
Here’s something I wrote in a previous post: “All I want is a day when addicts are offered recovery oriented treatment of an adequate duration and intensity. I have no problem with drug-assisted treatment being offered. Give the client accurate information and let them choose.”
Another: “Once again, I’d welcome a day when addicts are offered recovery oriented treatment of an adequate duration and intensity and have the opportunity to choose for themselves.”