The phases-of-treatment model for methadone maintenance: implementation and evaluation

The phases-of-treatment model for methadone maintenance provides a clinical framework for the use of methadone to effectively meet the needs of individual patients. The therapeutic process is highly structured and is divided into several phases of treatment for opioid addiction. The first three phases--Intensive Stabilization, Commitment, and Rehabilitation--provide intensive services and are designed to stabilize patients and allow them to attain an optimal level of productive functioning. Then, in consultation with the treatment team, patients select one of two tracks, the Medical Maintenance phase or the Tapering phase, followed by the Reinforcement phase. This article provides an overview of the phases-of-treatment model and discusses procedures for its implementation. Also discussed are staffing patterns and staff training issues, as well as the use of performance-based standards for program evaluation and quality improvement within the context of the phases model.