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Medication-assisted treatment with methadone: assessing the evidence

Catherine Anne Fullerton, Meelee Kim, Cindy Parks Thomas

    Psychiatric Services (Washington, D.C.)
    |November 20, 2013
    PubMed
    Abstract

    Insights

    Methadone maintenance treatment (MMT) significantly reduces illicit opioid use and improves treatment retention for individuals with opioid use disorder. MMT also benefits pregnant women and their infants, supporting its universal availability.

    Area of Science:

    • Addiction Medicine
    • Public Health
    • Pharmacology

    Background:

    • Detoxification and abstinence have limited success in reducing illicit opioid use.
    • Opioid use disorder (OUD) is a significant public health challenge requiring effective treatment.
    • Methadone maintenance treatment (MMT) is a cornerstone therapy for OUD.

    Purpose of the Study:

    • To review and synthesize evidence on the effectiveness of Methadone Maintenance Treatment (MMT).
    • To examine MMT's impact on illicit opioid use, treatment retention, and associated risks.
    • To evaluate MMT outcomes in pregnant women and their infants.

    Main Methods:

    • Systematic review of meta-analyses, systematic reviews, and randomized controlled trials (RCTs) from 1995-2012.
    • Searched multiple databases including PubMed, PsycINFO, and relevant social science indexes.
    • Evidence levels were rated (high, moderate, low) based on study quality and quantity.

    Main Results:

    • High evidence supports MMT's positive impact on treatment retention and reduced illicit opioid use, especially at doses >60 mg.
    • MMT is associated with improved outcomes in drug-related HIV risk behaviors, mortality, and criminality.
    • MMT in pregnancy demonstrated improved maternal and fetal outcomes with comparable neonatal abstinence syndrome rates across doses.

    Conclusions:

    • Methadone maintenance treatment is an effective intervention for individuals with opioid use disorder.
    • MMT offers significant benefits for pregnant women and their infants.
    • MMT should be a universally accessible and covered treatment service.

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