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Methadone maintenance: past, present, and future
Advances in Alcohol & Substance Abuse
|January 1, 1983
Summary
Methadone maintenance treatment has evolved significantly, now focusing on preventing withdrawal and managing emotional states, rather than just blocking heroin
Area of Science:
- Addiction medicine
- Pharmacology of opioids
- Clinical psychology
Background:
- Methadone maintenance treatment (MMT) was initially conceptualized by Dole and Nyswander.
- Early MMT focused on the 'blockade' effect against heroin's euphoria.
Observation:
- Clinical use of methadone has evolved based on program evaluations.
- Current understanding emphasizes methadone's role in preventing withdrawal and moderating affective states.
- Alternative treatments include therapeutic communities and detoxification.
Findings:
- Methadone's clinical application has shifted from a blockade concept to managing withdrawal and emotional states.
- Comparing MMT with other modalities highlights its successes and limitations.
- Program administration faces challenges balancing diverse stakeholder goals.
Implications:
- Effective treatment models are hindered by administrative pressures and conflicting goals.
- Clinicians need enhanced leadership to address policy and treatment challenges.
- Further development of rational drug abuse treatment policy is crucial.